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Lecture prepared by
Mark Randa; Ph.D.
Vaccines
History of Vaccines
 Variolation: Inoculation of smallpox into skin
(18th century). Mortality rate of 1% for variolation; 50%
mortality rate from smallpox.
 Vaccine: a suspension of organisms or fractions of
organisms that is used to induced immunity
 Vaccination:
- Inoculation of cowpox virus into skin (Jenner)
- Inoculation with rabies virus (Pasteur)
 Herd Immunity
What is a Vaccine ?
 A vaccine is the deliberate stimulation of adaptive immunity.
- Work by mimicking what happens during natural infection
without causing illness.
- Use altered versions of viruses or bacteria to trigger an
immune response.
- Are the most effective means of controlling infectious
diseases.
- Not only protect those who get them, but they also help
keep diseases at bay in the community; this is called herd
immunity
How Do Vaccines Work?
 During natural infection:
- The immune system recognizes a pathogen as foreign and
makes an immune response to it. When a pathogen causes an
immune response, it is known as an antigen.
- Unfortunately, while the immune response is gaining strength,
the person is likely to be ill as the struggle between the pathogen
and the immune response is decided.
- One part of the immune response creates antibodies; this is
known as the antibody-mediated or humoral immune response.
- Antibodies are specific to antigens and have the ability to
remember them, so that if the same (or a very similar) antigen
tries to infect the person again, the immune response will be
stronger and faster thereby protecting the person from infection
—and illness.
How Do Vaccines Work ?
 With a vaccine:
- The immune system recognizes the vaccine as foreign and
makes an immune response to it. The vaccine serves as an
antigen in that it causes the immune system to respond to it.
- One part of the immune response creates antibodies; this is
known as the antibody-mediated or humoral immune response.
- Antibodies are specific to the vaccine and have the ability to
remember it, so that if the vaccine or a very similar antigen is
seen again, the immune response will be stronger and faster
thereby protecting the person from infection.
- The main difference between a vaccine and natural infection is
that the person does not become ill while the immune system is
responding to the vaccine.
Vaccines changed medicine
 Vaccines have literally transformed the landscape of
medicine over the course of the 20th century. Before
vaccines, parents in the United States could expect that every
year:
- Polio would paralyze 10,000 children.
- Rubella (German measles) would cause birth defects and
mental retardation in as many as 20,000 newborns.
- Measles would infect about 4 million children, killing 3,000.
- Diphtheria would be one of the most common causes of death
in school-aged children.
- A bacterium called Haemophilus influenzae type b (Hib) would
cause meningitis in 15,000 children, leaving many with
permanent brain damage.
- Pertussis (whooping cough) would kill thousands of infants.
Prevalence of polio (blue), measles (red), mumps (green),
and rubella (purple) in the US from 1950-2009, the black
lines indicate the introduction of a vaccine to protect
against each disease
Vaccine
Vaccine
Vaccine
Vaccines herd immunity anti vaccine movt
Types of Vaccines
1. Attenuated whole-agent vaccines
 Living but weakened microbes.
 Living microbes more closely mimic an actual infection.
 Lifelong immunity is often achieved without booster
immunizations (effectiveness rate of 95% is not unusual).
 Long term effectiveness probably occurs because the
attenuated microbe replicates in the body, increasing the
original dose and acting as a secondary (booster)
immunization.
 Example: MMR (measles mumps and rubella) and TB
 Risk: Weakened microbes can back-mutate to virulent
form
Types of Vaccines
2. Inactivated whole-agent vaccines
 Use microbes that have been killed, usually by formalin or
phenol.
 Examples of viruses: rabies, influenza, and Salk polio.
 Examples of bacteria: pneumococcal pneumonia and
cholera.
3. Toxoids
 Inactivated toxins
 Tetanus and diphtheria
Types of Vaccines
4. Subunit vaccines
 Use only antigenic fragments of a microorganism that
best stimulates the immune response.
