This document contains an expert lecture on immunization and vaccines. It defines key terms like vaccines, immunization, active and passive immunity. It describes different types of vaccines including live attenuated, conjugated, and toxoid vaccines. Specific details are provided on various vaccines like BCG, polio, tetanus, diphtheria, pertussis, measles and hepatitis B. It addresses contraindications, dosage, efficacy and complications of different vaccines. Multiple choice questions at the end assess understanding of vaccine details like appropriate age for rotavirus vaccination and disease eradicated by vaccination.

2. »MCQ

3. • . Vaccines are defined as whole or
parts of microorganisms to prevent an
infectious disease.Which of the
following is a live attenuated vaccine?
• A. hepatitisA
• B. hepatitisB
• C. pneumococcal
• D. varicella
• E. diphtheria

4. • Rota virus vaccine should not be
initiated in infants older than
• A. 11 wk
• B. 13 wk
• C. 15 wk
• D. 17 wk
• E. 19wk

5. • The final dose of rota virus vaccine
must be given no later than
• A. 6 mo of age
• B. 8 mo of age
• C. 10 mo of age
• 0. 12 mo of age
• E. 18 mo of age

6. • Immunization is one of the most beneficial
and cost-effective disease prevention
measures. As a result which of the
following diseases has been eradicated?
• A smallpox
• B polio
• C measles
• D rubella
• E pertussis

7. • A toxoid is a modified bacterial toxin that
is made non-toxic but still able to induce
an active immune response against the
toxin.
Which of the following vaccine is a
toxoid?
• A hepatitis A
• B hepatitis B
• C pneumococcal
• D varicella
• E diphtheria

8. • .Which of the following vaccine is
contraindicated in patient with
X-Iinked agammaglobulinemia?
• A. BCG
• B. hepatitis B
• C. DPT
• D. injectable polio
• E. varicella

9. IMMUNIZATION
by
DR. zahid mehmood
PAEDIATRICS

10. IMMUNIZATION
Definition
Rendering a subject immune by inoculating with a
specific antigen or immune/gamma globulins
against a particular disease.
Immediate goal…Disease prevention in a person
Ultimate goal…Disease elimination/eradication
from the community

11. IMMUNIZATION
• IMMUNITY
Security against infections
Active Natural
Acquired
Passive: Natural
Acquired

12. ACTIVE IMMUNITY
• Antigen is inoculated
• Immunity produced by the individual
himself
• Delayed protection
• Long lasting
• Booster phenomenon

13. PASSIVE IMMUNITY
• Injected antibodies
• Immediate protection
• Only for few weeks or months.

14. VACCINATION
Introduction of vaccine into the
body for the purpose of inducing
immunity.

15. VACCINE
• A suspension
– of toxoids, genetically engineered, attenuated or
killed micro organism.
• Produces
– antibodies and/or cell-mediated immunity
– Provide protection against infectious
disease.

16. Types of vaccine
• LIVE ATTENUATED VACCINE
• CONJUGATED VACCINES
• TOXOID/killed

17. LIVE ATTENUATED VACCINE
• Virulent organism is weakened,
– Organism Virulence is attenuated
– BUT
– Antigenic response is preserved
– BCG,POLIO(oral),MMR,etc

18. CONJUGATED VACCINES
• Polysaccharide vaccines
• Response to Polysaccharide vaccines is incomplete
• Conjugated with other antigens to improve
the antigenic response.
• Mennigococcal , Pneumococcal, H inf.typeB

19. TOXOID
• A modified bacterial exotoxin
– that has lost toxicity
– But
– Antigenic response is preserved.
• Diphtheria and Tetanus toxoids.

20. IPV3

21. children not vaccinated during infancy and are
still below the age of 5 years .
How they will vaccinate?

22. IMMUNIZATION
In children who have not been vaccinated
during infancy and are still below the
age of 5 years vaccinate as follows
• BCG once
• DT and Polio drops 2 doses at 6wk
interval and 1st
booster
6 months later

23. GENERAL RECOMMENDATIONS
• Live vaccines should not be administered to
immunocompromised children
• Injections should be given into the lateral
thigh or into the deltoid.not in gluteal region
• In the event of an epidemic or high risk,
measles vaccine can be given at 6 months
age
.

