This ppt contains all the information about the Immunizing agents - Vaccines, Immunoglobulines and Antisera. It is useful for students of the medical field learning Preventive and social medicine, Swasthavritta (Ayurved), and everyone who is interested in knowing about it

1. Immunizing agents
Dr. Shubhangi Kshirsagar
Assistant Professor
Swasthavritta &Yoga department

2. Immunizing Agents
The immunizing agents may be classified as -
1. Vaccines
2. Immunoglobulins
3. Antisera

3. Vaccines

4. 1. Vaccines
 Vaccine is an immuno-biological
substance when administered stimulates
production of antibody and protect
individual against particular disease.
 Vaccines are used for active
immunization.

5. Types of vaccine
1. Live
2. Killed
3. Subunit vaccine
4. Combined
Subunit vaccine
1. Toxoid
2. Protein vac
3. Recombinant protein vac
4. Polysaccharide based vac
5. Conjugated vac

6. 1. Live vaccines
 Live vaccines are prepared from live or
wild (generally attenuated) organisms.
 These organisms are passed repeatedly in
the laboratory in tissue cultures or chick
embryos and have lost their capacity to
induce full blown disease but retain the
Immunogenicity.
 E.g BCG, Measles, Oral polio
6

7. Live Vaccines Are More Potent Immunizing
Agents Than Killed Vaccines Because
 Live organisms multiply in the host and the
resulting antigenic dose is larger than what is
injected.
 Have all the major and minor antigenic
components.
 Engage certain tissues of body (e.g. intestinal
mucosa by polio).
 Other mechanisms such as persistence of latent
virus.

8. Contraindication of live vaccine
 Immune deficiency disease
 Person whose immune response is suppressed
because of leukemia, lymphoma, malignancy
or therapy with corticosteroids, alkylating
agents, anti-metabolic agents or radiation
 Pregnancy
When two live vaccines are required they should
be given either simultaneously at different sites
or with an interval of at least three weeks.

9. Live vaccines
Bacterial Viral
BCG Oral polio
Typhoid oral Yellow fever
Measles
Rubella
Mumps
Influenza

10. 2. Killed or inactivated vaccines
 Inactivated vaccines are produced by growing
virus or bacteria in culture media and then
inactivating them with heat or chemicals
(usually formalin)
 They stimulate active immunity.
 They are generally safe but less effective than
live vaccines.
 Killed vaccine require a series of 2-3 doses of
vaccine to produce adequate antibody
response.
 Most cases require booster dose.

11.  The duration of immunity - varies from
months to many years.
 Usually administered by subcutaneous or
intramuscular route.
 Contraindication - severe local or general
reaction to previous dose.

12. Inactivated or Killed Vaccines
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Bacterial Viral
Typhoid Rabies
Cholera Salk polio
Pertusis Influenza
Plague Hepatitis A
Japanese encephalitis

13. 3. Toxoids
 Certain organisms produce exotoxins e.g.
diphtheria and tetanus bacilli.
 The toxins produced by these organisms are
detoxicated and used in preparation of the
vaccines.
 The antibodies produced neutralize the toxin
produced during the infection.
 The toxoid act against the toxin rather than act
on the organism.
 Toxoid preparations are highly efficacious and
safe immunizing agents.
 E.g. Dipththeria, tetanus

14. 4. Combined vaccines
 If more than one kind of immunizing agent is
included in the vaccine it is called a mixed or
combined vaccine.
 The aim of combined vaccines is to simplify
administration, reduce costs minimize the
number of contacts of the patient
with the health system, reducing the storage
cost, improving timelines of vaccination and
facilitating the addition of new
vaccine into immunization programme.

