immunization topic ppt with simplified basics......... good luck.... if u like this ppt....pls hit like button thank u

1. IMMUNIZATION
NAVAS SHAREEF.P.P
KMCT MED COLLEGE;CALICUT;INDIA
Email:nasmbbs@gmail.com

2. IMMUNIZATION
• Immunisation is the process by which
acquired immunity is induced.
Acquired Immunity
• Protection from disease
• Provided by introduction antigens or
premade antibodies into the body

3. Acquired Immunity
Active immunity
• In response to stimulus by an
antigen characterized by the
production of antibodies by the
host.
Passive immunity
• Immunity transferred in ready
made form.ie,no role of
immunesystem of the recipient.

4. Active immunity
Naturally acquired
• Repeated clinical &
subclinical infection
in childhood give
immunity.
• Eg:chicken pox
Artificially acquired
• Immunity induced
by vaccination

5. Passive immunity
Naturally acquired
• Transfer of maternal
antibodies
• Eg:
– Through placenta=Ig G
– Through colostrum=Ig A
Artificially acquired
• Following
administration of
Immune globulin or
antiserum
• Eg:Anti tetanus
serum(ATS)

6. Immunizing agents
• vaccines
• immunuglobulins
• antisera

7. VACCINATION
• A vaccine is an immuno-biological
substance(Ag) designed to produce specific
protection against a given disease.
• A vaccine is “antigenic” but not “pathogenic”.

8. Types of vaccines
• Attenuated live vaccines
• Inactivated killed vaccines
• Toxoids
• Polysaccharide and polypeptide (cellular fraction) vaccines
• Surface antigen (recombinant) vaccines.

9. Live Vaccines
Advantages
• Single dose enough
• Produce local immunity
• lnduce cell mediated immunity
• More convenient for mass immunization
Disadvantages
• Reversion to virulence
• Difficulty in storage

10. Killed Vaccines
Advantages
• No danger of spread
• Stability and safety
Disadvantages
• Multiple injection may be required
• May be contaminated with
• dangerous infectious agent

11. Live
Attenuated
vaccines
Killed
Inactivated
vaccines
Toxoids Cellular fraction
vaccines
Recombinant
vaccines
•BCG
•Typhoid
oral
•Plague
•Oral polio
•Yellow
fever
•Measles
•Mumps
•Rubella
•Intranasal
Influenza
•Typhus
•Typhoid
•Cholera
•Pertussis
•Plague
•Rabies
•Salk polio
•Intra-
muscular
influenza
•Japanise
encephalitis
•Diphtheria
•Tetanus
•Meningococcal
polysaccharide
vaccine
•Pneumococcal
polysaccharide
vaccine
•Hepatitis B
polypeptide
vaccine
•Hepatitis B
vaccine

12. Route
Intradermal BCG
Subcutaneous Measles, MMR, Meningococcal, Varicella
Intramuscular DTwP / DTaP, Hib, Hep A, Hep B, DTwP-
Hep B-Hib, DTwP-Hep B, DTwP-Hib, Hep A-
Hep B

13. VACCINE ADVERSE REACTIONS
• Local
– Pain, swelling, redness at site of injection
– Common with inactivated vaccines
– Usually mild and self-limited
• Systemic
– Fever, malaise, headache
– Nonspecific
– May be unrelated to vaccine
• Allergic
– Due to vaccine or vaccine component
– Rare

14. VACCINE COLD CHAIN
• The system of transporting, storing and distributing vaccines in
a potent state at the recommended temperature from the
point of manufacture to the point of use is the Cold Chain.
• Vaccine potency once lost cannot be restored.

15. VACCINE COLD CHAIN

16. Vaccine vial monitor

17. • Whole cell vaccine
–Contains suspension of whole bacterial cells
that have been killed. Eg: DTwP
–More effective but less safe
• Acellular vaccine
–Cell free vaccine prepared from purified
antigenic component of cell free
microorganism.
–ie,doesnot have complete cell but contains
fragments of cell best suited to stimulate
immune response. Eg: DTaP
–Less effective than DTwP but more safe

18. Vaccine Failure
• Primary = administration of recommended dose of vaccine
doesnot result in adequate protection against disease.
• Secondary = disease occur inspite of immunsiation.

19. INDIVIDUAL VACCINES

20. BCG VACCINE
• Live attenuated vaccine (Bacille Calmettee – Guerin
strain)
• Dose: 0.05ml in neonates & 0.1ml in others
• Intradermal injection in to left hand on deltoid area.
• Controls hematogenous spread thus preventing Miliary
TB, Disseminated TB, TB Meningo encephalitis(80%)
• Reconstitute with 1 ml of Sodium Chloride Inj. IP.
• Complications:ulceration ,lymphadenitis...
• C.I ---immunocompromised

21. Oral Polio Vaccine
• OPV – Live attenuated Polio virus
– Type I - Type II - Type III
• Dose – 2 drops oral at birth,6,10, 14 weeks, 16-24 months
• Contraindication-in immunocompromised, diarrhea, infectious
fever
• MgCl2 is the stablizing agent
• Pulse polio immunization -- giving 2 doses 1month apart
• Complications: Vaccine associated paralytic polio--VAPP (due to
type 2)

22. Injectable Polio Vaccine
• Formaldehyde killed and purified poilio virus
– Type I-40
– Type II-8 D antigen units
– Type III-32
• Immunity – humoral, local pharyngeal,
intestinal
• Safe
• 6,10,14 weeks according to IAP

23. DTwP / DTaP vaccines
• DTaP has been licensed in India for private use
• Current recommendations for use of DTaP
– For infants who had severe reaction to 1st dose of DTwP
– For adolescents and adults
– For infant immunized abroad with DTaP
• DTaP adult formulation has now been recommended as booster by
WHO for adolescents and adults.
• Absolute contra indications for DTwP
– Anaphylaxis to previous dose
– Progressive neurological disorder
– Hypotensive hyporesponsive episodes

24. MEASLES VACCINE
• Live attenuated vaccine (Edmonston-Zagreb strain)
• Given IM or SC
• Given at 9 months (because at that time maternal antibody
wean off)
• Contraindications
– Malignancy
– Therapy with alkylating agent/ corticosteroid
– Immune deficiency
• Side effect -- TSS (toxic shock syndrome) due to bacterial
contamination.

