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Chap 107 - Immunization Principles & Vaccine Use
Chap 107 - Immunization Principles & Vaccine Use
I. Impact of Immunization – Resut of Vaccine VII. Adjuvant Potentiation (ex. Aluminum salt & carrier protein)
• Global Eradication of smallpox • Render soluble antigen into particulate one (para di
• Eliminated naturally transmitted poliomyelitis matunaw agad)
• Measles nearly 100% infectivity rate in prevaccination • Mobilize phagocyte to the site of antigen deposition
• Hib conjugate vaccine for infants eliminate invasive H. • Slow down release of Ag to prolong stimulation of immune
influenzae infection (pneumonia & meningitis) response
• Polyvalent pneumococcal vaccine present significant
impact against invasive pneumococci VIII. Immune Response
Primary response – characterize by early appearance of IgM
Definition: Vaccination vs Immunization Antibody(M-aaga), which has low affinity & nonspecific to Ag
• Vaccination – simply administration of vaccine (latent period of 7-10 days before immune response). Then the
“thymus dependent” antigens, CD4+ T helper lymphocytes
• Immunization – process of inducing or providing immunity which shift IgM to IgG (high affinity and more specific Ab) – if
Active Immunization – induction of immune defense person lack Major Histocompatibility Complex (MHC)
by administration of antigen (Ag) in apparent form determinants which is required for antigen presentation, there
would be no antibody shift to IgG (Primary Vaccine Failure)
Passive Immunity – provision of temporary protection
by administration of exogenous product of immunity – Secondary Response – heightened humoral & cell mediated
Antibody(Ab/Immunoglobulin(Ig) response in second exposure to antigen within 4-5 days (rapid)
depending on Immunologic memory characterized by marked E. Administration of Vaccine
proliferation of IgG Ab produced by B Lymphocyte &/or T effector • Minimized the risk of spreading the disease during
cell. Although level of vaccine-induced Ab decline over time administration (universal precaution ex handwashing,
(secondary vaccination failure) so that revaccination is needed aseptic/antiseptic)
(exeption is the pneumococcal polysaccharide vaccine which • Discourage of multiple injection – combination vaccines are
evoked immune response independent of T cell & is not created for single shot
enhanced by repeat administration) • Primary healthcare should ensure access of medical
service & educate about vaccine – for patient compliance
IX. Hypersensitivity Reaction – unanticipated over-stimulation
of immune system by vaccination XIV. Use of Vacine (recommended in 2003)
X. Mucosal Immunity – secretory IgA – efficient way to block • Routine administration in Infants, Children & Adults
the essential first step in pathogenesis (refer to Table 107-4, page717)
• Vaccine for Special Use (Refer to Table 107-5, page 718)
XI. Herd Immunity
Vaccination of individual give direct protection from infection of
• Schedule of Immunization (Refer to Figure 107-1 & 2,
individual which decrease the %susceptible persons within a page 719-720)
population. Therefore if prevalence of immunization is increase
in a population (Herd Immunity), infection will not circulate and A. Recording & reporting Requirement
the remaining small % of unvaccinated person is indirectly • Regulated by National Children Injury Act of 1986 (mod
protected (Herd Immunity Effect). 1995 & 2002) requiring all vaccine must be recorded
permanently by healthcare professional including the date
XII. Target Population & Timing of Immunization of administration, the manufacturer and lot number of
• Different age group differ in disease attack rate vaccine and name of the provider.
• Effectiveness of vaccine depends on variety of factors • Health provider should inform the parents the benefit and
(individual responsiveness, demographic feature of risk of vaccination and the importance of up-to-date
population at risk & the duration & character of response) immunization record.
• Vaccination program is much effective if applied to
B. Vaccine for routine Use
community than to an individual
Infants & Children – DtaP, IPV, MMR, Hib, HepB, Varicella,
• Target Population: susceptible individual
Pneumococcal conjugate vaccine; others: HepA – if there is risk
• Time of Immunization: early in life as is feasible of exposure or in case of travel to endemic area, Influenza
vaccine – children 6-24months of age, in Europe –
XIII. The Development of Vaccine meningococcal conjugate vaccine is routinely administer (sa
A. Biologic Impediments (Problems) philippines, pTB ata routine)
• Antigenic drift of Influenza virus which annually produce
new antigenic version of the virus which differ from the Adults (>18y/o) vaccine classified into 4 categories:
previous vaccine 1 - Routinely use for adult – ex. all adult completed the pediatric
• Many pneumococcal polysaccharide serotype which render series should be boosted with Td (adult form) every 10 years
some sero-specific pneumococcal vaccine ineffective. 2 - For high risk exposure (ex. Healthcare worker, student,
military personel) – ex. 2nd dose of MMR for high risk medical
B. Strategy of Vaccine Development practitioner
• Phase 1 – Studies of animal to identify protective antigen 3 - For person at high risk for severe outcomeof infection (ex.
Pregnant, elderly, with chronic systemic disease) – ex. Rubella-
• Phase 2 – Determination of how to present this antigen
susceptible pregnant women should be vaccinated as early as
effectively to the immune system possible in the postpartum period, Influenza vaccine to adult with
• Phase 3 – Assessment of safety & Immunogenecity of the chronic disease or >50 y/o, HepA with those risk of clotting
preparation in small an then large human population at disorder or liver disease
various age 4 – vaccine for household contacts of person in group 3 – ex.
• Phase 4 – Evaluation of safety & efficacy in the target HepB vaccine to household living with patient with Hepatitis B
population infection
XVI. Delivery of Vaccine - ensure that every child is fully ZPDM 2005
immunized by the time of school entry
Programs:
National Immunization Week – April
AFIX Program by CDC
A-ssessment of coverage
F-eedback of diagnostic investigation
I-ncentive & Rapport
X-eXchange of information among provider