15. Examples of combined vaccines
 DPT (Diphtheria-pertussis-tetanus)
 DT (Diphtheria-tetanus)
 DP (Diphtheria-pertussis)
 DPT and typhoid vaccine
 MMR (Measles, mumps and rubella)
 DPTP (DPT + inactivated polio)
 Hepatitis A, and B
 Hepatitis A, and typhoid
 DTwP (Diphtheria, tetanus, whole-cell pertussis)
 DPT-Hep B-Hib (Diphtheria, pertussis, tetanus,
hepatitis B and haemophilus influenza type B)

16. Immunoglobulines

17. 2. Immunoglobulines
 The human immunoglobulin system is
composed of 5 major classes (IgG, IgM,
IgA, IgD and IgE) and sub-classes
within them.
 The various classes and sub-classes of
immunoglobulins represent different
functional groups that are required to
meet different types of antigenic
challenges.

18. 1. IgG
 80%
 Major immunoglobuline
 Antibodies to gram +ve
pyogenic bacteria
 Antiviral, antitoxic
antibodies are found in
IgG
 Half life - 21 days
 Extra-vascular
 Transported across
placenta
2. IgA
 13%
 Found in body secretion
e.g. saliva, milk, colostrum,
tears, bronchial secretion,
mucus secretion of
intestine
 Half life -6-8 days
 It provides primary defense
mechanism at mucus
membrane against local
infection

19. 3. IgE
 <0.0005%
 Found in submucus
tissue
 Responsible for
immediate allergic
anaphylactic reaction
 Increase in Helminthes
infestation
 Half life -2days
4. IgM
 6%
 It represents antibody that is
promptly formed with
exposure to antigen
 Its presence may be
indicative of recent infection
 High agglutinating &
complement fixing ability.
 Can be produced by fetus
undergoing infection
 Half life -7days

20. 5. IgD
 < 0.0003mg/ml
 Half life – 2 days.
 Act as antigen receptor when present on
certain B lymphocytes

21. Immunoglobuline preparation
 It is the readymade antibody preparation
obtained from human beings.
 It produces immediate immunity.
 These are used for passive immunization.
 These are -
a. Normal human immunoglobulin
b. Specific (hyper-immune) human
immunoglobulin
 These are used in the prophylaxis of viral
and bacterial infections and in replacement of
antibodies in immuno-deficient patients.

22.  Immunoglobulines are of two types -
1. Normal human immunoglobulin
2. Specific human immunoglobulin
Uses -
a. Used for prophylaxis of viral and
bacterial infection
b. Replacement of antibodies in immuno
deficient patients

23. a. Normal human immunoglobulin
 It is antibody rich fraction, obtained from pool of at
least 1000 donors.
 Prepared from plasma
 WHO standards for preparation NHIg
 Should contain 90% of intact IgG
 All IgG sub classes should be present
 Level of antibody against two bacterial species and two
virus.
 There should be a low lgA concentration
Uses –
1. For prevention of measles in highly susceptible contacts.
2. Temporary protection (12weeks) against Hepatitis A
infection in travelers.

24. b. Specific human immunoglobulin
 Prepared from the plasma of patients who have
recently recovered from an infection or are obtained
from individuals who have been immunized against a
specific infection.
 They therefore have a high antibody content against
an individual infection and provide immediate
protection e.g.
1. Chickenpox prophylaxis of highly susceptible
individuals
2. Hepatitis B - post exposure prophylaxis
3. Rabies
4. Tetanus prophylaxis

25. Adverse reaction of Immunoglobulines
1. Local – Pain, sterile abscess
2. Systemic –
a. Rapid
Occurs within minutes
Anaphylactic
b. Late
Occurs within hours or days
Urticaria, diarrhoea, pyrexia, arthralgia

26. Human Normal Ig Human Specific Ig Non Human
Antisera
Rabies Diphtheria
Hepatitis A Tetanus Tetanus
Measles Mumps Gas gangerene
Hepatitis B Botulism
Varicella Rabies
Diphtheria

27. Antisera or Antitoxins

28. 3. Antisera or Antitoxins
 Antisera are the materials prepared from non-human
source like animals-horse.
 Used for passive immunization
 Less effective
 Immunity up to 2-3 week
 Antitoxins prepared from non human sources are
 Tetanus – ante tetanus serum
 Diphtheria- anti diptheria serum
 Anti snake venom
 Anti Gas gangrene serum

29. References
K. Park - preventive and social medicine

30. Thank You !