 Acellular: a vaccine consisting of antigenic parts
(example- pertussis)
 Recombinant: uses recombinant DNA technology;
another microbes are programed to produce the
antigenic parts (example-hepatitis B).
Types of Vaccines
5. Conjugated Vaccine:
 A vaccine consisting of the desired antigen and other
proteins.
 Deals with poor immune response of children to vaccines
based on capsular polysaccharides (children typical to
respond to these antigens until 18-24 months).
 Polysaccharides are combined with proteins (diptheria
toxoid) which gives significant protection (2 months).
 Example: Haemophilus influenza type b
Types of Vaccines
6. Nucleic acid (DNA) vaccines
 Plasmid DNA injected into muscle results in the production
of the protein antigen encoded on the DNA
 Example: West Nile (for horses)
 Clinical trials underway in humans
 Many advantages for the less developed countries- gene
gun eliminate needles and syringes, requires no
refrigeration, and lower cost.
ANIMATION Vaccines: Types
Vaccines Used to Prevent Bacterial
Diseases
Disease Vaccine
Diphtheria Purified diphtheria toxoid
Meningococcal meningitis
Purified polysaccharide from
Neisseria meningitidis
Pertussis (whooping
cough)
Killed whole or acellular fragments of
Bordetella pertussis
Pneumococcal
pneumonia
Purified polysaccharide from 7
strains of Streptococcus pneumoniae
Tetanus Purified tetanus toxoid
Haemophilus influenza
type b meningitis
Polysaccharide from Haemophilus
influenzae type b conjugated with
protein to enhance effectiveness
Disease Vaccine
Influenza
Injected vaccine, inactivated virus
(nasally administered: attenuated
virus)
Measles Attenuated virus
Mumps Attenuated virus
Rubella Attenuated virus
Chickenpox Attenuated virus
Poliomyelitis Killed virus
Vaccines Used to Prevent Bacterial
Diseases
Disease Vaccine
Rabies Killed virus
Hepatitis B Antigenic fragments of virus
Hepatitis A Inactivated virus
Smallpox Live vaccinia virus
Herpes zoster Attenuated virus
Human papillomavirus Antigenic fragments of virus
Vaccines Used to Prevent Bacterial
Diseases
Adults
 Most adults don’t realize there are times when they, too,
need vaccines:
 At certain ages
 During pregnancy
 Before travel
 For occupational risks
 When they have certain medical conditions
Vaccines for Adults
• Td/Tdap
• Human Papillomavirus (HPV)
• Varicella
• Herpes Zoster
• Measles, Mumps and Rubella
• Influenza
• Pneumococcal
• Hepatitis A
• Hepatitis B
• Meningococcus
Vaccines herd immunity anti vaccine movt
Vaccines herd immunity anti vaccine movt
Vaccines herd immunity anti vaccine movt
Vaccines herd immunity anti vaccine movt
Vaccines herd immunity anti vaccine movt
Lecture prepared by
Mark Randa; Ph.D.
Herd Immunity
No one vaccinated…
Some of the population
vaccinated…
Most of the population vaccinated…
R0: basic reproduction number; this number represents how many people in an
unprotected population one infected person could pass the disease along to
Vaccines herd immunity anti vaccine movt
Lecture prepared by
Mark Randa; Ph.D.
Watch the Following Video (HAS PROFANITY)
Penn & Teller's Bullshit – Vaccinations
https://www.youtube.com/watch?v=lhk7-5eBCrs
Anti-Vaccine Movement
The cause of the anti-vaccine
movement…
 Many anti-vaccine parents mistakenly think that the scientific jury is out
 In reality, there are no lingering questions, and it is important to recognize
that deviousness was involved in the mere suggestion of a link.
 Not only was there never any evidence to support the notion that the
vaccination caused autism, the research that supposedly supported this
link was in fact wholly fabricated.
 Unfortunately, the facts of this fraud get forgotten.
 Discussions occasionally mention that the research has been
"discredited," but that description is in fact a massive understatement
The journal article…
 In 1998, a British surgeon, Dr. Andrew Wakefield, published a
paper in The Lancet with 12 co-authors, reporting that the
measles, mumps and rubella (MMR) vaccine was associated with
"regressive autism" and colitis in 12 children.
