This document discusses different types of vaccines, including live whole virus vaccines, killed whole virus vaccines, subunit vaccines, recombinant virus vaccines, anti-idiotype antibodies, and DNA vaccines. It provides details on how each type is produced and their relative advantages and disadvantages. Live vaccines induce stronger immune responses but carry a risk of disease from vaccine strain, while killed/subunit vaccines are safer but require more doses and adjuvants to be effective. Newer technologies like DNA vaccines aim to combine safety with strong immune responses. Herd immunity thresholds to eradicate diseases vary depending on their basic reproduction number.

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Different Types of Vaccine
Whole virus vaccines. either live or killed, constitute the vast majority of vaccines in
use at present. However, recent advances in molecular biology had provided
alternative methods for producing vaccines. Listed below are the possibilities;-
1. Live whole virus vaccines
2. Killed whole virus vaccines
3. Subunit vaccines;- purified or recombinant viral antigen
4. Recombinant virus vaccines
5. Anti-idiotype antibodies
6. DNA vaccines
1. Live Vaccines
Live virus vaccines are prepared from attenuated strains that are almost or completely
devoid of pathogenicity but are capable of inducing a protective immune response.
They multiply in the human host and provide continuous antigenic stimulation over a
period of time, Primary vaccine failures are uncommon and are usually the result of
inadequate storage or administration. Another possibility is interference by related
viruses as is suspected in the case of oral polio vaccine in developing countries.
Several methods have been used to attenuate viruses for vaccine production.
Use of a related virus from another animal - the earliest example was the use of
cowpox to prevent smallpox. The origin of the vaccinia viruses used for production is
uncertain.
Administration of pathogenic or partially attenuated virus by an unnatural
route - the virulence of the virus is often reduced when administered by an unnatural
route. This principle is used in the immunization of military recruits against adult
respiratory distress syndrome using enterically coated live adenovirus type 4, 7 and
(21).
Passage of the virus in an "unnatural host" or host cell - the major vaccines used
in man and animals have all been derived this way. After repeated passages, the virus

2. is administered to the natural host. The initial passages are made in healthy animals or
in primary cell cultures. There are several examples of this approach: the 17D strain
of yellow fever was developed by passage in mice and then in chick embryos.
Polioviruses were passaged in monkey kidney cells and measles in chick embryo
fibroblasts. Human diploid cells are now widely used such as the WI-38 and MRC-5.
The molecular basis for host range mutation is now beginning to be understood.
Development of temperature sensitive mutants - this method may be used in
conjunction with the above method.
2. Inactivated whole virus vaccines
These were the easiest preparations to use. The preparation was simply inactivated.
The outer virion coat should be left intact but the replicative function should be
destroyed. To be effective, non-replicating virus vaccines must contain much more
antigen than live vaccines that are able to replicate in the host. Preparation of killed
vaccines may take the route of heat or chemicals. The chemicals used include
formaldehyde or beta- propiolactone. The traditional agent for inactivation of the virus
is formalin. Excessive treatment can destroy immunogenicity whereas insufficient
treatment can leave infectious virus capable of causing disease. Soon after the
introduction of inactivated polio vaccine, there was an outbreak of paralytic
poliomyelitis in the USA use to the distribution of inadequately inactivated polio
vaccine. This incident led to a review of the formalin inactivation procedure and other
inactivating agents are now available, such as Beta-propiolactone. Another problem
was that SV40 was occasionally found as a contaminant and there were fears of the
potential oncogenic nature of the virus.
Live vs Dead vaccines
Feature Live Dead
Dose low high
no. of doses single multiple
need for adjuvant no yes
Duration of immunity many years less
antibody response IgG, IgA IgG

3. CMI good poor
Reversion to virulence possible not possible
Because live vaccines replicate inside host cells, bits of virus antigen are presented to
the cell surface and recognized by cytotoxic cells
Potential safety problems
Live vaccines
1. Underattenuation
2. Mutation leading to reversion to virulence
3. Preparation instability
4. Contaminating viruses in cultured cells
5. Heat lability
6. Should not be given to immunocompromized or pregnant patients
Killed vaccines
1. Incomplete inactivation
2. Increased risk of allergic reactions due to large amounts of antigen involved
Present problems with vaccine development include
1. Failure to grow large amounts of organisms in laboratory
2. Crude antigen preparations often give poor protection. eg. Key antigen not
identified, ignorance of the nature of the protective or the protective immune
response.
3. Live vaccines of certain viruses can (1). induce reactivation, (2) be oncogenic
in nature
3._Subunit Vaccines
Originally, non-replicating vaccines were derived from crude preparations of virus
from animal tissues. As the technology for growing viruses to high titres in cell
cultures advanced, it became practicable to purify virus and viral antigens. It is now
possible to identify the peptide sites encompassing the major antigenic sites of viral
antigens, from which highly purified subunit vaccines can be produced. Increasing
purification may lead to loss of immunogenicity, and this may necessitate coupling to
an immunogenic carrier protein or adjuvant, such as an aluminum salt. Examples of

