6. Vaccines Addition points to note: Site in body at which virus replicates Three major sites for viral replication www.freelivedoctor.com

8. There is little point in having a good neutralizing humoral antibody in the circulation when the virus replicates, for example, in the upper respiratory tract. Clearly, here secreted antibodies are important. Although in the case of influenza serum antibodies may be important www.freelivedoctor.com

20. New Recommendations To eliminate the risk for Vaccine-Associated Paralytic Poliomyelitis, the ACIP recommended an all-inactivated poliovirus vaccine (IPV) schedule for routine childhood polio vaccination in the United States. As of January 1, 2000 , all children should receive four doses of IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years. www.freelivedoctor.com

26. New Methods Recent ‘flu vaccine from Aviron Passage progressively at cold temperatures TS mutant in internal proteins Can be re-assorted to so that coat is the strain that is this years flu strain www.freelivedoctor.com

32. New methods Anti-idiotype vaccine epitope Antibody with epitope binding site Virus www.freelivedoctor.com antibody

33. Anti-idiotype vaccine cont Make antibody against antibody idiotype Anti-idiotype antibody mimics the epitope www.freelivedoctor.com antibody Anti- idiotype antibody

34. Anti-idiotype antibody cont 2 Use anti-idiotype antibody as injectable vaccine Antibody to anti-idiotype antibody Binds and neutralizes virus Use as vaccine www.freelivedoctor.com Anti-anti-idiotype antibody Anti-idiotype antibody Anti-anti-idiotype antibody Anti-anti-idiotype antibody

39. DNA Vaccines plasmid Muscle cell Gene for antigen Muscle cell expresses protein - antibody made CTL response www.freelivedoctor.com

45. Towards an anti-HIV Vaccine www.freelivedoctor.com What should vaccine elicit? Humoral response neutralizing antibody kill free virus Cellular response kill infected cells problem of cell-cell infection

46. Towards an anti-HIV Vaccine www.freelivedoctor.com Early faith in neutralizing antibodies backed by chimpanzee experiments HIV high levels of neutralizing antibody Can resist subsequent challenge by virus injected I.V. !!!! But not via rectum or vagina But chimps do not get AIDS

48. Towards an anti-HIV Vaccine Since 1986: > 15 SUBUNIT VACCINES Based on gp160/gp120 All safe None effective Low levels of strain-specific antibodies that quickly disappear Only ephemeral effects of cell-mediated immunity All done with gp160/gp120 of syncytium-inducing virus None tested on large groups of high risk people www.freelivedoctor.com

50. Towards an anti-HIV Vaccine Humans: NEF deletion mutant www.freelivedoctor.com