lmmunlzauon

Dr. Yulia Iriani, dr., SpAK

Subbag lnfeksl & edlaLrl 1ropls lkA 8SMP-lkunS8l
reface
lnfecuous dlsease ! hlgh morbldlLy &
morLallLy
lmmunlzauon
Successfull (eq. Smallpox)
CosL-eecuve
revenung lnfecuous dlseases

reface
lnfecuous dlsease
revenuon beuer Lhan LreaLmenL
Lasler
Cheaper
More comforLable
More eecuve ln dlsease conLrolllng
ConLrolllng beuer Lhan LreaLmenL
vacclnauon lmpacL
!"#$%&'() +,)$-)$
!..(",/0 -"1 !..(",2-&'"
lmmunlLy agalnsL conLaglous dlsease ! prevenL
lndlvldu from lnfecuon
lmmunlLy
lnnaLe lmmunlLy
Acqulred lmmunlLy
Acuve lmmunlLy ! organlsm exposure, vacclne
asslve lmmunlLy ! Lemporary, maLernal Ab Lransmlsslon Lo
feLus, lg or anuLoxln
lmmunlzauon
uenlng Alms/Coals
!..$1,-/$ 3'-4: prevenuon of dlsease ln lndlvldual
or groups
8educlng dlseases prevalence (change dlsease
epldemlology)
54&.-/$ 3'-4: eradlcauon of dlsease
uenlng Alms/Coals
!"#$ &''()&*+6
benLuk laln darl proLeksl yang dlcapal melalul
lmunlsasl akuf populasl yang berlslko dalam
proporsl yang bermakna.
^ [umlah lndlvldu yang udak Lerkena & udak
dapaL menularkan suaLu penyaklL ! perllndugan
Lerhadap orang yang non lmun
uenlng Alms/Coals
8educlng vacclne prevenLable dlsease !
,#-$&.-/0): reducuon of Lhe worldwlde lncldence of lnfecuon by a
speclc agenL Lo zero as a resulL of dellberaLe eorLs
,1&'&)-/0): reducuon Lo zero, or Lo Lhe level aL whlch lL ls no
longer a publlc healLh problem, of Lhe lncldence of a specled dlsease,
or of lnfec-uon caused by a speclc agenL, ln a dened geographlc
area
20)*#01: reducuon of dlsease lncldence, prevalence, morbldlLy, or
morLallLy.
uenluon and Ceneral ConcepLs
3-..&)-/0)6
admlnlsLrauon of any vacclne or /'7',1 (lnacuvaLed Loxln) for
prevenuon of dlsease.
4''()&5-/0)6
89'%$)) '# ,"1(%,"3 ,..(",/0 -9&:%,-440 ;0 $,/<$9 =-%%,"-&'" >-%&=$
,..(",2-&'"? '9 -1.,",)/9-&'" '# -"&;'10 >8-)),=$ ,..(",2-&'"?@
6./7" &''()&5-/0)6
admlnlsLrauon of all parL of mlcroorganlsm or a modled producL of
LhaL mlcroorganlsm Lo sumulaLe lmmune sysLem Lo produce
anubodles and cellular lmmune responses LhaL proLecL agalnsL Lhe
lnfecuous agenL.
uenluon and Ceneral ConcepLs
8-99&7" &''()&5-/0)6
provldes Lemporary proLecuon Lhrough admlnlsLrauon of exogenously
produced anubody, such as lmmune globulln.
also occurs naLurally Lhrough LransplacenLal Lransmlsslon of anubodles
Lo a feLus ! provldes proLecuon agalnsL many lnfecuous dlseases for
Lhe rsL several monLhs of lnfanL's llfe.
uenluon and Ceneral ConcepLs
4''()&5&): 6:")*9:
vacclne: A preparauon of proLelns, polysaccharldes, or nuclelc aclds of
paLhogens LhaL are dellvered Lo Lhe lmmune sysLem as slngle enuues,
as parL of complex parucles, or by llve-auenuaLed agenLs or vecLors, Lo
lnduce speclc responses LhaL lnacuvaLe, desLroy, or suppress Lhe
paLhogen
1oxold: A modled bacLerlal Loxln LhaL has been made nonLoxlc buL
reLalns Lhe capaclLy Lo sumulaLe Lhe formauon of anuLoxln
uenluon and Ceneral ConcepLs
lmmune globullne: An anubody-conLalnlng soluuon derlved from
human blood obLalned by cold eLhanol fracuonauon of large pools of
plasma and used prlmarlly for Lhe malnLenance of lmmunlLy of
lmmunodeclenL persons or for passlve lmmunlzauon, avallable ln
lnLramuscular and lnLravenous preparauons
AnuLoxln: An anubody derlved from Lhe serum of humans or anlmals
aer sumulauon wlLh speclc anugens, used Lo provlde passlve
lmmunlLy

