The document discusses various vaccines including BCG, oral polio, DPT, measles, hepatitis B, tetanus toxoid, and rabies. It defines key terms like vaccine, toxoid, and immunity. For each vaccine, it describes aspects like dosage, administration method, schedule, storage requirements, effectiveness, complications and contraindications. The aim is to educate on different vaccine types and their proper use to induce immunity against diseases.

1. VACCINES
Dr. Rajeev K Sookun
M.D
Dept. of Community Medicine

2. Definitions
 VACCINE-suspension of attenuated live or
killed microorganisms administered to
induce immunity
 TOXOID-modified bacterial toxin,now non-
toxic,which stimulates formation of
antitoxins
 IMMUNITY-resistance of a body to the effects
of a deleterious agent, such as pathogenic
microorganism

3. Types Of Vaccines
 Live Attenuated Vaccines
 Inactivated Vaccines
 Toxoids
 Sub-Unit Vaccines
 Conjugate Vaccines
 DNA Vaccines

4. BCG Vaccine
 Calmette and Guerin, two French scientists
began attenuating avirulent strain of M.Bovis
on 1906.
 After 230 subcultures over a period of 13
years, they were able to evolve a strain
known as bacilli Calmette Guerin or BCG.
 The WHO has recommended the ‘Danish
1331’ strain for the production of BCG
vaccine.

5. AIM
 The aim of BCG vaccination is to induce a
benign, artificial primary infection which will
stimulate an acquired resistance to possible
subsequent infection with virulent tubercle
bacilli.

6. Types of Vaccine
 There are 2 types of BCG vaccine.
 1) The liquid (fresh) vaccine
 2) The freeze-dried vaccine
 The freeze-dried vaccine is more stable
preparation than liquid vaccine.
 Present day vaccines are distributed in the
freeze-dried form

7. Dosage
 For vaccination,the usual strength is 0.1 mg
in 0.1 ml volume.
 The dose for newborn aged below 4 weeks is
0.05ml.
( This is because the skin of the newborn is
rather thin and intradermal injection with full
dose 0.1ml might penetrate into deeper tissue
and give rise to local abscess formation and
enlarged regional lymph nodes.

8. Administration
 The vaccine is injected intradermally using a
‘Tuberculin’ syringe
 The site of injection should be just
above the insertion of the deltoid
muscle
 A satisfactory injection should produce a
wheal of 5mm in diameter.

9. Age
 BCG should be administered very early in
infancy either at birth ( for institutional
deliveries) or at 6 weeks of age.
 BCG administration early in life provides a
high level of protection,particularly against
the severe forms of childhood tuberculosis
and tuberculous meningitis.

10. Complications
 Prolong severe ulceration at site of
vaccination.
 Suppurative lymphadenitis.
 Osteomyelitis.
 Disseminated BCG infection.
 Death

11. Protective Value
 The duration of protection is from 15 to 20
years.
 Studies have shown that the range of
protection offered by BCG varied from 0 to
80 % in different parts of the world.

12. Contraindications
Should not be given to people suffering from
 1) Generalised eczema
 2) Infective dermatitis
 3) Hypogammaglobulinaemia
 4) Deficient Immunity
 5) Leukemia
 6) Lymphoma
 7) General malignant diseases
 8) In pregnancy.

13. Oral Polio Vaccine
 Oral polio vaccine was described by Sabin in
1957.
 It contains live attenuated virus types 1, 2 and
3 grown in primary monkey kidney or human
diploid cell cultures.
 For administrative convenience the Trivalent
(TOPV) vaccine is given.

14. Dosage
• The dose is 2 drops.
 WHO recommends that vaccinators use
dropper supplied with the vial of oral polio
vaccine as this is the most direct and effective
way to deliver the correct drop size.

15. Administration
 The back of the child is tilted and gently squeeze
the cheek or pinch the nose to make the mouth
open.
 The drop is allowed to fall on
the child’s tongue from the
dropper.
 The OPV induces both local and systemic
immunity.

16. Advantages of OPV
 Does not require the use of highly trained
personnel.
 Induces both humoral and intestinal immunity.
 Antibody is quickly produced in a large
proportion of vaccines.
 The vaccinee excretes the virus and so infects
others who are also immunised
thereby
 (i) Useful in controlling epidemics
 (ii) relatively inexpensive.

17. Complications
 OPV vaccine associated with paralytic polio.

18. Contraindications
 Live vaccine is not usually given to
immunocompromised individuals.
 Leukemia
 Malignancy
 On corticosteroids therapy

19. Storage
 Sterilised vaccine should be kept at +4oc for a
year and at +25oc for a month
 Non-sterilised vaccine should be kept at -20oc
in deep freeze.

