vaccine

1. SEMINAR ABOUT IMMUNIZATION
S
DEFINITION
MMUNIZATION : is the process where by a personis made immune or resistant to
an infectious disease typically by the administration of vaccine
IMMUNITY: is the ability of the bodyto resist the infecting agent and protect the
bodyagainst micro organisms
VACCINE : a suspensionof attenuated or killed microorganisms administered for the
prevention of a specific infection
VACCINATION : A means of producing immunity to a disease by using a vaccines
.
TYPES OF IMMUNITY
Active immunity
1-
Natural : acquired active immunity from exposure to disease
-
Artificial : acquired active immunity from vaccinations
-
2-Passiveimmunity
Natural : acquired passive immunity by placenta
-
Artificial : acquired passive immunity by gamma globulin to contact
-
Expanded Program of Immunity (EPI)
The world health organization (who) was establish the expanded program on
immunization (EPI) in may 1974 to develop and expand immunization programs
throughout the world and make vaccines available to all children throughout the world
.In 1977, the goals was set to make immunization against diphtheria , pertussis ,
tetanus ,poliomyelitis ,measles and tuberculosis available to every child in the world

2. by 1990.problems encountered by the program have include :lack of public and
government awareness of the scopeand seriousness of the target disease, ineffective
program management , inadequate equipment and skills for vaccine storage and
handling ,and insufficient means for monitoring program impact as reflected by
increasing immunization coverage level and decreasing incidence of the target diseases
.the successes ofthe program represent a major public health achievement ,but much
remains to be done.
General objectives of EPI
1 – reduction in the morbidity and transmission of vaccine preventable
disease, such as pertussis, measles ,hepatitis
2 –reduction in mortality from vaccine preventable disease
3 – elimination and eradication of certain diseases such as smallpox, polio
4 – improvement in national economy – less health care costcaring for
sick children, less time off work of parents
COLD CHAIN SYSTEM
Cold chain : a network of refrigerators , cold stores , freezers and cold boxes organized
and maintained so the vaccines are kept at the right temperature to remain potent
during vaccine transportation , storage and distribution from factory to the point of use
. The cold chain has three main components : transport and storage equipment ,trained
personnel ,and efficient management procedures ,all three elements must combine to
ensure safe vaccine transport and storage

3. COLD CHAIN SYSTEM OF EPI
ENSURES
1-potency
2-quality
3-safety
The figure above illustrates the cold chain from manufacturer to end user (child to be vaccinated),
including all steps along the chain, in order to ensure a proper cold chain.

4. Vaccines schedule of Iraqi ministry of health for children 2015
Table1:
route
dose
Vaccine
Period of
administration
I.D Upper
left arm
I.M
Orally
0,05 or 0,1 ml
0,5ml
2 drop
-BCG (Bacillus Calmatte
Guerin )
HBV(Hepatitis B virus)
-
-OPV(oral polio vaccine)zero
dose
After birth-72 hr.
I.M
Oral drops
0,5 ml
1 ml
t
n
ale
ntav
e
P
-
dose
st
1
(DPT+HBV+HIB)
dose)
st
(1
vaccine
Rota virus
-
dose)
st
OPV(1
-
2 months
I.M
Oral drops
0,5 ml
1 ml
Tetravalent(DPT+HIB)
-
Rota virus vaccine
-
dose)
nd
2
(
dose)
nd
2
(
OPV
-
4 months
I.M
0,5 ml
(DPT,
dose
nd
2
Pentavalent
-
HIB, HBV)
e)
dos
rd
(3
OPV
-
6 months
S.C
0,5 ml
100,000 IU
Measle
, Vit A
9 months
S.C
0,5 ml
MMR
dose
st
1
(measle,mumps,rubella)
15 months

5. 200,000 IU
dose
booster
st
OPV 1
-
boosterdose
st
1
)
(DPT+HIB
-
-Vitamin A
18 months
boosterdose
nd
OPV 2
-
dose
booster
d
n
2
(DPT+HIB)
-
dose
nd
2
MR
M
-
4-6 years
Roles for vaccination
1- Every child should have a sterile needle and syringe
2- The temperature of the refrigerator where all vaccines are stored should be from 4 to 8
co
.
3- Do not put vaccines in the doorof the refrigerator, they warm up each time
you open the door
put the vaccines loosely , so that cold air can go between them
4-
5- Dissolved live vaccine should be used within one hour, and it should not be
exposed to sun light
6- read the paper that comes with the vaccine, you may need to use vaccines
from different makers in different ways
Always make sure that the vaccine is not expired
7-
Put several ice bags in the refrigerator to keep vaccines cold if the refrigerator fail

6. Contraindication to immunization
1-sever febrile illness
altered immune system
2-
-Those with immunological deficiency disease such as lymphoma ,aids
-Thosereceiving immunosuppressive therapy such as steroid , chemotherapy or
radiation
3-The presence of recently acquired passive immunity including blood transfusion
,immunoglobulin
Allergic responseto a previously administration of vaccine
4-
5- Gastroenteritis because it may interfere with colonization of the viruses in the
intestine
History of nervous system disorders such as convulsion
6-
If the child gets the disease e.g : mumps
7-
SIDE EFFECT OF VACCINATION
1-Fever,soreness,redness and swelling at the site of injection may last for week
and even month but gradually disappears.
2-Loss of consciousness,convulsion and thrombocytopenia may result from
pertussis vaccine
3-Local oedema
4-Tenderness
TYPES OF VACCINES
Inactivated or killed : some vaccines contain inactivated, but previously virulent
,microorganism that have been destroyed with chemical, heat, radiation, or
antibiotics. Example: influenza, cholera, bubonic plague, polio, hepatitis A.

