Viral Vaccine, Schedule, dose, route of admisnistration

1. Viral VaccinesViral Vaccines
DrVishal KulkarniDrVishal Kulkarni
MBBS MD(Microbiology)MBBS MD(Microbiology)

2. Vaccine- DefinitionVaccine- Definition
 A vaccine is any preparation intended toA vaccine is any preparation intended to
produce immunity to a disease byproduce immunity to a disease by
stimulating the production of antibodies.stimulating the production of antibodies.
 It include suspensions of killed orIt include suspensions of killed or
attenuated microorganisms, or products orattenuated microorganisms, or products or
derivatives of microorganisms.derivatives of microorganisms.

3. Types of VaccinesTypes of Vaccines
 Whole organism vaccine-Whole organism vaccine-
 Measles, mumps, polioMeasles, mumps, polio
 Purified MacromoleculesPurified Macromolecules
 HBsAg vaccineHBsAg vaccine
 Recombinant Vector vaccinesRecombinant Vector vaccines
 Vaccinia virus for smallpox, salmonella,Vaccinia virus for smallpox, salmonella,
canarypoxcanarypox

4.  DNA vaccinesDNA vaccines
 Herpes virus, AIDSHerpes virus, AIDS
 Multivalent subunit vaccines-Multivalent subunit vaccines-
 Measles, HIV, Influenzae vaccineMeasles, HIV, Influenzae vaccine

5. LIVE VIRAL VACCINESLIVE VIRAL VACCINES
 Advantages-Advantages-
 Single dose is sufficientSingle dose is sufficient
 Administered through natural routeAdministered through natural route
 Induce wide spectrum of immunoglobulinInduce wide spectrum of immunoglobulin
 Induce CMIInduce CMI
 More effective & more long lastingMore effective & more long lasting
 Economical & ConvenientEconomical & Convenient
 Disadvantages-Disadvantages-
 Risk of reversion to virulenceRisk of reversion to virulence
 Contamination with dangerous virusContamination with dangerous virus
 Heat labile (refrigeration)Heat labile (refrigeration)

6. KILLED VACCINESKILLED VACCINES
 Are prepared by inactivating viruses withAre prepared by inactivating viruses with
heat, phenol, formalin, BPLheat, phenol, formalin, BPL
 Advantages-Advantages-
 Stability, safetyStability, safety
 Can be given in combinationCan be given in combination
 No danger of spread of virusNo danger of spread of virus

7.  Disadvantages-Disadvantages-
 Multiple injections are requiredMultiple injections are required
 Local & CMI are not inducedLocal & CMI are not induced

8. PASSIVE IMMUNIZATIONPASSIVE IMMUNIZATION
 Indicated in those who are at riskIndicated in those who are at risk
 Gives temporary protectionGives temporary protection
 E.g measles, mumps , Hepatitis, rabiesE.g measles, mumps , Hepatitis, rabies
 Generally combined immunization is givenGenerally combined immunization is given

9.  Viral vaccine in common useViral vaccine in common use
Live Killed
Poliomyelitis Poliomyelitis
Yellow fever Rabies
Varicella JE
Mumps, measles, rubella Hepatitis B (Cloned)
Influenza Influenza

10. Hepatitis vaccinesHepatitis vaccines
Hepatitis A vaccinesHepatitis A vaccines ::
 Inactivated, whole-cell Virus vaccines.Inactivated, whole-cell Virus vaccines.
 Grown in human diploid fibroblast cells.Grown in human diploid fibroblast cells.
 Full course consist of 2 i.m injectionsFull course consist of 2 i.m injections
Protection last for 10-20yrs.Protection last for 10-20yrs.

11. Hepatitis-B vaccine:Hepatitis-B vaccine:
 Hbs ag vaccineHbs ag vaccine: 1: 1stst
vaccine prepared fromvaccine prepared from
pooled plasma of healthy human carrier.pooled plasma of healthy human carrier.
Immunogenic but unsafe.Immunogenic but unsafe.
 Genetically engineered vaccineGenetically engineered vaccine::
S gene of HBV cloned in bakers yeast.S gene of HBV cloned in bakers yeast.
Consist only non glycosylated Hbs ParticlesConsist only non glycosylated Hbs Particles
Alum is used as adjuvant.Alum is used as adjuvant.
Dose –Dose –
3 doses at 0,1,6 months, i.m into deltoid.3 doses at 0,1,6 months, i.m into deltoid.
 In infants into anterolateral aspect of thigh.In infants into anterolateral aspect of thigh.

12. Polio vaccinePolio vaccine::
 Killed polio vaccine (salk):Killed polio vaccine (salk):IPV.IPV.
Formalin inactivated preparation of three types ofFormalin inactivated preparation of three types of
polio virus grown in monkey kidney tissue culture.polio virus grown in monkey kidney tissue culture.
Dose:Dose: 3 doses 4-6 wks apart , booster after 63 doses 4-6 wks apart , booster after 6
months later.months later.
Provides 80-90% protection.Provides 80-90% protection.

13.  Live polio vaccine: (OPV).Live polio vaccine: (OPV).
 Attenuated strain are grown in monkeyAttenuated strain are grown in monkey
kidney Cell.kidney Cell.
 Issued in monovalent or trivalent form MgCl2Issued in monovalent or trivalent form MgCl2
or sucrose used as stabilizer.or sucrose used as stabilizer.