25. MMR vaccine
• Measles---Edmonston-Zagreb strain
• Mumps-Jeryl Lynn strain
• Rubell--RA 27/3 strain
• Dose is 0.5 ml (2 dose one at 15 month and another 8 weeks later)
(S / C).
• Contraindication--pregnancy,immunosuppression

26. HEPATITIS B VACCINE
• Recombinant DNA vaccine (in yeast)
• 0.5 mL IM in <1 year and 1 mL > 1 year
• 3 doses at 0, 1, 6 months
• HBIG gives passive immunity
• HBIG should be given preferably within 48 hours of exposure.

27. TYPHOID VACCINE
• 2 doses
• 0.5 mL SC 1 month interval (killed vaccine)
• Typhoral-- oral live vaccine (stable mutant S. typhi strain type 2
Ia)
• Typhim-- give SC or IM single dose

28. Hib VACCINE
• Capsular polysaccharide used as antigen
• Given particularly prior to splenectomy
• 3 dose below six months
• 2 dose between 6-12 months
• 1 dose between 12-15 months
• And a booster dose should be in this children at
18 months
• >15 months--only one dose

29. HPV Vaccine
• 0.5 mL IM deltoid
• Recommended age for initiation of vaccine is
10-12 years
• 3 doses at 0,2,6 months

30. Chickenpox Vaccine
• Dose--0.5 mL S /C or IM 2 doses 4-8 weeks apart >13
years
Pentavalent vaccine
• Trail in Kerala,Tamil Nadu
• Contains D , P , T , Hib , Hep B.
• Schedule-6,10, 14 week

31. National Immunization Schedule
Age Vaccines
Birth BCG, OPV0 (for institutional deliveries)
6 weeks DTwP1, OPV1, HepB1, Hib1$$ (BCG if not
given at birth)
10 weeks DTwP2, OPV2, HepB2, Hib2
14 weeks DTwP3, POV3, HepB3, Hib3
9-12 months Measles
16-24 months DTwP B1, OPV4, MMR
5-6 years DTwP
10 years TT
16 years TT
Pregnant women TT1 (early in pregnancy)
TT2 (1 month later)
TT booster (if vaccinated in past 3 years)

32. IAP recommended vaccines for
routine use
Vaccines under special
circumstances
BCG,
OPV
IPV
DTwP/DTaP
DT
Td
Tdap
Measles
Typhoid
Hib
Hep B
MMR
HPV
PCV
Hepatitis A
Chicken Pox
Rotavirus vaccine
Rabies
Influenza
PPSV23
Japanese Encephalitis
Meningococcal
Cholera
Yellow Fever

33. IAP Immunization Time Table
(recommended vaccines for routine use)
Age (completed weeks/ months/years) Vaccines
Birth BCG
OPV0
HepB 1
6 weeks DTwP1/DTaP1
OPV1*/ OPV1 + IPV1
Hib1
HepB2
Rotavirus 1 *#
PCV 1
10 weeks DTwP2/ DTaP2
OPV2*/ OPV2 + IPV2
Hib 2
Rotavirus 2
PCV 2

34. 14 weeks DTwP3/ DTaP3
OPV3*/ OPV3 + IPV3
Hib3
Rotavirus 3
HepB3**
PCV 3
9 months Measles
12 months Hepatitis A 1
15 months MMR1
Varicella
PCV booster
16 to 18 months DTwP B1/ DTaP B1
OPV4*/ OPV4 + IPVB1
Hib B1

35. 18 months Hepatitis A 2
2 years Typhoid 1
5 years DTwP B2 / DTaP B2
OPV5
MMR2
Typhoid 2
Varicella 2
10 to 12 years Tdap/Td
HPV^

36. vaccination schedule for an unimmunized child
Visit Suggested vaccines
First Measles (MMR if more than 12 months)
DTwP1/DTaP1 (Tdap if 7 years or more)
OPV1/IPV1 (only if less than 5 years)
Hib 1 (Only if less than 5 years)
Hep B 1
Second visit
(after 1 month of first visit)
BCG (only in less than 5 years)
DTwP2/ DTaP2 (Td if 7 years or more)
OPV 2 (if OPV given earlier)
Hep B 2
Hib 2 (if less than 15 mths
Third visit
(after 1 month of second visit)
OPV3/IPV2
MMR (if more than 12 months)
Typhoid (if more than 2 years)
Fourth visit
(6 months after first visit)
DTwP3/DTaP3 (Td if 7 years or more)
OPV4/IPVB1
HepB3

37. Do’s and Don'ts After Vaccine Administration
• Do not rub the site vigorously.
• Gentle pressure at the site for a few seconds will
suffice.
• If blood oozes do not blot. Just apply gentle pressure
with cotton swab.
• No Heat, Ice or Cold Water fomentation is advocated.
• The wet cloth soaked in ordinary portable water can
be applied at the site of swelling or tenderness for
about 5 – 10 minutes.
• Repeat the procedure, if necessary, 3-4 times a day.

38. THANK YOU