uenluon and Ceneral ConcepLs
ConsuLuenLs of vacclne:
reservauves, sLablllzers, anubloucs: ConsuLuenLs can lnhlblL or
prevenL bacLerlal growLh or sLablllze Lhe anugen. MaLerlals such as
mercurlals or anubloucs are used. Allerglc reacuons Lo any of Lhe
addluves may occur.
Ad[uvanLs: An alumlnum salL ls used ln some vacclnes Lo enhance Lhe
lmmune response (e.g., Loxolds, hepauus 8).
Suspendlng uld: SLerlle waLer, sallne, or more complex ulds derlved
from Lhe growlng medla or blologlc sysLem ln whlch Lhe agenL ls
produced (e.g., egg anugens, cell culLure lngredlenLs, serum proLelns).
1argeL ulseases
Disease
Type of
Organism
Incidence
(2000) Mode of Transmission Symptoms Complications
Diphtheria Gram-
positive
bacteria
1 Person-to-person direct
contact or contact with
airborne droplet usually
affects children under 15
years.
Sore throat, fever.
Characterized by formation of
yellow-white membranes on tonsils
and pharyngeal walls.
Potential respiratory
distress.
Haemophilus
influenzae b
Gram-
negative
bacteria
1,398
(invasive
disease)
Person-to-person
contact or droplet.
Bacteria may cause otitis media,
sinusitis, epiglottis and upper
respiratory infections.
Bacterial meningitis;
most cases of invasive
disease occur in
children 3 months to 3
years of age.
Hepatitis B Virus 8,036 Exposure to infected
blood or body fluids. In
children primarily
prenatally spread.
General flu-like symptoms (may be
asymptomatic). Liver may be
enlarged, dark urine, light stool,
jaundice. Symptoms last 4-6 weeks.
Chronic hepatitis;
cirrhosis; liver cancer.
Measles Virus 86 Person-to-person
contact or droplet.
Flu-like symptoms, high fever
(greater that 101), cough, and
conjunctivitis. Rash usually starts
on the face and spreads to the
body. Kopliks spots in the mouth
are bluish with very fine red spots.
Pneumonia and
encephalitis. Persons
allergic to eggs may
have severe reactions to
the vaccine.

Table. Vaccine Preventable DIseases
1argeL ulseases
Disease
Type of
Organism
Incidence
(2000) Mode of Transmission Symptoms Complications
Mumps Virus 338 Person-to person contact
or droplet. Communicable
6 days before to 9 days
after swelling. Most often
occurs in children.
Low-grade fever, headache,
earache, pain and swelling of
parotid glands (may be unilateral
or bilateral). Swelling lasts about
a week.
Infrequent complications
are encephalitis and
meningitis. Orchitis may
occur in males who
have reached puberty,
but sterility is rare.
Pertussis Gram-
negative
bacteria
7,867 Person-to person contact
or droplet. Very
contagious.
Characteristic cough is
nonproductive with quick
expiratory phase followed by
inspiratory "whoop." Small scleral
and conjunctival hemorrhages
can occur because of severe
coughing.
Infants younger than 1
year are severely
affected. Pneumonia,
seizures, and ear
infections may occur.
Pneumococcus Gram-
positive
bacteria
Not a
reportable
disease
Person-to-person, likely
by droplet contact; in
many persons are
colonized in the upper
respiratory tract.
Causes otitis media, sinusitis,
and invasive bacterial infections.
Pneumonia meningitis
Polio Virus 0 Direct contact of virus with
mouth.
Low-grade fever and sore throat
(most cases are asymptomatic).
Muscle weakness
progressing to paralysis
in 0.1-2% of cases. May
affect any muscle group
including limbs and
respiratory muscles.
Adults may develop
postpolio syndrome 30-
40 years after the
disease.

