Immunization 2 Milestones in immunization u 3000 BC

Immunization 2

Milestones in immunization u 3000 BC u Evidence of sniffing powdered small pox crust in Egypt u 2000 BC u Sniffing of small pox crust in China u 1500 BC u Turks introduce variolation u 1700 AD u. Introduction of variolation in England later in the US 3

Introduction of variolation The wife of the British Ambassador in Turkey, in March 1717 wrote, following the variolation of her son, to a friend in England: “The small pox, so fatal, so general amongst us, is entirely harmless here by the invention of ingrafting…. I am patriot enough to bring this invention into fashion in England. 4

Milestones in immunization u 1780 AD u Edward Jenner discovers small pox vaccine 5

Edward Jenner Discovery of small pox vaccine 6

Edward Jenner Among patients awaiting small pox vaccination 7

Modern era of the vaccine 1885 Rabies vaccine (Pasteur) 1920 s Diphtheria and Tetanus 1934 Pertussis 1955 Salk polio 8

Modern era of the vaccine 1960 s 1985 Mumps measles and rubella virus Sabin polio Haemoph ilus 1990 s Hepatitis and varicella 9

Pre- & post-vaccine incidence of common preventable diseases 10

Different modes of acquiring immunity Immunity Natural Acquired resistance Passive Active Artificial Natural 11

Passive Immunity Natural Placental transfer of Ig. G Colostral transfer of Ig. A Artificial Antibodies or immunoglobulins Immune cells 12

Passive Immunization disease antibody source indication diphtheria, tetanus human, horse prophylaxis, therapy vericella zoster human immunodeficiencies gangrene, botulism, snake bite, scorpion sting horse post-exposure rabies, human post-exposure hypogammaglobulinemia human prophylaxis 13

Advantages and Disadvantages of Passive Immunization Advantages immediate protection Disadvantages no long term protection serum sickness risk of hepatitis and Aidsvs. graft host disease (cell graft only) 14

Active Immunization Natural exposure to sub-clinical infections Artificial Attenuat ed organisms killed organisms subcellular fragments tox ins oth ers 15

Live Attenuated Vaccines polio* not used in std. schedule hepatitis A measles, mumps & rubella not required inyellow SC fever Military and travelers Varicella zoster tuberculosis children with no history of chicken pox not used in this country 16

Killed Whole-Organism Vaccines p olio influenza elderly and at risk rabies post exposure Q fever population at risk typhoid, cholera, plague epidemics and pertussis travelers replaced by the acellular vaccine 17

Microbial Fragment Vaccines Bordetella. Pertussis virulence factor Haemophilus protein influenzae B protein conjugated Streptococcus polysaccharide pneumoniae Polysaccharide mixture Neisseria meningitidis polysaccharide 18

Microbial Fragment Vaccines Clostridium tetani (tetanus) inactivated toxin (toxoid) Corynebacterium diphtheriae inactivated toxin (toxoid) Vibrio cholerae toxin subunits Hepatitis B virus cloned in yeast 19

Modification of Toxin to Toxoid Toxin Toxoid chemical modification toxin moiety antigenic determinants 20

Future Vaccines anti-Idiotype Vaccine DNA Immuno-dominant peptide 21

Recommended Childhood Immunization Schedule 22

Adverse Events Occurring Within 48 Hours DTP of Vaccination Event Frequency local redness, swelling, pain systemic: Mild/moderate fever, drowsiness, fretfulness vomiting anorexia systemic: more serious persistent crying, fever collapse, convulsions acute encephalopathy permanent neurological deficit 1 in 2 -3 doses 1 in 5 -15 doses 1 in 100 -300 doses 1 in 1750 doses 1 in 100, 000 doses 1 in 300, 000 doses 23

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