 The paper ignited and propelled anti-vaccine campaigns
throughout the world.
 A journalist, Brian Deer, began investigating these children's
medical records and found that the paper's data were largely
fabricated.
The truth about the children…
 Of the 11 children reported as having colitis, only 3 did, according to
the medical records.
 Wakefield claimed that all 12 children were "previously normal," while
in fact 5 had developmental problems before receiving the vaccine.
 Of the 9 with regressive autism, 3 had no autism at all.
 Of the 8 children who reportedly developed symptoms only days after
receiving the vaccine -- which would be important in convincing a
court that the vaccine was to blame -- 6 took much longer, and for 2
it is not clear.
 While Wakefield claimed 6 of the 12 children had all three features --
autism, colitis, and development of symptoms days after the
vaccination, in fact, 0 did.
And it gets worse…
 It turns out that in 1994, a British-based anti-vaccine group,
JABS, claimed that the MMR vaccine causes brain damage
and other problems, and hired a lawyer, Richard Barr, who
then retained Wakefield, a surgeon.
 Barr began sending Wakefield patients from the group, and
paid Wakefield over $700,000.
 Most of the children's parents were associated with the anti-
vaccine group -- hardly an unbiased group.
What happened…
 After Deer's investigation, Wakefield at first claimed
innocence, saying that the other authors had written the
final paper. In fact, he had written the paper, and the other
authors had signed on.
 The General Medical Council began an investigation,
lasting 217 days, and concluded that Wakefield had
falsified the research.
 The Lancet later retracted the paper, but only 12 years
after publishing it.
Vaccines herd immunity anti vaccine movt
Where is he now…
 Wakefield's medical ambitions having been stifled, he is now
appearing as a speaker at conspiracy crank events, as well as
being the patron saint of anti-vaxxers everywhere.
 In January 2012, Wakefield filed a defamation suit against Brian
Deer, the British Medical Journal and the BMJ's editor Fiona
Godlee personally.
 The BMJ Group has noted that they stand by their article (and
pointedly call him "Mr. Wakefield" throughout the press release to
this effect). This suit was dismissed on jurisdictional grounds.

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Vaccines herd immunity anti vaccine movt

  • 1. Lecture prepared by Mark Randa; Ph.D. Vaccines
  • 2. History of Vaccines  Variolation: Inoculation of smallpox into skin (18th century). Mortality rate of 1% for variolation; 50% mortality rate from smallpox.  Vaccine: a suspension of organisms or fractions of organisms that is used to induced immunity  Vaccination: - Inoculation of cowpox virus into skin (Jenner) - Inoculation with rabies virus (Pasteur)  Herd Immunity
  • 3. What is a Vaccine ?  A vaccine is the deliberate stimulation of adaptive immunity. - Work by mimicking what happens during natural infection without causing illness. - Use altered versions of viruses or bacteria to trigger an immune response. - Are the most effective means of controlling infectious diseases. - Not only protect those who get them, but they also help keep diseases at bay in the community; this is called herd immunity
  • 4. How Do Vaccines Work?  During natural infection: - The immune system recognizes a pathogen as foreign and makes an immune response to it. When a pathogen causes an immune response, it is known as an antigen. - Unfortunately, while the immune response is gaining strength, the person is likely to be ill as the struggle between the pathogen and the immune response is decided. - One part of the immune response creates antibodies; this is known as the antibody-mediated or humoral immune response. - Antibodies are specific to antigens and have the ability to remember them, so that if the same (or a very similar) antigen tries to infect the person again, the immune response will be stronger and faster thereby protecting the person from infection —and illness.
