VACCINES

By:
R.Ph Dr. Saba Inayat Ali
Lecturer
Dow College of Pharmacy

23-09-2014
 LEARNING OBJECTIVES
At the end of this topic, students will be able to:
• Define immunity
• Describe different types of immunity
• Differentiate between active and passive immunity
• Define vaccines
• Describe different types of vaccines with examples
• Understand the current childhood immunization
Schedule
 THE IMMUNE SYSTEM

INNATE ACQUIRED
• PHYSICAL BARRIERS
• NATURAL KILLER
CELLS CELL-MEDIATED HUMORAL
• MACROPHAGES
 T-CELLS
(HELPER T CELLS  B-CELLS
AND
CYTOTOXIC T  ANTIBODIES
CELLS) (MADE BY PLASMA CELLS)
CLASSIFICATION OF
ACTIVE PASSIVE
 Differences between active and passive immunity
Active immunity Passive immunity
Antibodies are produce by Antibodies are obtained
our own bodies from outside sources
(outside of our body)
do not give us immediate Antibodies give us
immunity because our body immediate immunity
needs time to produce them

Will last for long period of Wont last for long period of
time time

Immunological memory No immunological memory

present
VACCINES
• Difference between
Immunization and
vaccination?
• History
 History
• Edward jenner, a young british physician, in
1798, deliberately inoculated people with cow
pox in an attempt to prevent small pox.
• When a young milkmaid informed jenner that
she couldn’t get small pox because she
already had been sick from cow pox- a much
milder disease-
• he decided to put the girl’s story to the test.
 History
• First Jenner collected scrapings from cow pox
blisters. Then he inoculated a healthy 8 year
old volunteer with the cow pox material by
scratching the person’s arm with a pox-
contaminated needle.
 History
• The search turned into a raised bump. In a few
days, the volunteer became mildly sick but
recovered and never again contracted either
cow pox or small pox.
• The process was called vaccination, from the
latin word vacca, meaning cow. Pasteur gave
it this name in honor of Jenner’s work.
 VACCINES
• A vaccine is a suspension of microorganisms
or fractions of organisms that is used to
induce immunity
 VACCINE
• A vaccine typically contains an agent that resembles a
disease-causing microorganism, and is often made
from weakened or killed forms of the microbe or its
toxins.
• The agent stimulates the body's immune system to
recognize the agent as foreign, destroy it, and
"remember" it, so that the immune system can more
easily recognize and destroy any of these
microorganisms that it later encounters.
• Small pox has been eradicated worldwide by the use of
vaccine.
24-09-2014
 Types of Vaccines
• There are numerous types of vaccines.
• Each different type of vaccine has its own
unique properties.
• Their function, however, is the same, to
establish immunity against a particular
pathogen.
 Attenuated whole agent vaccines
• These vaccines consist of live, but weakened,
viruses or bacteria.
• These organisms have been altered, either
genetically or chemically, in a way that they
are not pathogenic.
• Measles, mumps, rubella, chickenpox
 Inactivated Whole agent vaccines
• This vaccine consist of the actual pathogen,
however, it has been killed, either by a heat
treatment or chemically.

• Rabies, influenza, Salk polio vaccine

 Toxoids

• Toxoids are inactivated toxins.

• Toxoids are vaccines which consist of
exotoxins that have been inactivated, either
by heat or chemicals.
• Some examples are tetanus and diphtheria
toxoid
 Subunit vaccine
• Proteins, carbohydrates, and lipids, that are found on
the surface of pathogens, are isolated and used as a
vaccine.
• An example of surface molecules used as a vaccine
are hepatitis B surface antigens.
 Hepatitis B Virus

VIRION

SPHERE

FILAMENT
 Conjugated vaccines
• Polysacchrides are combined with proteins
such as diphtheria toxoid
• Used to deal with poor immune response of
children to vaccines based on capsular
polysacchride
• Haemophilus influenza type B
 Adjuvants
• An adjuvant is a
chemical substance that
can be added to a
vaccine in order to
enhance the immune
response to the
vaccine.
• alum
 Boosters
• For most vaccines, the
immunity against a
particular pathogen has a
tendency to wear off over
time.
• In this case, a periodic
“booster” administration
must be given in order to
strengthen and lengthen
the duration of immunity.
 Routes of Administration

• There are three different routes of

administration:
• Intradermal administration.
intramuscular, and subcutaneous.
• Oral administration.
• Intranasal administration
 IMMUNIZATION SCHEDULE