24. IMMUNIZATION
• In case of high risk due to contact with a case of
Pertussis, DPT can be initiated at 2 weeks of age
• After 2 years of age children should not receive
cellular Pertussis vaccine.
• Children with brain damage or previous history of
convulsions should not receive Pertussis vaccine.
.
• If convulsions occur within 72 hours of DPT injection
further administration of Pertussis vaccine is
contraindicated.

25. IMMUNIZATION
• Immunization should be delayed only in case
of illness with
– high fever
– Any sign of serious illness
• Administration of live attenuated vaccines
should be delayed
– for at least six weeks when a
polyvalent immune globulin has been given.

26. GENERAL CONTA INDICATIONS
• Severe febrile illness which needs
hospitalization.
• Severe reaction to previous dose of
vaccine.
SPECIAL NOTE
• Malnutrition of any degree is no contra
indication for vaccination.

27. BCG VACCINE
• Most widely used vaccination
• Live attenuated (weakened)
• 1st week
• Vaccine Dose: It is given
•
– intra-dermally in a
– dose of 0.05 ml for newborns
– 0.1 ml for all other children.
If an older child reports for vaccination, do
mantoux test first, then
vaccinate only –ve cases

28. • Vaccine Efficacy: 0-80% for TB lung;
75-85% for meningitis and millary
tuberculosis.
• Normal course of BCG: Wheal, nodule,
indurate, superficial abscess, ulcerates,
heals with scar.
– Scar shows vaccine uptake
– Nodule abcess/ulceration scar

29. Complications of BCG
• Lymphadenopathy (BCG Granuloma)
• Generalized tuberculosis
• Erythema nodosum
• Deep abscess and ulceration

30. CONTRA INDICATIONS
• Severe eczema
• Tuberculin positive individual

31. POLIOMYELITIS VACCINE
• Two types
• Live attenuated oral poliovirus vaccines
(OPV, Sabin)
• Killed Injectable poliovirus vaccine
(IPV, Salk)
• Even if a child has suffered from
poliomyelitis, he should be vaccinated.

32. IMMUNIZATION
• Efficacy of vaccine: >90%
.
• Duration of Immunity: Life long

33. IMMUNIZATION
Advantages of OPV Vaccine:
• Easy to administer.
• Superior antibody response
• Provides mucosal protection through
IgA
• Provides rapid immunity within 1 week.
• Provides herd immunity

34. Side Effects of OPV:
• Poliomyelitis in Immunized child (1 in 6 M),
Close contact of immunized child (1 in 5 M)
Contra-indications of OPV:
• Infection with HIV
• Known immunodeficiency
• Immune-deficient household contact

35. TETANUS TOXOID
For prevention of the tetanus.
• If a person previously suffered from the disease, he
should be vaccinated
• Newborns can be protected from tetanus if mother is
actively immunized
• Vaccine Efficacy:
>95% (>80% after 2 doses)

36. • Nature of Immunity:
– Specific anti-toxin
• Duration of Immunity:
– 5 years after primary series.
• 5 doses in adults provide over 20 years
protection.

37. • Dose of Toxoid:
– 0.5 ml doses
– Two doses at 4-8 weeks interval;
– third dose after 1 year.
–
• Booster dose after 5-10 years.

38. DIPHTHERIA TOXOID
• For prevention of diphtheria
– Prepared by the formaldehyde
inactivation.
– Dose: 0.5 ml
• Administered intramuscularly.
• Duration of immunity:
– Around 5 years.

39. PERTUSSIS VACCINE
• Two types
– Whole cell vaccines(EPI)
– Acellular Pertussis vaccine available.
• Dose of vaccine:
– 0.5 ml intramuscularly

40. Side Effects
• Encephalopathy within 7 days
• Fever of >40.50C (105oF)
• Collapse or shock.
• Seizures within 3 days.
• Inconsolable crying >3 hours within
48 hours
• Neurological sequelae

41. CONTRA INDICATIONS
• Encephalopathy within 7 days of
administration of previous dose of DPT.
• Anaphylactic reaction to the vaccine.

