microbiology

1. Prophylactic Immunization

2. Immunization
• Is to produce a degree of resistance sufficient to
prevent a clinical attack of the natural infection.
• Jennerian vaccination led to the global
eradication of small pox
• Started with Pasteur's discovery of vaccines for
Anthrax & rabies advanced techniques for
cultivation of infectious agents has led to the
development of vaccines against most of them.

3. Immunization
• Immunization against diseases is one
of the greatest success of modern
medicine.
• Vaccination has controlled nine major
diseases.
• Small pox Diphtheria
• Pertussis Tetanus
• Polio Mumps
• Measles Rubella
• Yellow fever

4. Immunization-Types
• Active:
1.Live 2. Killed
3.Toxoids 4.Subunit
• Passive:
1. Homologous & heterologus sera
2. Pooled Ig
3. Specific Ig
• Combined Passive & active Immunization

5. Active immunisation
• Use of vaccines
• 1. Specificity : vaccination induces
production of specific Ab
2. Memory cells : memory cells allow
the immune system to mount a much
stronger immune response on
second encounter with Ag
- the secondary response is prompt,
powerful & prolonged with
production of much higher level of
Abs

6. 1. Live attenuated vaccines:
• Suspension of living organisms with
reduced virulence.
• Mimic natural infection but without
symptoms.
• A single dose of live vaccine induces
long lasting immunity .
• Sometimes related organisms with
shared Ag used for live vaccine.
• Live vaccines should not be used in
pregnancy due to risk of fetal infection
& in immunocompromised hosts.

7. Live attenuated vaccines
• BCG vaccine
• OPV vaccine
• MMR vaccine
• Oral typhoid fever vaccine
• Varicella vaccine
• Yellow fever vaccine

8. 2. Killed vaccines:
• Posses antigen common to original
pathogen .
• Do not replicate.
• Effective immune response requires
large doses.
• Booster doses are necessary

9. Killed vaccines
• Pertussis vaccine
• Cholera vaccine
• Rabies vaccine
• Killed polio vaccine
• Influenza vaccine
• Hepatitis A vaccine
• Plague vaccine
• Pneumococcal vaccine
• Meningococcal vaccine
• Japanese B encephalitis
• Typhoid &
• Paratyphoid vaccine

10. 3.Toxoids
• Toxins without toxigenicity
• Retains antigenicity
• Prepared by treating toxins with
formalin
Eg: Tetanus toxoid
Diphtheria toxoid

11. 4.Microbial structural components
(Subunit)
• Subunit vaccines consist of purified
fragments of major immunogenic components
of microorganism produced by rDNA
technology.
Exs:
Hepatitis B vaccine
Haemophilus influenzae type B vaccine
Pneumococcal vaccine
Meningococcal vaccine
Vi typhoid fever vaccine

12. National Immunisation schedule
Age Vaccine Route of
administration
Infants & children at
birth (For institutional
deliveries)
BCG
OPV-Zero dose
Intradermal
Oral
6 Weeks DPT-I
OPV-1
BCG (if not given at birth)
Hepatitis B-I
Intramuscular
Oral
Intradermal
10 Weeks DPT-2
OPV-2
Hepatitis B-2
Intramuscular
Oral
14 Weeks DPT-3
OPV-2
Hepatitis B-3
Intramuscular
Oral

13. National Immunisation schedule
Age Vaccine Route of
administration
9 months Measles
vaccine
Subcutaneous
16-24 months DPT booster
OPV booster
Intramuscular
Oral
5-6 yrs DT** Intramuscular
10yrs TT** Intramuscular
16 yrs TT** Intramuscular
For pregnant women
Early in pregnancy TT-1 or booster Intramuscular

14. WHO EPI Immunisation schedule
Age Vaccine
Birth BCG, Oral Polio vaccine (OPV)
6 Weeks DPT,OPV
10 Weeks DPT, OPV
14 Weeks DPT, OPV
9 months Measles vaccine

15. WHO EPI Immunization schedule
• In May 1974, WHO officially launched a
global immunization programme known as
Expanded Programme of Immunization (EPI)
• To protect all children of world against
vaccine preventable diseases by the year
2000.
• EPI was launched in India in Jan 1978.
• EPI is called as Universal child Immunization
(1990)

16. Passive immunisation
• Provide immediate protection to an
anticipated infection.
• Immunity-short lasting
• By use of Human sera &
Animal sera.