4. purified subunit vaccines include the HA vaccines for influenza A and B, and HBsAg
derived from the plasma of carriers.
4. Recombinant viral proteins
Virus proteins have been expressed in bacteria, yeast, mammalian cells, and viruses.
E. Coli cells were first to be used for this purpose but the expressed proteins were not
glycosylated, which was a major drawback since many of the immunogenic proteins
of viruses such as the envelope glycoproteins, were glycosylated. Nevertheless, in
many instances, it was demonstrated that the non-glycosylated protein backbone was
just as immunogenic. Recombinant hepatitis B vaccine is the only recombinant
vaccine licensed at present.
An alternative application of recombinant DNA technology is the production of
hybrid virus vaccines. The best known example is vaccinia; the DNA sequence coding
for the foreign gene is inserted into the plasmid vector along with a vaccinia virus
promoter and vaccinia thymidine kinase sequences. The resultant recombination
vector is then introduced into cells infected with vaccinia virus to generate a virus that
expresses the foreign gene. The recombinant virus vaccine can then multiply in
infected cells and produce the antigens of a wide range of viruses. The genes of
several viruses can be inserted, so the potential exists for producing polyvalent live
vaccines. HBsAg, rabies, HSV and other viruses have been expressed in vaccinia.
Hybrid virus vaccines are stable and stimulate both cellular and humoral immunity.
They are relatively cheap and simple to produce. Being live vaccines, smaller
quantities are required for immunization. As yet, there are no accepted laboratory
markers of attenuation or virulence of vaccinia virus for man. Alterations in the
genome of vaccinia virus during the selection of recombinant may alter the virulence
of the virus. The use of vaccinia also carries the risk of adverse reactions associated
with the vaccine and the virus may spread to susceptible contacts. At present, efforts
are being made to attenuate vaccinia virus further and the possibility of using other
recombinant vectors is being explored, such as attenuated poliovirus and adenovirus.
5. Synthetic Peptides
The development of synthetic peptides that might be useful as vaccines depends on
the identification of immunogenic sites. Several methods have been used. The best
known example is foot and mouth disease, where protection was achieved by
immunizing animals with a linear sequence of 20 aminoacids. Synthetic peptide
vaccines would have many advantages. Their antigens are precisely defined and free
from unnecessary components which may be associated with side effects. They are
stable and relatively cheap to manufacture. Furthermore, less quality assurance is

5. required. Changes due to natural variation of the virus can be readily accommodated,
which would be a great advantage for unstable viruses such as influenza.
Synthetic peptides do not readily stimulate T cells. It was generally assumed that,
because of their small size, peptides would behave like haptens and would therefore
require coupling to a protein carrier which is recognized by T-cells. It is now known
that synthetic peptides can be highly immunogenic in their free form provided they
contain, in addition to the B cell epitope, T- cell epitopes recognized by T-helper
cells. Such T-cell epitopes can be provided by carrier protein molecules, foreign
antigens. or within the synthetic peptide molecule itself.
Synthetic peptides are not applicable to all viruses. This approach did not work in the
case of polioviruses because the important antigenic sites were made up of 2 or more
different viral capsid proteins so that it was in a concise 3-D conformation.
Advantages of defined viral antigens or peptides include:
1. Production and quality control simpler
2. No NA or other viral or external proteins, therefore less toxic.
3. Safer in cases where viruses are oncogenic or establish a persistent infection
4. Feasible even if virus cannot be cultivated
Disadvantages:
1. May be less immunogenic than conventional inactivated whole-virus vaccines
2. Requires adjuvant
3. Requires primary course of injections followed by boosters
4. Fails to elicit CMI.
6. Anti-idiotype antibodies
The ability of anti-idiotype antibodies to mimic foreign antigens has led to their
development as vaccines to induce immunity against viruses, bacteria and protozoa in
experimental animals. Anti-idiotypes have many potential uses as viral vaccines,
particularly when the antigen is difficult to grow or hazardous. They have been used
to induce immunity against a wide range of viruses, including HBV, rabies, Newcastle
disease virus and FeLV, reoviruses and polioviruses.
7. DNA vaccines

