based on spm,park

1. IMMUNISING AGENTS
AND AEFI

2. • VACCINES
– LIVE VACCINES
– KILLED VACCINES

3. LIVE ATTENUATED VACCINES
• VIRUS WHEN PASSED THROUGHT THE CELL
CULTURE PASSAGES LOOSES ITS VIRULENCE
PROPERTY WITH RETAINED IMMUNOGENIC
PROPERTY
• LIVE VACCINE PRODUCE IMMUNITY FOR A
QUIT LONG TIME AND NO NEED FOR SECOND
DOSE.
• IT ALSO CONFERS THE HERD IMMUNITY

4. EXAMPLES OF LIVE ATTENUATED
VACCINES• BCG
• POLIO
• YELLOW FEVER
• MMR
• TYPHOID
• VARICELLA
• ROTAVIRUS
• CHOLERA
• COLD – ADAPTED INFLUENZA
• ZOSTER

5. TWO LIVE VACCINES INJECTION
• WHEN WE NEED TO GIVE TWO LIVE VACCINES
INJECTION SIMULTANEOUSLY,IT SHOULD BE
GIVEN 3 WEEKS APART

6. DOSAGE
• USUALLY SINGLE DOSE IS SUFFICIENT FOR THE
LIVE VACCINE
• SECOND DOSE WAS GIVEN TO ENSURE
SEROCONVERSION

7. CONTRAINDICATIONS TO LIVE
VACCINES
• PREGNANCY
• IMMUNODEFICIENCY STATES
– LEUKEMIA
– LYMPHOMA
– STEROID THERAPY
– ALKYLATING AGENTS

8. STABILITY OF LIVE VACCINES
• STABILITY AT ROOM TEMPERATURE IS LOW
• IT HAS MAINTAINED AT APPROPRIATE PH AND
AT APPROPRIATE TEMPERATURE
• ANTIBIOTICS ARE USED IN VACCINES LIKE
MMR AND POLIO TO DECREASE THE
BACTERIAL CONTAMINATION ( 25 ug-
neomycin in each dose)

9. INACTIVATED VACCINES
• MOSTLY VIRUS GROWN IN CULTURE IS
INACTIVATED MOST COMMONLY BY USING
“FORMALIN”
• MULTIPLE DOSES ARE REQUIRED
• DURATION ALSO SHORT
• SO BOOSTER DOSE REQUIRED
• TO DECREASE THE DOSE AND TO INCREASE THE
IMMUNOGENICITY, “ADJUVANTS “ ARE USED (
ALUMINIUM COMPOUNDS)

10. INACTIVATED VACCINES
• IT HAS HIGH STABILITY AT ROOM
TEMPERATURE

11. SUBUNIT VACCINE
• TOXOID
• PROTEIN VACCINES
• RECOMBINANT PROTEIN VACCINES
• POLYSACCHARIDE BASED VACCINES(avoided in
children <2 years, as it produces T-CELL
INDEPENDENT IMMUNITY MECHANISM)
• CONJUGATED VACCINES
• COMBINATION VACCINES

12. POLYVALENT
• REFERS TO THE VACCINES PRODUCED FROM
THE TWO OR MORE STRAINS OF THE SAME
SPECIES

13. IMMUNOGLOBULINS
• 5 TYPES
• IgG
• IgA
• IgM
• IgD
• IgE

14. IMMUNOGLOBULIN PREPARATIONS
• NORMAL HUMAN Ig
• IT SHOULD CONTAIN 90% OF FREE IgG NOT IN
“AGGREGATE FORM “
• WITH LOW LEVEL OF IgA

15. LIVE VACCINES AND HUMAN Ig
• Live vaccines given after 12 weeks after
human IMMUNOGLOBIN INJECTION

16. SPECIFIC HUMAN Ig
• 5 times the antibody potential of standad
preparation per unit volume
• From the plasma of the individual who
developed illness due to specific infection/ or
by giving vaccination

17. SPECIFIC HUMAN Ig
• Route of administration
• Usually intramuscular(preferably not in gluteal
region- as fat interferes with absorption)
• Intravenous route preparation also available

18. Antisera / antitoxins
• Antisera
– Refers to preparation obtained from animals
– E.g
• Diphtheria
• Tetanus
• Gas gangrene
• Rabies
• botulism

19. COLD CHAIN
• SYSTEM OF STORAGE AND TRANSPORT OF
VACCINES FROM THE MANUFACTURER TO THE
VACCINE SIITE

20. FREEZER -- PM
• POLIO
• MEASLES

21. STORED IN COLD PART NOT ALLOWED
TO FREEZE “T VACCINES”
• DPT
• TT
• DT
• HEPATITIS B
• BCG
• DILUENTS

22. RECONSTITUTED BCG AND MEASLES
VACCINES FOR 4 HOURS IN -2-8
DEGREE C
• IN CASE OF JAPANESE ENCEPHALITIS =2
HOURS
• IF THE VACCINE IS “RETURNED UNUSED”, IT
CAN BE UPTO 3 TIMES AFTER 3 TIMES IT IS
DISCARDED