17. Passive immunisation
1. Homologous & Heterologous sera
• Antitoxic, antibacterial or antiviral
antibodies in human (homologous) &
animal (heterologous) serum is injected to
give temporary protection.
• Protection:
Homologous sera : 3-6 months
Heterologous sera: few weeks

18. A. Human sera
2. Pooled immunoglobulin:
• Prepared from pooled normal human serum
containing high levels of appropriate
antibody.
• Used for short term prophylaxis.
• Ex. Hepatitis A, Measles.

19. A. Human sera
3. Specific (Hyper immune) immunoglobulin:
• Prepared from sera of patients who are
recovering from infection
• From persons who have been actively
immunised against a specific infection.
• Ex. Tetanus -
Human Tetanus Immunoglobulin-HTIG
Hepatitis B- (HBIG)
Rabies -(HRIG)
Varicella –Zoster (ZIG)

20. 3.Combined Passive &
Active Immunization
• In some diseases (Tetanus, Diphtheria,
Rabies) passive immunisation is often
undertaken in conjunction with inactivated
vaccines
• Provide both immediate passive immuntiy
& slowly developing active immunity.
• Both injections should be administered at
separate sites.

21. Individual Immunisation
• Vaccines offered under National
Immunisation schedule are limited by
economic considerations.
• Like Varicella vaccine, typhoid vaccine.
• May be supplemented by individual
initiative, whenever possible.

22. Individual Immunisation
• Varicella vaccine:
- Live attenuated vaccine.
- Given as single SC dose in children 9 months-
12 years of age
- Two doses at an interval of at least 6 weeks (in
older)
• Typhoid vaccine:
• Live oral Gal-E mutant
• Injectable purified Vi polysaccharide vaccine.

23. BCG
• Useful in infants & children
against T.B meningitis & miliary
T.B
• Administered soon after birth
before discharged from hospital
• Natural infections maintain the
immunity
• Complications – local ulceration,
enlargement & suppuration of
lymph nodes & keloid formation
• Infection may occur in
immunocompromised
• Afford some protection against
leprosy & leukemia

24. DPT
• Contains the toxoids of
Diphtheria, tetanus & a
killed suspension of
pertusis
• Given together, minimizes
the number of injections &
improves immune
response
• 3 doses – (6,10,14 weeks)
• Booster dose 18th
month &
booster tetanus at school
entry

25. OPV
• 5 doses
• Live attenuated
developed by
Sabin in 1961
• Annual pulse polio
vaccination for
eradication of
polio

26. Measles vaccine
• Live attenuated
• Recommended age
– 9-12 months,
• _ 16-24 months
• During outbreak

27. Mumps & Rubella
• Live attenuated
• Supplied as Rubella & Mumps – MR or
Measles, Mumps & Rubella – MMR
• Selective Rubella immunisation for
girls at adolescent age
• Universal immunisation of pre-school
boys & girls
• Prevents congenital Rubella

28. Hepatitis B vaccine
• Plasma derived HBsAg
• HBsAg from genetically
engineered yeast cells
• If mother a known carrier –
HBIg & HB vaccine at birth
• HB vaccine given at the 6th
week
• If mother’s status not known
HB vaccine given at birth
• IM injection in the deltoid
region

29. Optional vaccines
Typhoid vaccine:
1. Vi polysaccharide: 0.5 ml I.M at or after 2 yrs
2. Live attenuated S.typhi – Ty 21a
- orally on 3 alternate days
- repeated 3-5 days later
- age : 6 yrs & above
H.influenzae type b vaccine:
- 3 doses 1-2 months apart, booster at 15 -18
Japanese encephalitis &
Meningococcal A& C vaccines

30. NEWER VACCINES & VACCINES UNDER
DEVELOPMENT
• Live attenuated varicella (oka) vaccine
• Hepatitis A killed vaccine
• Conjugated pneumococcal vaccine
• Conjugated S. typhi Vi vaccine
• Rota virus vaccines
• RSV vaccine
• Dengue virus types 1-4 vaccine
• Vaccines against ETEC, Cholera