7. Attenuated
Live, attenuated vaccines contain a version of the living microbe that has been
weakened in the lab, these vaccines are good “teachers” of the immune system: They
elicit strong cellular and antibody responses and often confer lifelong immunity with
only one or two doses .e.g BCG , measle ,mumps, rubella
Subunit
subunit vaccines include only the antigens that best stimulate the immune system. In
some cases, these vaccines use epitopes—the very specific parts of the antigen that
antibodies or T cells recognize and bind, e.g. Hepatitis B, Hamophilus influenza type
b,Pertussis.
Toxoid
For bacteria that secrete toxins, or harmful chemicals, a toxoid vaccines are made from
inactivated toxic compound that cause illness rather than microorganism examples
diphtheria and tetanus
Conjugate
Certain bacteria have polysaccharide outer coated that are poorly immunogenic.by
linking these outer coated to proteins, the immune system can led to recognize the
polysaccharide as if it were a protein antigen. This approachis used in the
haemophilus influenza type B vaccine.
Valence
May be monovalent vaccine is designed to immunize against a single antigen or single
micro organism. Or multivalent vaccine against two or more strains of same
microorganism, or against two or more microorganism.

8. Heterotypic
Called heterologous or jennerian ,these are vaccines that are pathogens of other
animals that cause mild disease in the organism being treated.e.g. use of BCG
vaccine made from mycobacterium bovis to protectagainst human tuberculosis.
Infectious disease
- Poliomylitis : is a viral disease caused by poliovirus mainly affects young
children, transmitted by personto person spread through the fecal-oral route or by
common vehicle e.g.( contaminated water or food)and multiplied in the intestine,
from where it can invade the nervous system and can cause paralysis. Clinical
manifestation: fever, fatigue, headache, vomiting, stiffness in the neck, and pain in
the limb. the disease cause permanent paralysis ,there is no cure for polio ,only
prevented by immunization.
-Tuberculosis : is caused by mycobacterium tuberculosis ,spread through the air
from personto another . clinical manifestation :bad cough that last 3 weeks or
longer, pain in the chest , weakness, weight loss, no appetite, chills, fever, sweating
at night ,prevention by BCG vaccine
-Hepatitis B is a liver infection caused by the Hepatitis B virus (HBV). Hepatitis
B is transmitted when blood, semen, or another bodyfluid from a personinfected
with the Hepatitis B virus enters the bodyof someone who is not infected. This can
happen through sexual contact; sharing needles, syringes, or other drug-injection
equipment; or from mother to baby at birth
-Rota virus: is a virus that infects the intestinal tract of almost all young children
by age 5. Children The virus spreads through contactwith the stoolfrom an
infected child
Clinical manifestation :Vomiting, fever and diarrhea( watery diarrhea)

9. - Diphtheria : is bacterium infection caused by the Coryne bacterium
diphtheria . spread by direct contact or through the air or by contaminated
objects. Symptoms of diphtheria include fever of 38 °C or above, chills, fatigue,
cyanosis, sorethroat, hoarseness, cough, headache, difficulty swallowing,
painful swallowing, difficulty breathing, rapid breathing, foul-smelling blood
stained discharge and lymphadenopathy, cardiac arrhythmias, myocarditis, and
cranial and peripheral nerve palsies .prevention by DPT vaccine.
-Tetanus is a serious bacterial disease that affects your nervous system, leading to
painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can
interfere with your ability to breathe and, ultimately, threaten your life. Tetanus is
commonly known as "lockjaw." Prevention by DPT vaccine.
- Haemophilusinfluenza type b: is a Gram-negative bacterium that causes meningitis
and acute respiratory infections, mainly in children manifestations include epiglottitis,
osteomyelitis, septic arthritis and septicemia transmitted by droplets from infected
people.
-Measlesis a highly contagious, serious disease caused by measles virus
infects. It is spread by coughing and sneezing, close personal contactor direct
contact with infected nasal or throat secretions. clinical manifestation The first
sign of measles is usually a high fever, coryza, conjunctivitis, photophobia,
kopliks spots in the mouth, hacking cough, enlarged lymph node,rashlast 5
days. Prevention by measles vaccine
-German measles (Rubella): viral infection caused by rubella virus spread by
direct or indirect contact with nasopharyngeal secretion also the virus present in
urine and stooland blood, from mother to fetus. Clinical manifestation slight fever,
mild coryza, pink or pale red malcules closely grouped, swelling of posterior
cervical and occipital lymph node. Prevention by MMR vaccine.

10. -Mumps: viral infection caused by paramyxo virus ,spread by direct or indirect
contact with salivary secretion of infected person. clinical manifestations swelling
and pain of salivary glands , pain when drink or eat acidic food, difficulty in
swallowing ,headache, fever and malaise, Prevention by MMR vaccine.
-Pertussis:caused by bordatella pertussis bacteria ,spread by direct contact and air
born by droplet .clinical manifestation :there are 3 stages 1- catarrhal stages: begin
with URTI eg. Coryza, sneezing, lacrimation, cough, low grade fever for 4-14
days.
2-paroxysmal stage(1 month): series of short, rapid cough at night followed by
sudden inspiration associated with whooper.
3- convalescent stage: good appetite, gaining weight.
Prevention by DPT vaccine.