Vaccine. Specific defenses Immunity. natural. acquired. Live vaccines. Killed Inactivated vaccines. Cellular fraction vaccines

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1 Introduction Vaccine has been a importance medical breakthrough in preventing morbidity and mortality from infectious diseases worldwide. Vaccination has managed to eradicate the deadly and mutilating smallpox and paralyzing poliomyelitis is now a days present only in a few developing countries. Fatal neonatal tetanus is becoming rare even in African countries and the incidence of fearful measles is steeply declining There are many precautions (not contraindications) associated with immunizations, such as moderateto severe illness (all ) or a history of seizure or shock-like state after a previous dose (diphtheria-tetanus-acellular pertussis [DTaP]), polio vaccination, small pox, measles, mumps, rubella, Japanese B encephalitis, influenza, hepatitis B, Vaccine Insulin.

2 Active immunity Specific defenses Immunity Passive immunity Vaccine The is an immunobiological product containing one or more immunizing agents (isolated or in combination) under different ways: live attenuated bacteria or viruses, inactivated viruses, killed bacteria and components of infectious agents purified and/or chemically or genetically modified. Following clinical infection Following subclinical infection Following vaccination natural acquired Transfer of maternal Antibodies Through placenta Transfer of maternal Antibodies Through milk Following administration of Immunoglobulin or antiserum Live, attenuated are composed of micro-organisms that have been cultivated under conditions which disable their ability to induce disease, examples of live, attenuated MMR, DPT, small pox Live Live Attenuated Killed Inactivated Toxoids Cellular fraction Recombinant Small pox variola BCG Typhoid oral Plague Oral polio Yellow fever Measles Mumps Rubella Intranasal Influenza Typhus Typhoid Cholera Pertussis Plague Rabies Salk polio Intramuscular influenza Japanise encephalitis Diphtheria Tetanus Meningococcal polysaccharide Pneumococcal polysaccharide Hepatitis B polypeptide Hepatitis B Maturasi Program Immunisasi - Kementrian Kesehatan Republik Indonesia. Pemantauan dan Penanggulangan Kejadian Ikutan Pasca Imunisasi Available from://www. depkes.go.id.

3 Tetanus & Diphteria Tetanus and diphtheria specific antibody concentrations are frequently below the levels considered to be protective for adults, and are even lower for the elderly. A more detailed overview of tetanus and diphtheria vaccination of the elderly has recently been published. Antibody responses to booster vaccination against tick-borne encephalitis are also lower in old compared to young adults PERTUSSIS Pertussis component of the DPT is mainly responsible for neurologic reactions. It causes neurologic damage: by affecting cellular signaling, catecholaminergic and GABAergic systems and defect in blood brain barrier due to endotoxinmediated endothelial damage. This leads to decrease in release of the inhibitory neurotransmitters GABA and adenosine in the hippocampus and induce convulsive activity. The higher cost may be the reason for inclusion of DPT instead of DTaP immunization Miravalle A, Roos KL. Encephalitis Complicating Smallpox Vaccination. Arch Neurol 2003; 60: A smallpox vaccination program has been initiated. One of the earliest descriptions of post infectious encephalitis is recorded in Encephalitis is a rarely reported complication of smallpox, the majority of cases are associated with primary. Demonstration of high levels of vaccinia IgG antibody in the absence of IgM supports the history or prior vaccination against smallpox. A large number of infectious agents or have been reported to link with Acute Disseminated Encephalomyelitis (ADEM), such as infection of hepatitis A virus, hepatitis B virus, hepatitis C virus, and some vaccinations. However, to the best of our knowledge, rare cases with ADEM after hepatitis B vaccination have been reported in a child. Here, we describe a case of 12-year old child who suffered from ADEM three weeks after the vaccination of hepatitis B.

4 Vaccine Diabetes Glutamic acid decarboxylase (GAD) or glutamate decarboxylase, - aminobutyric acid, and more specifically GAD65, the only isoform of the enzyme present in pancreatic beta cells, is another target antigen that has been widely used in the field of diabetes vaccination. A recent Phase II clinical trial used an formulated human recombinant GAD65 to test the effects of this immunomodulation approach. Forty-seven patients with latent autoimmune diabetes of adults were subcutaneously administered two antigen doses 4 weeks Vaccine MMR Measles, mumps, and rubella (MMR) viruses are neurotropic. Involvement of the central nervous system is common in measles, and electroencephalographic changes have been reported in 50% of uncomplicated cases. Measles virus causes a variety of central nervous system syndromes, including meningitis, encephalitis, measles inclusion body encephalitis (MIBE), Subacute Sclerosing Panencephalitis (SSPE), and acute disseminated encephalomyelitis. Annamari M, Pekka N, Heikki P. Neurologic Disorders After Measles Mumps Rubella Vaccination. Pediatrics 2002; 110: Vaccine Influenza Influenza infection may cause serious morbidity and mortality. In the winter of , influenza A/H1N was the major influenza strain in Europe. From among all the adult cases in which influenza A/H1N1 infection was initially considered to be a cause, ten of the patients had had a recent influenza A/H1N1vaccination. Five of the adults developed isolated transverse myelitis, and five developed ADEM. Ussel IV, Boer W, Parizel P, Cros P, Jorens P. Encephalitis Related to H1N1 vaccination: Case Report and Review of the literature. Conclusion The is an immunobiological product containing one or more immunizing agents (isolated or in combination) under different ways: live attenuated bacteria or viruses, inactivated viruses, killed bacteria and components of infectious agents purified and/or chemically or genetically modified. Vaccines as below: rubella mumps (MMR), smallpox, Diphtheria Pertussis Tetanus (DPT) has been debated to stimulate encephalitis. Vaccine metabolic diseases are not related stimulating encephalitis

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