Group C
Amr Abdel Raouf
Definition:- Immunization:- Immunization is the process whereby a person is made immune or resistant to a specific infectious disease. Vaccine: is the administration of antigenic material to stimulate an individual's immune system to develop adaptive immunity to a pathogen.
Types of immunization: 1) passive immunization 2) active immunization 1)Passive immunization :- Passive immunization is where presynthesized elements of the immune system are transferred to a person so that the body does not need to produce these elements itself.
The passive immunization is sub-classified to:- A) Natural I -passage of maternal antibodies (IgG antibodies) to the fetus through the placenta in the last trimester E.g antibodies against measles, poliomyelitis, diphtheria, scarlet fever and mumps II : through breast milk and colostrum
B)Acquired: By administration of exogenously produced immunoglobulins or antitoxins for temporary prevention and treatment of certain infections and diseases. This includes:- 1-immunoglobulins from human source general non specific immunoglobulin specific antibodies against an infectious agent 2-from animal sources : e.g antitoxins
Indications for Immunoglobulins and antitoxins Mohammad Abbas
Indications for immune globulins and antitoxins:- Exposure to hepatitis A or B Exposure to measles Exposure to rabies Exposure to Tetanus in a non immunized or incompletely immunized person Chicken pox in immunesuppressed child Tetanus and Diphtheria Snake, Scorpion and spider bites
Immune suppressant therapy:- -Anti Rh (D)immune globulins to prevent Rh disease -Anti lymphocyte globulin
Active immunization Duaa Salah
Active immunization : Entry of antigens which stimulates formation of antibodies by the immune system. 1- Natural : by acquiring the infection either subclinically or clinically.its life long in measles. German measles chicken pox and mumps. but when more than immunologic strain exist eg. in poliomyelitis and influenza, second attack may occur caused by different strains. the same occurs in common cold where the immunity is rapidly lost because of the superficial nature of the infection ( in mucous membranes of the respiratory tract ).
2- Acquired : By vaccines which may be viral, bacterial or toxins.the vaccines may be : Live attenuated : BCG, Polio, etc. Killed : Polio (salk ). Modified toxin : Diphtheria, tetanus
Types of vaccines Muna Ahmed AlFaki
Live attenuated virus vaccines:- Measles, mumps, rubella, varicella, Rota and Polio(Sabin) Live attenuated bacteria vaccines-bcg, Typhoid oral vaccine Killed virus vaccine(inactivated)-salk for Polio, Rabies and influenza virus Killed bacteria vaccines-pertussis, Cholera and Typhoid Immunological components of the infective agents(sub-unit vaccines)-pneumococcal polysaccharide vaccines, meningococcal polysaccharide, H. Influenza, acellular
Toxoids(Modified toxins of the offending bacteria)-tetanus and Diphtheria Vaccine produced by genetic engineering(recombinant)-hepatitis B vaccine
Mechanism of immune response:- Lymphocytes play a major role in generating the immune response following exposure to an antigen. -B and T lymphocytes -Majority of antigens are T cell dependant T-helper cells(cd4) are activated, following which a cascade of mediators is triggered Primary exposure-detectable Antibodies in the serum after about 2 weeks (IgM followed by IgG)
Factors affecting Immune response:- Host factors -Age -Nutrition -Pre-existing antibodies -Immunocompromised status Vaccine related factors -Type of vaccine -Route of Administration -Storage conditions -Adjuvants
BCG-Bacillus Calmette and Guerin Yousif Hussein
Bacillus -Calmette and Guerin is an attenuated strain of bovine type of Mycobacterium tuberculosis. Administration: 0.1 ml intradermally at the site of insertion of the deltoid at the age of 40 days (but maybe given earlier even in the first day ). Indication : 1. Expected unavoidable exposure. 2. Infants of mothers with active TB
Contraindications : prematures, malnourished infants and in skin infections. Complications : 1. persistent ulcer at the site of vaccination. 2. Regional suppurative lymphadenitis. 3. Marked lymphadenitis. 4. Generalized BCG infection especially in infants with deficient immune system.
Value of BCG vaccination : Although the degree of protection against infection is not 100% (about 60-70%) and the vaccine interferes with the Tubercullin skin test which is valuable in diagnosis,the vaccine prevents the hematogenous spread of the organism (i.e prevent miliary TB, which is fatal)
D.P.T Aymen Babikir
Diphtheria (Toxoid), Tetanus (Toxoid) and pertussis ( killed organism ) are used in combination to decrease the number of injection and to increase the immune respones by adjuvant effect. Side effects: 1- Mild side effects : - Local swelling and local tenderness. - Fever which may reach 40 C (These side effects disappear in few days.)
