A Primer on Vaccines

A vaccine is a biological suspension of weakened or killed pathogens or their

components. Vaccines can be delivered as a nasal spray, orally, or by injection.
The goal of administering vaccines, vaccination, is to duce artificially acquired,
active immunity to a specific disease.
The purpose of vaccine is to stimulate active immunity and create an immune
memory so that exposure to the active disease microorganism will stimulate an
already primed immune system to fight the disease.
CHARACTERISTICS OF VACCINES
2 types:
Live attenuated vaccines (weakened)
Nonreplicating vaccines
Newer synthetic vaccines use subunit vaccines, conjugate vaccines, and naked DNA
vaccines. Subunit vaccines, consisting of components of the pathogens are
additives called, adjuvants which amplify the immune response.
2 adjuvants licensed for clinical use are Aluminum salt-based called ALUM and Oilbased substance called MF59.
HOST RESPONSE TO VACCINATION
The earliest host response to vaccination is called the innate immune response. This
response is an evolutionary ancient system of host defense that occurs within
minutes or hours after vaccination.
HISTORY OF VACCINES
According to the World Health Organization (WHO), immunization is one of the
greatest breakthroughs in medical science. This practice saves 3 million lives a year.
Vaccines have reduced some preventable infectious diseases to an all-time low; few
people now experience the devastating effects of measles, pertussis, and other
infectious diseases.
begins as early as 1000BCE, when the Chinese used smallpox inoculation or
variolation
By the 18th century, the practice of variolation became known to Europeans
and Americans
In 1796, Edward Jenner, an English physician, used cowpox scabs to create
immunity to smallpox
Louis Pasteur in 1879, developed first vaccine for chicken cholera
In 1885, Pasteur developed a rabies vaccine.
APPLICATION OF VACCINES
Widespread vaccination programs against contagious infectious diseases now have
a positive influence worldwide.
In 1721, Cotton Mather, a Boston minister, encouraged smallpox variolation
as a preventive step subsequent to the Boston smallpox epidemic.
In 1910, Sir William Osler expressed his frustration with the antivaccinationist
movement
A new vaccine was introduced in the 18th century, the antivaccine movement
receded between the 1940s and the early 1980s. Three trends promoted a positive
attitude toward vaccines:
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A boom in scientific discovery and the production of vaccines

A desire to protect children from significant outbreaks of infectious diseases,
including polio, measles, mumps, rubella, and pertussis (whooping cough)
An increase in the birth rate among more educated and affluent parents, who
accepted the use of vaccines

VACCINE APPROVAL
Safety Issues
The safety of vaccines is a controversial public health issue because vaccines are in
a unique niche in the marketplace. No vaccine is totally effectibe or 100% safe.
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In 1986, Congress enacted the National Childhood Vaccine Injury Act (NCVIA)
to establish a no fault compensation system for children who were harmed by
adverse events.
Vaccine Adverse Events Reporting System (VAERS) and the Clinical
Immunization Safety Assessment Network, are essential to ensure tracking of
actual but rare adverse events that may be related to vaccination.
In 2011, the U.S. Supreme Court ruled that vaccine makers are immune from
lawsuits alleging that the design of a vaccine is defective.

A U.S. Food and Drug Administration (FDA) approved vaccine must meet specific
requirements, as follows:
1. Produce protective immunity with only minimal side effects
2. Be immunogenic enough
3. Be stable during its shelf life
Vaccine development is an important focus of research related to acquired
immunodefieciency syndrome (AIDS) , malaria and other devastating diseases.
CONCERNS ABOUT VACCINES
In the past 20 years, the number of recommended pediatric vaccines has increased
dramatically, despite unproven theories alleging connections between vaccines and
illnesses, including autism, diabetes, and multiple sclerosis.
REPRESENTATIVE VACCINES
HIV-AIDS
The goal of an effective HIV vaccine is to induce a response in the recipient that is
unnatural immunity. The problem with HIV vaccine candidates is that although these
vaccines can be modestly protective, they generally do not induce neutralizing
antibodies nor reactive cytotoxic T cell responses against HIV.
The status of HIV vaccines to date is a follows:
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There are no proven effective therapeutic or preventive HIV vaccines

There is a lack of knowledge related to the ability of a vaccine to induce HIV
specific immune responses that are effective in preventing or treating HIV
infection
Therapeutic HIV vaccine research is still in its early stages

VACCINE DEVELOPMENT
The goal producing HIV vaccines is to destroy HIV or keep the virus in check so that
it causes no further damage. An ideal vaccine would stop progressibe
immunodeficiency and restore the immune system to a healthy state.
The requirement for a preventive HIV vaccine are to generate humoral and cellular
immunity against HIV in the host before exposure to the virus.
3 types of HIV vaccines:
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Preventive or prophylactic vaccines to protect individuals from HIV infection

Therapeutic vaccines to prevent HIV-infected patiens frin progressing to AIDS
Perinatal vaccines for administration to HIV infected pregnant women to
prevent transmission of HIV to the fetus

Challenges associated with HIV vaccine development include the ff:

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A high rate of viral mutation and recombination

At the book

VACCINE PROBLEMS
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At the book

VACCINE EXPECTATIONS
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At the book

CYTOMEGALOVIRUS
No available vaccine
Only few CMV vaccines have been tested (live attenuated)
Do not spread easily
HAY FEVER
An experimental DNA based vaccine have been developed, to protect against
this disease after six injections
The vaccine lessens the immune system to turn off the Th2 helper cells
IgE activated by Th2 is a protein largely responsible for allergy symptoms
Dendritic cells, keeping inflammation in check over the long term and breaks
self-sustaining allergic cycle
HUMAN PAPILLOMAVIRUS
These vaccines work by exposing the bodys immune cells to weakened forms
of an antigen that form on the surface of an infectious agent.
These vaccines can prevent cervical cancer caused by HPV-16 and HPV18
INFLUENZA
FDA has approved FluLaval, an influenza vaccine, for immunizing people 18
years and older against flu.
Currently, there are 5 FDA licensed vaccines
LEUKEMIA
MALARIA
Bloodborne parasite
Transmitted throught the bite of Anopheles mosquitoes.
4 types of human malaria:
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Plasmodium falciparum
Vivax
Malariae
Ovale