6. Recently, encouraging results were reported for DNA vaccines whereby DNA coding
for the foreign antigen is directly injected into the animal so that the foreign antigen is
directly produced by the host cells. In theory these vaccines would be extremely safe
and devoid of side effects since the foreign antigens would be directly produced by
the host animal. In addition, DNA is relatively inexpensive and easier to produce than
conventional vaccines and thus this technology may one day increase the availability
of vaccines to developing countries. Moreover, the time for development is relatively
short which may enable timely immunization against emerging infectious diseases. In
addition, DNA vaccines can theoretically result in more long-term production of an
antigenic protein when introduced into a relatively nondividing tissue, such as muscle.
Indeed some observers have already dubbed the new technology the "third revolution"
in vaccine development—on par with Pasteur's ground-breaking work with whole
organisms and the development of subunit vaccines. The first clinical trials using
injections of DNA to stimulate an immune response against a foreign protein began
for HIV in 1995. Four other clinical trials using DNA vaccines against influenza,
herpes simplex virus, T-cell lymphoma, and an additional trial for HIV were started in
1996.
The technique that is being tested in humans involves the direct injection of plasmids -
loops of DNA that contain genes for proteins produced by the organism being targeted
for immunity. Once injected into the host's muscle tissue, the DNA is taken up by host
cells, which then start expressing the foreign protein. The protein serves as an antigen
that stimulate an immune responses and protective immunological memory.
Enthusiasm for DNA vaccination in humans is tempered by the fact that delivery of
the DNA to cells is still not optimal, particularly in larger animals. Another concern is
the possibility, which exists with all gene therapy, that the vaccine's DNA will be
integrated into host chromosomes and will turn on oncogenes or turn off tumor
suppressor genes. Another potential downside is that extended immunostimulation by
the foreign antigen could in theory provoke chronic inflammation or autoantibody
production
Presentation of immunogenic proteins and peptides
Proteins separated from virus particles are generally much less immunogenic than the
intact particles. This difference in activity is usually attributed to the change in
configuration of a protein when it is released from the structural requirements of the
virus particle. Many attempts have been made to enhance the immunogenic activity of
separated proteins.
Adjuvants

7. Used to potentiate the immune response
1. Functions to localize and slowly release antigen at or near the site of
administration.
2. Functions to activate APCs to achieve effective antigen processing or
presentation
Materials that have been used include;-
1. Aluminum salts
2. Mineral oils
3. Mycobacterial products, eg. Freud's adjuvants
Immunostimulating complexes (ISCOMS)
1. An alternative vaccine vehicle
2. The antigen is presented in an accessible, multimeric, physically well defined
complex
3. Composed of adjuvant (Quil A) and antigen held in a cage like structure
4. Adjuvant is held to the antigen by lipids
5. Can stimulate CMI
6. Mean diameter 35nm
In the most successful procedure, a mixture of the plant glycoside saponin, cholesterol
and phosphatidylcholine provides a vehicle for presentation of several copies of the
protein on a cage-like structure. Such a multimeric presentation mimics the natural
situation of antigens on microorganisms. These immunostimulating complexes have
activities equivalent to those of the virus particles from which the proteins are derived,
thus holding out great promise for the presentation of genetically engineered proteins.
Similar considerations apply to the presentation of peptides. It has been shown that by
building the peptide into a framework of lysine residues so that 8 copies instead of 1
copy are present, the immune response induced was of a much greater magnitude. A
novel approach involves the presentation of the peptide in a polymeric form combined
with T cell epitopes. The sequence coding for the foot and mouth disease virus
peptide was expressed as part of a fusion protein with the gene coding for the
Hepatitis B core protein. The hybrid protein, which forms spherical particles 22nm in
diameter, elicited levels of neutralizing antibodies against foot and mouth disease
virus that were at least a hundred times greater than those produced by the monomeric
peptide.
Immunization and Herd Immunity

8. The following questions should be asked when a vaccination policy against a
particular virus is being developed.
1. What proportion of the population should be immunized to achieve eradication.
2. What is the best age to immunize?
3. How is this affected by birth rates and other factors
4. How does immunization affect the age distribution of susceptible individuals,
particularly those in age-classes most at risk of serious disease?
5. How significant are genetic, social, or spatial heterogeneities in susceptibility to
infection?
6. Hoe does this affect herd immunity?
A basic concept is that of the basic rate of the infection R0. for most viral infections,
R0 is the average number of secondary cases produced by a primary case in a wholly
susceptible population. Clearly, an infection cannot maintain itself or spread if R0 is
less than 1. R0 can be estimated from as B/(A-D);B = life expectancy, A = average
age at which infection is acquired, D = the characteristic duration of maternal
antibodies.
The larger the value of R0, the harder it is to eradicate the infection from the
community in question. A rough estimate of the level of immunization coverage
required can be estimated in the following manner: eradication will be achieved if the
proportion immunized exceeds a critical value pinc = 1-1/R0. Thus the larger the R0,
the higher the coverage is required to eliminate the infection. Thus the global
eradication of measles, with its R0 of 10 to 20 or more, is almost sure to be more
difficult to eradicate than smallpox, with its estimated R0 of 2 to 4. Another example
is rubella and measles immunization in the US. Rubella (A = 9 years) has an Ro
roughly half that of measles (A = 5 years) and indeed rubella has been effectively
eradicated in the US while the incidence of measles have declined more slowly.
Why do we not require 100% coverage to eradicate an infection? Immunization has
both a direct and indirect effect. The susceptible host population is reduced by mass
immunization so that the transmission of infection has become correspondingly less
efficient and eventually, the infection will be unable to maintain itself.
Average age
of infection
Epidemic
period
R0
Critical
coverage
Measles 4-5 2 15-17 92-95
Pertussis 4-5 3-4 15-17 92-95
Mumps 6-7 3 10-12 90-92
Rubella 9-10 3-5 7-8 85-87

9. Diptheria 11-14 4-6 5-6 80-85
Polio 12-15 3-5 5-6 80-85
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