Preventive Pediatrics Immunization: -Ultimate goal: Eradication of Disease -Immediate goal: Prevention of Disease -timely immunization as high priority

y -intense surveillance -effective public health control -Objective: provide effective immunity by establishing adequate levels of antibodies and a primed population of memory cells which can rapidly expand on renewed contact with an antigen and so provide protection against infection. -evidence by protection against natural disease -serum antibody concentrations are not always predictive of protection -sero-convertion of at least 80% is a good vaccine Types of Immunization: 1. Active evokes an immunologic response Contains: -all or part of a microorganism -modified product of an organism 2. Passive provides passive protection -does not produce an immunologic response -useful for those that cannot produce antibodies Contains: -serum with antibodies -sensitized cells *Non-immune compromised host might develop disease before active immunization could stimulate antibody production (7-10 days) *Herd immunity Majority of a population is immune to a disease preventing the disease to establish in the population, thus giving immunity to the minority who are not immune. Types of immunity 1. Natural Active natural infection 2. Natural Passive trans-placental 3. Artificial Active vaccination 4. Artificial Passive parenteral immunoglobulin (Ig)

Requirements for a successful vaccine 1. Effective Must evoke protective levels of immunity at the appropriate site of relevant nature of adequate duration 2. Availability Readily cultured or accessible source 3. Stability Stable under extreme climatic conditions, preferably not requiring refrigeration 4. Cheapness not expensive in developing, limiting the cost 5. Safety Eliminate any pathogenicity Major constituent of vaccines 1. Active immunizing agent -Single antigen that is a highly defined constituent -complex or less well defines (live viruses or killed bacteria) 2. Suspending fluid -Sterile water -saline -tissue culture fluid 3. Preservatives, stabilizers, antibodies -thiomersals or antibiotics (neo & streptomycin) - prevents bacterial growth, to stabilize 4. Adjuvant -usually metals -Aluminium salts -used to increase the immunogenicity ` -prolongs the stimulatory effect particularly those containing inactivated microorganisms or their products Types of vaccines 1. Killed bacteria microbes is destroyed but antigenic constitution is maintained -less potent -short duration -(typhoid, killed poliomyelitis(Salk)) 2. Inactivated modified microbes that mimics the natural behaviour of original disease w/o causing significant disease -immunity is more superior than killed organisms, as the replication of the living microbes give the host a larger and more sustained dose of antigen -immune reaction takes place at the site of natural infection

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-(BCG, OPV) 3. Live attenuated component of the original microorganism with only the known antigen portion -(H.influenza type-B, Pneumococcal, meningococcal) *Purified Polysaccharide vaccine requires coupling to an immunologic carrier protein (Tetanus Toxoid (TT)) 4. *Gene cloning a. DNA recombinant makes gene encode parts or the whole protein peptide chain b. yeast derived gene fused with yeast element which assembles into a highly immunogenic virus-like particle (Hep.B vac) 5. Toxoid detoxified toxin 6. Conjugate proteins/toxins from an organism are linked to the outer coat of another organism to into AB formation *immature immune system of infants cannot recognize these organisms -(H.inluenza type B capsular polysaccharide is conjugated to D/T) *Vaccines -Vaccines Not available in the RP -Staphylococcal -Cholera -Anthrax -Yellow fever -Live Attenuated -BCG-bacteria -Anthrax-bacteria (animal) -OPV-virus -Measles-virus -Mumps-virus -Rubella-virus -Chicken pox (varicella)-virus -Yellow fever-virus

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