42. MEASLES VACCINE
• Measles vaccine is live attenuated
• Vaccine efficacy: >90%
• Duration of Immunity: Lifelong if
boosted by wild virus.

43. • Dose of vaccine: 0.5 ml
subcutaneously.
Adverse effects
• Mild febrile illness
• Febrile convulsion
• Measles like rash.
• Encephalitis ( 1 in 30,000) within 30
days.

44. CONTRA INDICATIONS
• Anaphylactic reactions to Neomycin
• Anaphylactic reactions to gelatin
• pregnancy
• Known immunodeficiency
• long term immuno suppressive therapy

45. question
• What treatment you will advise
– to
Infants born to HBsAg positive
mothers.

46. Infants born to HBsAg- positive mothers
should receive
– 0.5 ml of hepatitis B immune globulin (HBIG)
– Plus
– vaccination within 12 hours after birth,and
– Hepatitis B vaccine in EPI
• At 12-15 months of age immunized infants
– should be tested for HBsAg and anti-HBs.
• If the anti-HBsAg is positive,
– vaccination has been effective.
• If HBsAg is +ve, this is
– Immunization failure,
– Pt is chronic carrier.
• If both HBsAg and Anti-HBsAg are negative,
– then vaccine series should be repeated

47. HEPATITIS B VACCINE
• Hepatitis B vaccine
– is 95% effective in Preventing postnatally
acquired infections.
• Three intramuscular doses of hepatitis
B vaccine.
• Dose of vaccine
– is 0.5 ml if age is less than 19 years.
– 1 ml if age is more than 19 year

48. HAEMOPHILIUS INFLUENZAE TYPE b
(HIB) VACCINE
• (HIB) VACCINE
• conjugated vaccines.
• Older children and adults require only 1
dose.
• Administer by IM Injection.

49. NEWER VACCINE
• MMR
• Chicken Pox Vaccine
• Hepatitis A Vaccine
• Meningococcal vaccine
• Pneumococcal vaccine
• Typhoid vaccine
• Influneza vaccine
• Rabies vaccine
• Rota virus vaccine
• Yellow fever vaccine

50. • Vaccinesare defined as whole or parts
of microorganisms administered to
prevent
an infectious disease.Which of the
following is a live attenuated vaccine?
• A. hepatitisA
• B. hepatitisB
• C. pneumococcal
• D. varicella
• E. diphtheria

51. • 6.rota virus vaccine should not be
initiated in infants older than
• A. 11 wk
• B. 13 wk
• C. 15 wk
• D. 17 wk
• E. 19wk

52. • 7 The final dose of rota virus vaccine
must be given no later than
• A. 6 mo of age
• B. 8 mo of age
• C. 10 mo of age
• 0. 12 mo of age
• E. 18 mo of age

53. answer
• 7.(B). Two rotavirus vaccinesare available,
RotaTeq (RVS) and Rotarix (RV1). With both
• vaccines, the lst dose can be administered as
early as 6 wk of age and must be
• administered by 14 wk 6 days. The final dose in
the series must be administered no
• later than 8 mo of age. The RVSvaccine is
administered in 3 doses at least 4 wk apart.
• The RV1 vaccine is administered in 2 doses at
least 4 wk apart. Immunization should
• not be initiated for infants 15 wk of age and
older as stated in the immunization
• schedule.

54. • 8. Immunization is one of the most
beneficial and cost-effective disease
prevention measures. As a result of
effective and safe vaccines, which of the
following diseases has been eradicated?
• A smallpox
• B polio
• C measles
• D rubella
• E pertussis

55. • 13. A toxoid is a modified bacterial toxin
that is made non-toxic but still able to
induce an active immune response
against the toxin.
Which of the following vaccine is a
toxoid?
• A hepatitis A
• B hepatitis B
• C pneumococcal
• D varicella
• E diphtheria

56. • 18.Which of the following vaccine is
contraindicated in patient with X-Iinked
agammaglobulinemia?
• A. BCG
• B. hepatitis B
• C. DPT
• D. injectable polio
• E. varicella

57. Q

58. • THANX