Months Vaccines
Birth BCG + OPV-1 + HBV-1
1 ½ months OPV-2 + HBV-2 + DPT-1 + Hib-1
2 months PCV-1
2 ½ months OPV-3 + DPT-2 + Hib-2 + ROTARIX-1
3 ½ months OPV-4 + DPT-3 + Hib-3
4 months PCV-2 + ROTARIX-2
6 months HBV-3 + PCV-3
9 months MEASLES
12 months MMR-1 + VARICELLA-1
15 months Hib-4 + PCV-4
18 months HEPATITIS A-1 + DPT-4 + OPV-5
24 months HEPATITIS A-2 + TYPHOID-1
5 years OPV-6 + DPT-5 + TYPHOID-2 + MMR-2 +
VARICELLA-2
12 years DT
 BCG VACCINE

• Given at birth
• Against Tuberculosis in infants
• Bacillus of Calmette and Guerin
• One dose of 0.05ml
• It is usually injected in the top layer of skin of
the upper left arm
Needle position for injection of BCG vaccine
(intradermal)
 OPV
• Oral polio vaccine
• Contains three live attenuated strains of virus
• Trivalent OPV
• Sabin vaccine
 HBV
• Hepatitis B virus vaccine
• 3 doses are given each
of 0.5 ml
• Hepatitis B vaccine is
injected in the muscle
of the upper thigh.
 DPT vaccine
• Diphtheria-pertussis-tetanus (DPT) vaccine is
made from:

– diphtheria toxoid;
– pertussis vaccine;
– tetanus toxoid.
• TIG
• DPT is injected into the muscle in the outer
part of the thigh.
• Usually 0.5ml each dose
• A child may have fever the evening after
receiving DPT vaccine. The fever should
disappear within a day.
 Hib
• Haemophilus influenza type B
• Hib-caused meningitis occurs mostly in children
under age 4, especially at about 6 months,
when antibody protection provided by the
mother weakens.
• The incidence is decreasing because of the Hib
vaccine, which was introduced in 1988. H.
influenzae meningitis has accounted for most
of the cases of reported bacterial meningitis
(45%), with a mortality rate of about 6%.
• Infants should receive four total doses of the
HiB vaccine.
• meningitis
 PCV
• Pneumococcal conjugate vaccine
• PCV immunizations are given as a series of
four injections starting at 2 months of age and
following at 4 months, 6 months, and 12 to 15
months.
• Pneumonia, blood infections and bacterial
meningitis
 ROTARIX VACCINE
• Rotavirus vaccine
• 2 doses
• 1 ml given by mouth
 MMR
• The optimum age for
the first dose is 12-15
months
• A booster dose should
be given at age 5 years.

*Congenital rubella syndrome ( Tortora, Pg= 628)

 Congenital rubella syndrome
• The seriousness of rubella was not
appreciated until 1941, when certain severe
birth defects were associated with maternal
infection during the first trimester (3 months)
of pregnancy, a condition called congenital
rubella syndrome.
 Congenital rubella syndrome
• If a pregnant woman contracts the disease
during this time, there is about a 35%
incidence of serious fetal damage, including
deafness, eye cataracts, heart defects, mental
retardation, and death.
• Some 15% of babies with congenital rubella
syndrome die during their first year.
 Congenital rubella syndrome
• It is therefore important to identify women of
childbearing age who are not immune to
rubella. In some states, the blood test
required for a marriage license includes a test
for rubella antibodies.
 Hepatitis A
• 2 doses
• 18 months
• 24 months
• Deltoid muscle
 Typhoid vaccine
• There are two types of typhoid vaccines.
• One vaccine contains killed Salmonella typhi bacteria.
– This vaccine is administered through a shot.
– This typhoid vaccine should not be given to children
younger than 2 years of age.

• The other vaccine contains a live but weakened strain of the

Salmonella bacteria that causes typhoid fever.
– This typhoid vaccine is taken by mouth.
– This typhoid vaccine should not be given to children
younger than 6 years of age.
 VARICELLA
• Two doses are always recommended.
• In the first case a first dose is administered at
12 to 15 months
• second dose at age 4-6 years.
• For people older than 13 the two doses are
administered 4 to 8 weeks apart.
 REFERENCE
• AN INTRODUCTION TO MICROBIOLOGY BY
TORTORA, 9th edition
– Ch # 17 (pg= 520-521)
– Ch # 18 (pg= 528-531)

• Fundamentals of Microbiology by Alcamo, 6th

edition
– Ch # 19 (pg= 608-616)