23. COLD CHAIN EQUIPMENTS
• WIC- WALK IN COLD ROOMS
• STORAGE UPTO “3 MONTHS”
• AND SERVE “4-5 DISTRCITS “

24. COLD CHAIN EQUIPMENTS
• DEEP FREEZERS(-15 TO -25 DEGREE C )
– DISTRICT
– PHC ( FOR MANUFACTRING ICE PACKS)
– IN CASE OF “POWER FAILURE “ IT CAN HOLD UPTO
22 HOURS MAXIMUM

25. COLD CHAIN EQUIPMENTS
• ICE LINED REFRIGERATOR
– PHC FOR STORING VACCINES
– DIAL THERMOMETER – TEMPERATURE RECORDED
TWICE A DAY

26. ILR
• VACCINES ARE ARRANGED IN BASKED FROM
TOP TO BOTTOM
– HEPATITIS B
– DPT AND TT
– BCG, MEASLES
– OPV

27. • COLD BOXES
– PERIPHERAL CENTRE
– MAINLY FOR TRANSPORTATION OF VACCINES

28. • VACCINE CARRIERS
• 16-20 VIALS
• 4 ICE PACKS
• “CARE GIVEN TO ‘ T’ VACCINES”””””

29. • DAY CARRIERS
• 6-8 VIALS
• TWO FROZEN ICE PACKS USED

30. • ICE PACKS
• CONTAIN ONLY WATER NO SALT IS ADDED.
• WATER IS FILLED UPTO THE MARK ON THE
PACK
• IN CASE OF LEAK, IT SHOULD BE DISCARDED

31. COLD CHAIN FAILURE
• MAXIMUM AT THE VILLAGE LEVEL AND AT THE
SUBCENTRE LEVEL

32. VVM-VACCINE VIAL MONITOR
• A LABEL CONTAININING A HEAT SENSITIVE
MATERIAL
• 4 STAGES
• STAGE I AND II  USABLE
• STAGE III AND IV  NOT USABLE

33. AEFI
• ADVERSE EFFECTS FOLLOWED BY
VACCINATION , INFORMATION ARE CO-
ORDIANTED BY THE NATIONAL INSTITUTE OF
BIOLOGY AND LINKED WITH THE MINISTRY OF
FAMILY AND HEALTH WELFARE

34. AEFI
• VACCINE PRODUCT RELATED REACTION
• VACCINE QUALITY DEFECT RELATED REACTION
• IMMUNISATION ERROR RELATED REACTION

35. AEFI
• IMMUNISATION ANXIETY RELATED REACTION
• CO-INCIDENTAL REACTION

36. SIDE EFFECTS
• IT CAN BE MINOR OR MAJOR REACTION

37. RARE VACCINE REACITON
• BCG
– SUPPURATIVE LYMPHADENITS (2-6 MONTHS )
– BCG OSTEITIS (2-12 MONTHS )
– DISSEMINATED BCG INFECTION (1-12 MONTHS)

38. • HEPATITIS B – ANAPHYLAXIX – 0-1 HOURS
• MEASLES – FEBRILE SEIZURES (6-12 DAYS ),
• VARICELLA – FEBRILE SEIZURES
• MR – THROMBOCYTOPENIA (UPTO 35 DAYS)
• ENCEPHALOPATHY – 12 DAYS

39. • ORAL POLIO VIRUS
– VAPP – 4-30 DAYS
TT – BRACHIAL NEURITIS ( 28 DAYS)
YELLOW FEVER – VACCINE ASSOCIATED
VISCEROTROPIC DISEASE

40. • HYPOTONIC, HYPORESPONSIVE EPISODE
– BY DPT
– ITS PRESENCE IN PAST, IS NOT A
CONTRAINDICATION FOR FUTURE DOSES

41. • PERSISTENT OR INCONSOLABLE SCREAMING
– PERTUSSIS VACCINE

42. PRECAUTIONS FOR ANTISERUM
• TESTING MANDATORY
– - INSTILLATION OF DROP OF ANTISERUM INTO THE
CONJUNCTIVAL SAC
– INTRADERMAL INJECTION OF 0.2 ml Of
ANTISERUM IN TO THE ARM AND OBSERVE AFTER
10 MINUTES

43. • ADRENALINE (1;1000) 0.5 ML – GIVEN INCASE
OF ANAPHYLAXIS SHOCK, REPEATED EVERY 20
MINUTES IF THE BP IS BELOW 100 mmHg
• CHLORPHENIRAMINE -10-20MG I.M IS GIVEN
FOR THE AFTER EFFECTS

44. • INVESTIGATING A CASE OF AEFI

45. • THANK YOU