14.  ContainsContains
 Type 1 virus- 10 lakhType 1 virus- 10 lakh
 Type 2 virus – 2 lakhType 2 virus – 2 lakh
 Type 3 virus- 3 lakhType 3 virus- 3 lakh
 Dose – 3 doses in 4-6 wk intervalDose – 3 doses in 4-6 wk interval

15. Antirabies vaccineAntirabies vaccine::
 Neural vaccineNeural vaccine::
• SempleSemple
• BPLBPL
• Infant brain vaccineInfant brain vaccine
 Non neural vaccine :Non neural vaccine :
• Egg vaccines-Egg vaccines-
- duck egg vaccine- duck egg vaccine
- live attenuated chick embryo vaccine- live attenuated chick embryo vaccine

16. • Tissue culture vaccine-Tissue culture vaccine-
- Human diploid cell vaccine.- Human diploid cell vaccine.
- Purified Chick Embryo Cell Vaccine (PCEC) .- Purified Chick Embryo Cell Vaccine (PCEC) .
- Purified Vero Cell Vaccine (PVC).- Purified Vero Cell Vaccine (PVC).

17. Zoster vaccineZoster vaccine
 It is a lyophilized preparation of the Oka strain ofIt is a lyophilized preparation of the Oka strain of
live, attenuated VZV.live, attenuated VZV.
 Give in children 1-12 yrs old.Give in children 1-12 yrs old.
 Single 0.65-mL s.c in the deltoid region of the upperSingle 0.65-mL s.c in the deltoid region of the upper
armarm
 VZIG in immunodeficient & elderyVZIG in immunodeficient & eldery

18. JAPANESE B ENCEPHALITIS VACCINEJAPANESE B ENCEPHALITIS VACCINE::
 Inactivated JE vaccine (Nakayama strain):Inactivated JE vaccine (Nakayama strain): derivedderived
from infected mouse brain. licensed in Japan sincefrom infected mouse brain. licensed in Japan since
1954.1954.
 JE strain 14-14-2JE strain 14-14-2 - Similar mouse brain derived JE- Similar mouse brain derived JE
vaccinesvaccines
 produced in primary hamster kidney cellsproduced in primary hamster kidney cells
 2 doses i.m. 1 yr apart2 doses i.m. 1 yr apart

19. Vaccine against HPVVaccine against HPV::
 BivalentBivalent human papilloma virus vaccine( HPV2)-human papilloma virus vaccine( HPV2)-
 Contains types 16 and 18 aloneContains types 16 and 18 alone
 QuadrivalentQuadrivalent human papilloma virusVaccin(HPV4)human papilloma virusVaccin(HPV4)
--covers four serotypes of HPV, 16 ,18, & 6covers four serotypes of HPV, 16 ,18, & 6
and 11and 11..


20. Ideal age for Vaccination and efficacy:Ideal age for Vaccination and efficacy:
• The duration of the immunity conferred by theThe duration of the immunity conferred by the
vaccines is not yet known..vaccines is not yet known..
• The best subjects for vaccination will beThe best subjects for vaccination will be
pre adolescents or adolescentspre adolescents or adolescents..
 Contraindicated in pregnancyContraindicated in pregnancy

21. SWINE FLU VACCINESWINE FLU VACCINE
FDA approved H1 N1 vaccinesFDA approved H1 N1 vaccines
 Influenza A (H1N1) 2009 Monovalent Vaccine
 Indications And Usage
 an inactivated influenza virus vaccine persons ≥6 months of
age
 Children 4- 9 years of age: Two 0.5-mL i.m. injections, 1
month apart
 > 10 yrs- 0.5 ml single dose i.m

22. HIV Vaccine ApproachesHIV Vaccine Approaches

23. Challenges in HIV Vaccine ResearchChallenges in HIV Vaccine Research
• Viral Genetic DiversityViral Genetic Diversity:: HIVHIV
is not just one specificis not just one specific
virus.virus.
• Neutralizing AntibodyNeutralizing Antibody::
Difficult to generateDifficult to generate
broadly neutralizingbroadly neutralizing
antibodies.antibodies.
• Vaccine TestingVaccine Testing:: SlowSlow
process, very expensiveprocess, very expensive

24. Status of HIV Vaccine DevelopmentStatus of HIV Vaccine Development
product Company HIV
subtype
Phase Site
Peptide
V3 peptide
CIBG B 1 Cuba
Recombinant subunit
Bivalent rpg 120
VaxGen B+E 3 Thailand
Live viral vector
Canary pox - env-gag-pr
Aventis B 1 Uganda
Live bacterial vector
Salmonella - env
Univ. Md. B 1
Combinations (Vector
prime + subunit boost)
Canary pox - env-gag-pr,
• Nef, pol rgp 120
• rgp 120
Canary pox - env gag-pr
Aventis E
2
Chiron
VaxGen
Aventis
E
E
B+E
B
2
2
Thailand
Haiti,
Thailand,
Brazil

25. Several other antiviral vaccines are available:Several other antiviral vaccines are available:
 MeaslesMeasles
 RubellaRubella
 MumpsMumps
 MMRMMR
 Yellow feverYellow fever

26. Vaccines under trialVaccines under trial
 DengueDengue
 KFDKFD
 EbolaEbola
 SARSSARS
 RotavirusRotavirus
 Swine influenzaSwine influenza

27. Thank you….!!Thank you….!!