Table. Vaccine Preventable DIseases
1argeL ulseases
Disease
Type of
Organism
Incidence
(2000) Mode of Transmission Symptoms Complications
Rubella Virus 176 Person-to-person contact or
droplet. Communicable 4 days
before to 4 days after rash
appears. Highly contagious.
Mild in adults and young
children; macular rash on
scalp, trunk, and limbs lasting
1-3 days.
Severe complications in
early fetal
developmentmay
result in congenital
malformations and
death. Vaccine is live so
it must NOT be given to
pregnant women.
Tetanus Neurotoxin
produced by an
anaerobic,
Gram-positive
bacteria
35 Exposure of wound to the
bacterium. Deep-puncture
wounds are at greatest risk.
Neonatal tetanus results from
contamination of the umbilical
stump.
Severe generalized muscle
spasms.

Varicella Virus 27,382 Person-to-person contact or
contact with airborne droplets.
Very contagious.
Communicable 2 days before to
6 days after vesicles appear.
Primarily affects children.
Low-grade fever, listlessness.
Lesions appear within 2-4
days. Rash has three phases:
raised spots, fluid-filled
vesicles, and scabs. Rash
itches and is found over entire
body.
Grandparents and older
adults should avoid
caring for children
because they may
develop herpes zoster
(shingles).

Table. Vaccine Preventable DIseases
vacclne 1ypes
" BCG " OPV
" Measles
" MMR
" Varicella
" Yellow fever
" Difteria
" Tetanus
" Pertusis
" Cholera
" Meningococ
" Pneumococ
" Hib
" Typhoid Vi
" Influenza
" IPV " Rabies
" Hepatitis B
" Hepatitis A
Bacterial Vaccine Viral Vaccine
Vaksin sensitif
suhu panas
Vaksin sensitif
suhu dingin
Vaksin sensitif
suhu dingin
1ypes of vacclne
vacclne
!"#$%&'$()&*$+ or ,"--$+ /"012213&("4/4
lnacuvaLed producL
Speclc componenL
8ecomblnanL unA segmenL
1ypes of vacclne
!"#$ &'$()&*$+ #&00"($:
vlrus aLau bakLerl llar yang dllemahkan (auenuaLed) dl lab,
blasanya dengan pemblakan berulang-ulang
Mampu repllkasl & menlmbulkan kekebalan, udak
menyebabkan saklL
8espons lmun pe[amu ~ lnfeksl alamlah prlmer ! -"5$-2(3
"//)("*6
vacclne 1ypes
7(&08#&*$+ #&00"($9
8akLerl / vlrus dlblak ! dlbuaL udak akuf ("(&08#&*$+)
keseluruhan aLau fraksl vlrus / bakLerl
8asls vaksln fraksl: proLeln aLau pollsakarlda
! llfelong lmmunlLy (-) ! perlu boosLer secara berkala
vacclne 1ypes
7(&08#&*$+ #&00"($9
!enls:
Whole organlsm
urled proLeln aLau anugen pollsakarlda darl whole organlsm
urled anugen yang dlhasllkan darl geneucally alLered organlsm
Chemlcally modled anugen
vacclne 8ecomendauons
uevelopmenL of recomendauons and schedule for
vacclne admlnlsLrauon:
epldemlology of Lhe dlsease,
age-speclc morbldlLy and morLallLy,
vacclne lmmunogenlclLy,
rlsks of vacclne-relaLed adverse reacuons,
cosL eecuveness,
ages of recommended rouune healLh care vlslLs.
vacclne 8ecomendauons
Lach counLry has each own pollcles
lndonesla:
l (rogram engembangan lmunlsasl):
8CC, ollo, Pepauus 8, u1, Campak
luAl (lkaLan uokLer Anak lndonesla):
l (dlwa[lbkan)
non l (dlan[urkan)
vacclne 8ecomendauons
vacclne 8ecomendauons
vacclne 8ecomendauons