2- Moderate side effects : - Protracted cry, and shock like state. 3- Severe side effects : - Febrile convulsions, encephalopathy. - Rarely, brain damage
Contraindications of pertussis vaccine:- : 1- Encephalopathy within 7 days of previous DPT vaccination. 2- Epilepsy of recent onset or if poorly controlled. 3- Convulsions within 72 hours of pervious DPT vaccination. 4- Fever >40 C unexplained by other cause, or persistent unusual cry (>3 hours ), or shock like sate or somnolence ( all within 48 hours of DPT vaccination ). 5- Allergic ( anaphylactic reaction ) reaction to
Poliomyelitis Hanadi Vaccine Mohamed
1. Sabin vaccine (oral) live attenuated Advantages : - protects the community (herd immunity ) -Easy of administration. -solid prolonged immunity. Disadvantages: - It needs proper refrigeration. - Other enteroviruses and ECHO viruses may interfere with the effectiveness of the vaccine.
2. Salk vaccine (I.M) killed organism : Advantages : -Effective in prevention of the disease. -Helps in the immune deficient infants. -Easy to preserve and transport. Disadvantages : - It has to be injected, thus difficult in mass immunization - It does not give immunity to the GIT thus, immunized persons can transmit the disease by their stools.
Causes of failure of polio vaccine : 1. if the vaccine is given just before or after breastfeeding. 2. If vomiting occurs immediately after vaccination. 3. Bad refrigeration or exposure to heat. 4. Interference with the vaccine by infection of the GIT with other enterovirses Complications : - If the infant is immune deficient, paralysis may occur. Salk vaccine should be used in these case. - Paralysis may occur in immune deficient contacts by spread of the vaccine virus.
Measles Samah Salah
Side effects : Mild fever ( usually less than 38C) and transient skin rash may occur 6-11 days after vaccination. Measles vaccine Its given 0.5 cc subcutaneously. its better given at the age of 13-15 months to ensure good respones because persistent maternal immunity may cause vaccine failure if given before this age, however when outbreaks of measles occur the vaccine should be given as early as 9 months of age but repeated (in MMR) at the age of 15moths.
MMR Ghofran Siddig
MMR (measles,mumps and rubella ) : Its given 0.5cc subcutaneously at the age of 13-15months. Side effects: 1. Fever and transient skin rash may occur 6-11 days after vaccination. 2. Transient arthralgia rarely arthritis.
Other vaccines Duaa Salah
Other vaccines: 1. Meningococcal polysaccharide vaccine 2. Pneumococcal vaccine 3. Haemophilous influenza vaccine 4. Hepatitis A vaccine 5. Varicella vaccine 6. Rotavirus vaccine 7. Typhoid paratyphoid vaccine 8. Rabies vaccine 9. Cholera vaccine 10.Influenza virus vaccine
Delayed Immunization Aymen Babikir
Delayed immunization : If the infants or children were not vaccinated in the proper time (eg. due to family neglect ignorance or previous disease ) the following schedules are used. 1. infants less than 14 months of age : they are immunized according to the usual schedule. 2. children 14 months -7 years of age : - The first visit : DPT + Polio + Tuberculin test. - One month later : MMR - Another month later : DPT + Polio - Another 2 months later : DPT + Polio - After one year : Booster dose of polio + DPT ( if
3. children above 7 years : - The first visit : DPT + Polio - One month later MMR. - After another 1 month : DPT + Poilo. - After another 2 months later : DT + Polio
Contra-indications
Contraindications of active immunization : Absolute contraindications:- Convulsions or encephalopathy after the first dose of DPT vaccination. Anaphylaxis after a previous dose Immunodeficiency (for live vaccines)- Malignancy or use of immunosuppressive drugs.
Relative contraindications:- Evolving (undiagnosed) neurological illness Acute febrile illness Within 6 weeks of immunoglobulins administration or receiving blood transfusion. Pregnant females.
Storage AND Transportation Mohamad Othman
Vaccines should always be kept refrigerated during transportation, distribution and storage. (Between 0 & -8 degrees) Freezing damages the killed adsorbed vaccines and toxoids (DPT, DT and TT) Disinfectants and antiseptics as alcohol and detergents can damage vaccines Strong light, heat and direct sunlight should be avoided
Schedule of Vaccination in Sudan Alaa