This document discusses the principles of vaccination. It covers: - Active and passive immunity and how they are obtained naturally or artificially through vaccination or antibody transfer. - The components of vaccines, including antigens, antibodies, and epitopes. - The different types of vaccines such as live attenuated, inactivated, toxoid, subunit, and polysaccharide vaccines. - How vaccines work to produce immunity through replication or exposure to antigens without causing disease. - The development process, safety testing, and surveillance of new vaccines.

1. Principles of Vaccination
D C Sharma

2. Meningitis – Hib,
Streptococcus, Neisseria

3. Diphtheria

4. Whooping cought

5. Tetanus

6. Measels

7. Poliomyelitis

8. Iron lung – after poliomyelitis

9. Jenner, Variolisation,
Ramses, eradication

10. Principles of Vaccination
• Self vs. nonself
• Protection from infectious disease
• Usually indicated by the presence
of antibody
• Very specific to a single organism
Immunity

11. Principles of Vaccination
• Protection produced by the person's
own immune system
• Usually permanent
• Protection transferred from another
person or animal
• Temporary protection that wanes
with time
Active Immunity
Passive Immunity

12. Way to get immunised
Aktívna imunita Pasívna imunita
Prirodzene získaná Prirodzene získaná
Umelo navodená Umelo
navodená
Stávame sa imúnnymi prirodzenou cestou alebo umelo. Očkovaním si vytvárame
umelo získanú aktívnu imunitu voči chorobám.
actively
disease
vaccination
passively
transplacentarly
immunisation
immunotherapy
immune sera
Naturally
Artificially

13. Principles of Vaccination
• A live or inactivated substance
(e.g., protein, polysaccharide)
capable of producing an immune
response
• Protein molecules (immuno-
globulin) produced by B
lymphocytes to help eliminate an
antigen
Antigen
Antibody

14. Protilátky produkované bunkami imunitného systému rozpoznávajú cudzie antigény –
ich charakteristické molekuly – antigénne determinanty - epitopy
Protilátky
Antigény
Epitopy

15. Passive Immunity
• Transfer of antibody produced by
one human or other animal to
another
• Temporary protection
• Transplacental most important
source in infancy

16. Sources of Passive Immunity
• Almost all blood or blood
products
• Homologous pooled human
antibody (immune globulin)
• Homologous human
hyperimmune globulin
• Heterologous hyperimmune
serum (antitoxin)

17. Monoclonal Antibody
• Derived from a single type, or
clone, of antibody-producing cells
(B cells)
• Antibody is specific to a single
antigen or closely related group of
antigens
• Used for diagnosis and therapy of
certain cancers and autoimmune
and infectious diseases

18. Vaccination
• Active immunity produced by
vaccine
• Immunity and immunologic
memory similar to natural
infection but without risk of
disease

24. Classification of Vaccines
• Live attenuated
– viral
– bacterial
• Inactivated

25. Inactivated Vaccines
• viruses
• bacteria
• protein-based
– toxoid
– subunit
• polysaccharide-based
– pure
– conjugate
Whole
Fractional

26. Principles of Vaccination
General Rule
The more similar a vaccine is to
the disease-causing form of the
organism, the better the immune
response to the vaccine

27. Live Attenuated Vaccines
• Attenuated (weakened) form of
the "wild" virus or bacterium
• Must replicate to be effective
• Immune response similar to
natural infection
• Usually produce immunity with
one dose*
*except those administered orally

28. Live Attenuated Vaccines
• Severe reactions possible
• Interference from circulating
antibody
• Fragile – must be stored and
handled carefully

29. Live Attenuated Vaccines
• Viral measles, mumps,
rubella, varicella/zoster,
yellow fever, rotavirus,
intranasal influenza,
rotavirus, vaccinia
• Bacterial BCG, oral typhoid

30. Inactivated Vaccines
• Cannot replicate
• Generally not as effective as live
vaccines
• Less interference from circulating
antibody than live vaccines
• Generally require 3-5 doses
• Immune response mostly humoral
• Antibody titer may diminish with time

31. Inactivated Vaccines
• Viral polio, hepatitis A,
rabies, influenza*
• Bacterial pertussis*, typhoid*
cholera*, plague*
Whole-cell vaccines
*not available in the United States

32. Inactivated Vaccines
• Subunit hepatitis B, influenza,
acellular pertussis,
human papillomavirus,
anthrax
• Toxoid diphtheria, tetanus
Fractional vaccines

33. Pure Polysaccharide Vaccines
• Not consistently immunogenic in
children younger than 2 years of
age
• No booster response
• Antibody with less functional
activity
• Immunogenicity improved by
conjugation

34. Polysaccharide Vaccines
• pneumococcal
• meningococcal
• Salmonella Typhi (Vi)
• Haemophilus influenzae type b
• pneumococcal
• meningococcal
Pure polysaccharide
Conjugate polysaccharide

35. Future of vaccine
• Antiidiotype vaccines, DNA vaccines,
• One, not hurting, for everybody,
immunogenic, not harming, protecting
against all diseases, only one
disadvantage = not real
• Multivalent vaccines – more
immunogenic

36. Fases of new vaccines
development – laboratory,
preclinical

37. Field, clinical study
Skôr ako je vakcíne udelená licencia, prebieha testovanie jej bezpečnosti a stanovenie
účinnosti u dobrovoľníkov v niekoľkých fázach s presne stanovenými podmienkami

38. Risks of immunisation
• Side effects on any part of vaccine -
redness, indurance, ache, fever, cry,
alergy
• Immunisation – small regulated
infection - mild reaction, not target
tissue infection
• Not real expectances

39. Population immunity
• Collectove immunity – more than 85%
vaccinated against infection spread
from 1 to the other
• Protection of not immunisable or not
immunised „herd effect“
• Not present for tetanus, rabies

40. Surveillance a immunological
surveys
• Surveillance – system of epidemiological
patrolling
• Immunological surveys – targeted
sampling of sera from different age
groups to find not protected groups, to
organise aimed vaccination - mopping,
or catch up vaccination or changes of
immunisation schedule

41. Decrease of morbidity for DTP
after introduction of DTP
vaccination

42. 0
5
10
15
20
1 2 3 4 5 6 7 8 9
všetky
0 rokov
1- 4 rokov
0
50 000
100 000
150 000
200 000
1
´94 ´95 ´96 ´97 ´98 ´99 ´00 ´01
´02
INCIDENCE of HIb MENINGITIS - decrease
influenced by the amount of applicated
vaccines

43. Antivaccination activity
• Vaccination mostly in child population
• very sesitive topic, period of discovery of
many diseases and handicapes in children
• demagogical arguments,
• not causal connection,
• medialisation, not medically graduated
people, usually educated in other vague
topics – ecology, homeopathy.....
• Dangerous – more people affected by
vaccination preventable diseases in USA
and Germany then for bioterroristic threat