Beruflich Dokumente
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Dr.T.V.Rao MD
What is a Vaccine
The term vaccine
derives from Edward Jenner's 1796 use of the term cow pox (Latin) variola vaccin, adapted from the Latin vaccn-us, from vacca cow), which, when administered to humans, provided them protection against smallpox
Vaccine- Definition
A vaccine is any preparation intended to
produce immunity to a disease by stimulating the production of antibodies. Vaccines include, for example, suspensions of killed or attenuated microorganisms, or products or derivatives of microorganisms. The most common method of administering vaccines is by injection, but some are given by mouth or nasal spray.
Preparation of Vaccines
a. Live
attenuated organisms which have been passed repeatedly in tissue culture or chick embryos so that they have lost their capacity to cause disease, but retained an ability to induce antibody response, such as polio (Sabin), measles, rubella, mumps, yellow fever, BCG, typhoid and plague.
b. Inactivated or killed organisms which have been killed by heat or chemicals but retain and ability to induce antibody response. They are generally safe but less efficacious than live vaccines and require multiple doses; e.g. polio (Salk), influenza, rabies and Japanese encephalitis.
Preparation of Vaccines
c. Cellular fractions: usually polysaccharide fraction of the cell wall of a disease causing organism, such as pneumococcal pneumonia or meningococcal meningitis d. Recombinant vaccines: produced by methods in which specific DNA sequences are inserted by molecular engineering techniques, e.g. DNA sequences spliced to vaccinia virus grown in cell culture to produces an effective influenza vaccine, and Hepatitis B vaccine by similar methods.
Immune globulin: An antibody containing solution derived from human blood in the form of pooled plasma, used primarily for immunity for passive immunization such as for immuno-compromised persons e.g. smallpox response groups.
Antitoxin: is an antibody derived from serum of animals after stimulation with specific antigens and used to provide passive immunity in humans.
Timeline of Vaccines
18th century 1796 First vaccine for smallpox,
first vaccine for any disease 19th century 1882 First vaccine for rabies
Timeline of Vaccines
20th century 1932 First vaccine 1945 First vaccine 1952 First vaccine 1954 First vaccine
encephalitis
for for for for yellow fever influenza polio Japanese
1957 First vaccine for adenovirus-4 and 7 1962 First oral polio vaccine 1964 First vaccine for measles 1967 First vaccine for mumps
Timeline of Vaccines
1970 First vaccine 1974 First vaccine 1977 First vaccine 1978 First vaccine 1981 First vaccine 1992 First vaccine 1998 First vaccine
for for for for for for for rubella chicken pox pneumonia meningitis hepatitis B hepatitis A rotavirus
Number of Childhood Vaccines Routinely Used in Developing and Established Market Countries Acell pertussis
13 12 11 10 9 8 7 6 5 1975 1980 1985 1990 1995 2000
*Estimated future use **Used in ~ 50% of global birth cohort
Pneumococcal * meningoccoal C*
Varicella
Newer Vaccines
Stage I Development
The human trials
focus initially on safety, involving small groups of people
Stage II of Development
Progress to
moderate-sized "target" populations (persons close to the age and other characteristics for whom the vaccine is intended) to determine both safety and the stimulation of immune response.
20%
19%
13%
Total - 12.8 million
The Global Burden of Disease Murray and Lopez, editors
Pneumococcus
25- 35% of bacterial meningitis
Meningococcus
25 - 35% of bacterial meningitis (except during epidemics)
Rotavirus Diarrhoeas
Acute diarrhoea is responsible for nearly 1.9 million deaths per year in children under age five. Rotavirus is responsible for as much as one fourth of these casualties, almost all of which occur in developing countries.
GARDASIL
Gardasil, an HPV vaccine recently
licensed by Merck, covers four types of HPV, including the cancer-causing types 16 and 18 and types 6 and 11 for noncancerous genital warts. A second vaccine, developed by GSK, covers HPV types 16 and 18 alone
GARDASIL
GARDASIL is the only human papillomavirus
(HPV) vaccine that helps protect against 4 types of HPV. In girls and young women ages 9 to 26, GARDASIL helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases. In boys and young men ages 9 to 26, GARDASIL helps protect against 90% of genital warts cases.