20. DPT Vaccine
 It gives protection against 3 diseases
 1) Diphtheria
 2)Pertusis
 3)Tetanus
 The vaccine is a toxoid preparation of 2 types
 1)Plain
 2) Absorbed
 Has a protective efficacy of 85%

21. Dosage and Administration
 0.5ml is available
 Administrated in deep intramuscular
injection in upper and outer aspect of thigh.

22. Schedule
 3 doses at 3, 10, 14 weeks.
 Booster dose at 18 months.

23. Adverse Reaction
 Fever
 Mild local reactions
 Pain
 Swelling
 Induration at site of injection
 Neurological complications (encephalitis)
 Encephalopathy
 Convulsion
 Reye’s syndrome

24. Contraindications
Severe reaction to previous dose like:
 Collapse
 Shock
 Persistent screaming
 Convulsions
 Other neurological and anaphylactic
reactions

25. Measles Vaccine
 Only live attenuated vaccines are
recommended for use.
 Presented as a freeze-dried product.
 Before use, the vaccines is reconstituted with
sterile diluent.

26. Dosage
 0.5ml single dose given subcutaneously at 9
months old.
 Suspected contacts are
immunised with vaccine
within 3 days of exposure

27. Storage
 Kept at 20-80C in dark, refrigerated in freeze
compartment.
 The vaccine in sensitive to sunlight, hence it
is kept in coloured vials.

28. Immune response
 It induces both humoral and cellular
immunity

29. Reactions
 When injected, the attenuated virus
multiplies and induces a mild ‘measles’
illness (fever and rash) 5-10 days after
immunization
 Fever may last for 1-2 days and rash 1-3 days.

30. Immunity
 It develops within 11-12 days after vaccination
and usually persists for life

31. Contraindications
 Pregnancy
 HIV infection
 Immunodeficiency
 Malignancy
 Steroid therapy
 Radiation therapy

32. Adverse Reaction
 Toxic shock syndrome

33. Hepatitis B Vaccine
 The recombinant hepatitis B vaccine was
introduced in 1986.
 The active substance in recombinant
hepatitis B vaccine is HBsAg.

34. Dosage
 Adult dose is 10-20 mcg initially (depending
on formulation) and again at 1 and 6 months.
 Children under 1o yrs of age should be given
half of the adult dose at the same time
intervals.

35. Administration
 For greatest reliability of absorption, the
deltoid muscle is preferred for injection as
gluteal injection often results in deposition of
vaccine in fat rather than muscle.

36. Advantages
 All children and adolescent aged less than 18 yrs and
not previously vaccinated should receive the vaccine.
 Indicated for certain groups at high risk of
contracting HBV infection. E.g.
 High risk sexual behaviour
 Partner
 Household contacts of HBsAg positive persons
 Injecting drug users
 Person who frequently required blood transfusions
 Recipient of solid organ transplantation
 Health care workers dealing with HBV patients
 International travellers to endemic countries

37. Contraindications
 History of allergic reactions

38. Storage
 The vaccine should be stored at 2 – 8oc .
 Freezing must be avoided.

39. Tetanus Toxoid
 2 types
 1) Plain
 2) Fluid (purified)
 Fluid tetanus toxoid stimulates higher and
longer immunity response than plain toxoid

40. Dosage and Schedule
 A primary course of immunisation consists of
2 doses given at interval of 1-2 months.
 1st booster at 1 yr after the initial 2 doses.
 2nd booster given 5 yrs after 3rd dose.
 In pregnancy, 2 doses are given:
 1st at 16-2o weeks
 2nd at 20-24 weeks

41. Administration
 Intramuscular in upper arm into deltoid
muscle.

42. Complications
 Allergy

43. Storage
 Tetanus Toxoid is stored at 4-10oc.
 It is not allowed to freeze.

44. Rabies Vaccine
 Against the rabies virus.
 Prevention by
 1) post exposure prophylaxis
2) pre exposure prophylaxis
 3) Post exposure treatment of persons who
have been vaccinated previously.

45. Dosage
 Adult 0.5 ml or 1ml depending on type of
vaccine

46. Administration
 Rabies vaccine is given intramuscular or
intradermal

47. Complications
 Minor and transient erythema, pain and
swelling at site of injection.
 Fever, headache, dizziness, gastro intestinal
symptoms.

48. YO, IT’S
OVER