  • 5. How Do Vaccines Work ?  With a vaccine: - The immune system recognizes the vaccine as foreign and makes an immune response to it. The vaccine serves as an antigen in that it causes the immune system to respond to it. - One part of the immune response creates antibodies; this is known as the antibody-mediated or humoral immune response. - Antibodies are specific to the vaccine and have the ability to remember it, so that if the vaccine or a very similar antigen is seen again, the immune response will be stronger and faster thereby protecting the person from infection. - The main difference between a vaccine and natural infection is that the person does not become ill while the immune system is responding to the vaccine.
  • 6. Vaccines changed medicine  Vaccines have literally transformed the landscape of medicine over the course of the 20th century. Before vaccines, parents in the United States could expect that every year: - Polio would paralyze 10,000 children. - Rubella (German measles) would cause birth defects and mental retardation in as many as 20,000 newborns. - Measles would infect about 4 million children, killing 3,000. - Diphtheria would be one of the most common causes of death in school-aged children. - A bacterium called Haemophilus influenzae type b (Hib) would cause meningitis in 15,000 children, leaving many with permanent brain damage. - Pertussis (whooping cough) would kill thousands of infants.
  • 7. Prevalence of polio (blue), measles (red), mumps (green), and rubella (purple) in the US from 1950-2009, the black lines indicate the introduction of a vaccine to protect against each disease Vaccine Vaccine Vaccine
  • 9. Types of Vaccines 1. Attenuated whole-agent vaccines  Living but weakened microbes.  Living microbes more closely mimic an actual infection.  Lifelong immunity is often achieved without booster immunizations (effectiveness rate of 95% is not unusual).  Long term effectiveness probably occurs because the attenuated microbe replicates in the body, increasing the original dose and acting as a secondary (booster) immunization.  Example: MMR (measles mumps and rubella) and TB  Risk: Weakened microbes can back-mutate to virulent form
  • 10. Types of Vaccines 2. Inactivated whole-agent vaccines  Use microbes that have been killed, usually by formalin or phenol.  Examples of viruses: rabies, influenza, and Salk polio.  Examples of bacteria: pneumococcal pneumonia and cholera. 3. Toxoids  Inactivated toxins  Tetanus and diphtheria
  • 11. Types of Vaccines 4. Subunit vaccines  Use only antigenic fragments of a microorganism that best stimulates the immune response.  Acellular: a vaccine consisting of antigenic parts (example- pertussis)  Recombinant: uses recombinant DNA technology; another microbes are programed to produce the antigenic parts (example-hepatitis B).
  • 12. Types of Vaccines 5. Conjugated Vaccine:  A vaccine consisting of the desired antigen and other proteins.  Deals with poor immune response of children to vaccines based on capsular polysaccharides (children typical to respond to these antigens until 18-24 months).  Polysaccharides are combined with proteins (diptheria toxoid) which gives significant protection (2 months).  Example: Haemophilus influenza type b
  • 13. Types of Vaccines 6. Nucleic acid (DNA) vaccines  Plasmid DNA injected into muscle results in the production of the protein antigen encoded on the DNA  Example: West Nile (for horses)  Clinical trials underway in humans  Many advantages for the less developed countries- gene gun eliminate needles and syringes, requires no refrigeration, and lower cost. ANIMATION Vaccines: Types
  • 14. Vaccines Used to Prevent Bacterial Diseases Disease Vaccine Diphtheria Purified diphtheria toxoid Meningococcal meningitis Purified polysaccharide from Neisseria meningitidis Pertussis (whooping cough) Killed whole or acellular fragments of Bordetella pertussis Pneumococcal pneumonia Purified polysaccharide from 7 strains of Streptococcus pneumoniae Tetanus Purified tetanus toxoid Haemophilus influenza type b meningitis Polysaccharide from Haemophilus influenzae type b conjugated with protein to enhance effectiveness
  • 15. Disease Vaccine Influenza Injected vaccine, inactivated virus (nasally administered: attenuated virus) Measles Attenuated virus Mumps Attenuated virus Rubella Attenuated virus Chickenpox Attenuated virus Poliomyelitis Killed virus Vaccines Used to Prevent Bacterial Diseases
