Immunization. ppt

Community medicine

1. Dr. Susan Peter Lado
Family Medicine Physician

5. > 12 million children under 5 yr die every year
3 million < 1 wk
2 million of these deaths could be prevented by
basic 6 vaccines
1
st
vaccine 200 yr ago- smallpox
Today more than 60 vaccines

6. Vaccination:
Administration of any
vaccine or toxoid for
prevention of disease

7. Immunization:
The process of inducing immunity
artificially by either vaccination
(active immunization) or
administration of antibodies (passive
immunization)
Passive immunization occurs naturally
through transplacental transmission
of antibodies- first 4-6 months of life

8. Vaccine: preparation of proteins,
polysaccharides, or nucleic acids of pathogenic
organisms
Toxoid: modified bacterial toxin made non-
toxic but capable of stimulating immunity
Immunoglobulin: antibody-containing
solution prepared from large pools of human
plasma

9. Antitoxin: antibody derived from
humans or animals after
stimulation with specific antigens

10. Most vaccines require a temperature of 2°C-
8°C- must not be freezed
OPV must be stored at < 0°C
Varicella virus vaccine must be stored at -15°C
or lower

11. Launched in 1974 by WHO

12. Age Age Vaccine Vaccine
Birth Birth BCGBCG OPV0OPV0
6 weeks6 weeks Penta 1Penta 1 OPV1OPV1
10 weeks10 weeksPenta 2Penta 2 OPV2OPV2
14 weeks14 weeksPenta 3Penta 3 OPV3OPV3
9 months9 monthsMeasles (yellow Measles (yellow
fever)fever)

13. EPI plus: 6 vaccines+ HBV+ yellow fever v+ vit
A+ iodine
Immunization is one of the most cost-effective
public health interventions
National immunization days NID.

17. OPV or IPV
Oral polio vaccine (Sabin)
Live-attenuated- 3 serotypes
Dose: 2 drops orally
Enhances intestinal immunity
Eradicates wild polio virus

19. Inactivated polio vaccine (Salk)
Inactivated injectable vaccine
OPVOPV IPVIPV
Cheap Cheap Costy 5 timesCosty 5 times
Easy Easy Painful Painful
Gut immunityGut immunity NoNo
Mass immunization Mass immunization
(herd immunity(herd immunity
Individual Individual

20. Risk of paralysis: 2 in every 5 million doses of
OPV
Contraindications:
HIV infection
Immunodeficiency, tumours, drugs
Family member with immunodeficiency
Precautions: pregnancy

21. Live-attenuated
BCG→ bacille Calmett-Guerin
Intrademal injection at birth or any time thereafter
50-80% effective in preventing disseminated TB &
meningitis
Less effective in preventing pulm TB

22. Dose 0.05 ml
Contraindications: immunodeficiency
Side effects:
1.Local ulceration & lymphadenitis 0.1-1%
2.Immunodeficient individuals may develop
disseminated BCG infection

30. Live-attenuated
Injectable- subcutaneous
EPI→ 9 months
12-15 months in low endemic areas
6 & 9 months at high endemic areas
The least coverage of the EPI vaccines

31. Contraindications:
Anaphylaxis
Pregnancy
Immunodeficiency
Untreated tuberculosis
Precautions:
◦Severe intercurrent illness
◦Personal or family history of convulsions
May be combined with rubella & mumps in MMR

32. Part of triple vaccine DPT or DT or dT
Toxoid given as IM injection
Dose 0.5 ml
Given at anterior lateral thigh in infants
(gluteus intermedius)
Should be boosted every 10 years for life
The higher potency dose DT is used for
children up to 6 years of age

33. The less potency dose dT is used > 7 years
dT less amount of toxoid to decrease local
reaction
Side effects: local reaction
No contraindications

34. Neonatal tetanus
3Cs: clean hands, clean delivery surface, clean
cord cutting & care
80% of neonatal tetanus occur in only 12
countries: Ethiopia, Ghana, Nepal, Somalia
Women of child bearing age should be
immunized with at least 2 boosters
Non-immunized→ 5 doses

35. Two vaccines
Cellular as in DPT
Acellular as in DaPT
DaPT has ↓ side effects
Pertussis vaccine is not given after 7 years of age
because
◦↑ of side effects & local reaction
◦Pertussis is mild disease in this age group

38. The commonest vaccine with severe side effects
Absolute contraindications:
1.Immediate anaphylactic shock
2.Encephalopathy within 7 days
Relative contraindications:
1.Convulsions within 3 days
2.Persistent, severe, inconsolable crying for ≥ 3hours
within 2 days

39. 3. Collapse or shock within 2 days
4. Fever ≥ 40° within 2 days
DT should be given instead

40. Complications of the disease:
1.Chronic hepatitis
2.Cirrhosis
3.Hepatocellular carcinoma
4.Fulminant hepatic failure
100 times more infectious than HIV
Second only to tobacco as a cause of cancer

41. Recommended by EPI
Has been introduced recently in S. Sudan
Recombinant DNA vaccine
Injectable IM
3 doses

42. Infants of mothers known to be HBsAg
positive should receive hepatitis B
immunoglobulin (HBIG) + vaccine

45. Live-attenuated
Single dose
Subcutaneous injection
0.5 ml
Immunity lasts for 30-35 yr probably for life.

46. Polysaccharide vaccine
Group A & C
Quadrivalent vaccine→ A,C,Y,W135
Group B is the most common during epidemics→
no vaccine
Not effective < 2 years of age

47. Indications :
1.During epidemics
2.Splenectomized patients & splenic dysfunction eg
sickle cell anaemia

49. Polysaccharide conjugate vaccine
Children < 18 months of age
3 doses
No contraindication
80-100% effective in protection against Hib
pneumonia & meningitis

55. Rubella & mumps vaccine:
◦Live attenuated in MMR
◦Single IM inj
◦12-15 months
Chickenpox vaccine: SHOW
◦Live attenuated
◦Single inj
◦1-12 years

56. Pneumoccocal vaccine:
◦Polysaccharide
◦Injectable
Respiratory syncytial virus RSV vaccine
Rota virus vaccine→ intussusception
Typhoid fever vaccine
◦Inactivated whole cell-3 inj- one month apart
◦Oral live-attenuated vaccine

57. Hepatitis A vaccine:
◦Inactivated vaccine
◦Oral drops
◦2-3 drops
Cholera vaccine:
◦Inactivated whole cell injectable vaccine
◦Partial protection for up to 4 months

58. Shigella vaccine
E coli vaccine
HIV vaccine
Malaria vaccine
Schistosomiasis vaccine
Dengue fever vaccine SHOW
Herpes simplex
Cervical cancer- human papillomavirus