Meningococcal vaccine
Meningococcal conjugate vaccine (MCV4) if preferred for adults aged 55 years or younger; meningococcal polysaccharide vaccine (MPSV4) is preferred for adults aged 56 years or older. Revaccination with MCV4 after 5 years is recommended for adults previously vaccinated with MCV4 or MPSV4 who remain at increased risk for infection.
Zoster vaccine
The zoster vaccine licensed in the United States
(ZOSTAVAX, Merck & Co., Inc.) is a lyophilized preparation of the Oka/Merck strain of live, attenuated VZV, the same strain used in the varicella vaccines (VARIVAX, PROQUAD). The Oka strain was isolated in Japan in the early 1970s from vesicular fluid from a healthy child who had varicella; the strain was attenuated through sequential propagation in cultures of human embryonic lung cells, embryonic guinea-pig cells, and human diploid cells (WI-38).
Japanese B encephalitis
Japanese B encephalitis
(JE), a mosquito-borne Arboviral infection, is the leading cause of viral encephalitis in Asia Approximately 50,000 sporadic and epidemic cases of JE are reported annually from the People's Republic of China (PRC), Korea, Japan, Southeast Asia, the Indian subcontinent, and parts of Oceania.
New/Improved: Hib: PRP-conjugates Pneumococcus: PS-conjugates Cholera: inactivated Rotavirus: live, attenuated Typhoid: Vi, Ty2la Pertussis: Acellular HAV: Inactivated Group A Meningococcus: PS-conjugates Rabies: Cell-culture based Varicella: Live-attenuated
Naked DNA
Inactivated Virus
Viral Genetic Diversity: HIV is not just one specific virus. Immune Protection: We dont know what immune responses are needed, or how strong they need to be. Neutralizing Antibody: Difficult to generate broadly neutralizing antibodies. Vaccine Testing: Slow process, very expensive
Very young taken for trails in view of High mortality and Morbidity
Phase III trial will
demonstrate how the vaccine performs in two groups of childrenone aged 6 to 12 weeks and a second aged 5 to 17 monthsin different transmission settings across a wide geographic region in Africa.
DNA Vaccines
DNA Vaccines
DNA vaccines are at
present experimental, but hold promise for future therapy since they will evoke both Humoral and Cellmediated immunity, without the dangers associated with live virus vaccines.
rd 3
Corn Flakes
Iowa State University
researchers are putting flu vaccines into the genetic makeup of corn, which may someday allow pigs and humans to get a flu vaccination simply by eating corn or corn products.
Vaccine Controversies
The public health benefits of vaccinations
are exaggerated. Critics of vaccination policy point out that the mortality rates of some illnesses were already dramatically reduced before vaccines were introduced, and claim that further reductions cannot immediately be attributed to vaccines. Secondary and long-term effects on the immune system from introducing immunogens directly into the bloodstream are not fully understood.
Vaccine Controversies
Vaccinations contain chemical
components that are known to be toxic, such as formaldehyde, aluminum in various compounds, acetone, glyceride, ethylene glycol, and neomycin when injected in large enough quantities
the Public
Anti-vaccine lobbyists
Not everybody believes that vaccines are good Despite the ridiculousness of anti-vaccine
arguments, there are significant and influential followers
They can bring untold damage to immunization programs and cause diseases and deaths
Recent examples Northern Nigeria and polio MMR and measles in UK Hepatitis B in India
All the New Vaccines are Under Scanner by Health Authorities and Social Activists
AIDS
Our goal is not to
completely eradicate the infection - that would be very difficult - but to produce a vaccine that will prevent not infection but disease. I think this is more possible. It's clear that prevention will never be sufficient. That's why we need a vaccine that will be safe.