  • 16. Disease Vaccine Rabies Killed virus Hepatitis B Antigenic fragments of virus Hepatitis A Inactivated virus Smallpox Live vaccinia virus Herpes zoster Attenuated virus Human papillomavirus Antigenic fragments of virus Vaccines Used to Prevent Bacterial Diseases
  • 17. Adults  Most adults don’t realize there are times when they, too, need vaccines:  At certain ages  During pregnancy  Before travel  For occupational risks  When they have certain medical conditions
  • 18. Vaccines for Adults • Td/Tdap • Human Papillomavirus (HPV) • Varicella • Herpes Zoster • Measles, Mumps and Rubella • Influenza • Pneumococcal • Hepatitis A • Hepatitis B • Meningococcus
  • 24. Lecture prepared by Mark Randa; Ph.D. Herd Immunity
  • 26. Some of the population vaccinated…
  • 27. Most of the population vaccinated…
  • 28. R0: basic reproduction number; this number represents how many people in an unprotected population one infected person could pass the disease along to
  • 30. Lecture prepared by Mark Randa; Ph.D. Watch the Following Video (HAS PROFANITY) Penn & Teller's Bullshit – Vaccinations https://www.youtube.com/watch?v=lhk7-5eBCrs Anti-Vaccine Movement
  • 31. The cause of the anti-vaccine movement…  Many anti-vaccine parents mistakenly think that the scientific jury is out  In reality, there are no lingering questions, and it is important to recognize that deviousness was involved in the mere suggestion of a link.  Not only was there never any evidence to support the notion that the vaccination caused autism, the research that supposedly supported this link was in fact wholly fabricated.  Unfortunately, the facts of this fraud get forgotten.  Discussions occasionally mention that the research has been "discredited," but that description is in fact a massive understatement
  • 32. The journal article…  In 1998, a British surgeon, Dr. Andrew Wakefield, published a paper in The Lancet with 12 co-authors, reporting that the measles, mumps and rubella (MMR) vaccine was associated with "regressive autism" and colitis in 12 children.  The paper ignited and propelled anti-vaccine campaigns throughout the world.  A journalist, Brian Deer, began investigating these children's medical records and found that the paper's data were largely fabricated.
  • 33. The truth about the children…  Of the 11 children reported as having colitis, only 3 did, according to the medical records.  Wakefield claimed that all 12 children were "previously normal," while in fact 5 had developmental problems before receiving the vaccine.  Of the 9 with regressive autism, 3 had no autism at all.  Of the 8 children who reportedly developed symptoms only days after receiving the vaccine -- which would be important in convincing a court that the vaccine was to blame -- 6 took much longer, and for 2 it is not clear.  While Wakefield claimed 6 of the 12 children had all three features -- autism, colitis, and development of symptoms days after the vaccination, in fact, 0 did.
  • 34. And it gets worse…  It turns out that in 1994, a British-based anti-vaccine group, JABS, claimed that the MMR vaccine causes brain damage and other problems, and hired a lawyer, Richard Barr, who then retained Wakefield, a surgeon.  Barr began sending Wakefield patients from the group, and paid Wakefield over $700,000.  Most of the children's parents were associated with the anti- vaccine group -- hardly an unbiased group.
  • 35. What happened…  After Deer's investigation, Wakefield at first claimed innocence, saying that the other authors had written the final paper. In fact, he had written the paper, and the other authors had signed on.  The General Medical Council began an investigation, lasting 217 days, and concluded that Wakefield had falsified the research.  The Lancet later retracted the paper, but only 12 years after publishing it.
  • 37. Where is he now…  Wakefield's medical ambitions having been stifled, he is now appearing as a speaker at conspiracy crank events, as well as being the patron saint of anti-vaxxers everywhere.  In January 2012, Wakefield filed a defamation suit against Brian Deer, the British Medical Journal and the BMJ's editor Fiona Godlee personally.  The BMJ Group has noted that they stand by their article (and pointedly call him "Mr. Wakefield" throughout the press release to this effect). This suit was dismissed on jurisdictional grounds.