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VACCINES

Vaccine
PRESENTED BY:
ARSLAN ARSHAD
PHARM-D IPS,UVAS
M.PHIL SCHOLAR UOL,LAHORE
INCHARGE PHARMACIST CLINIX PLUS PHARMACY

CONTENTS

Introduction to vaccine

History

Types of vaccine

Immunization schedule.

General consideration

Side effects

Reasons of vaccine failure

INTRODUCTION

A vaccine is a biological preparation that improves immunity to a particular disease. It

contains certain agents that not only resembles a disease-causing microorganism but it
also stimulates bodys immune system to recognize the foreign agents.

History:

British physician Edward Jenner, who in 1796 used the cowpox virus to confer
protection against smallpox.

In 1885 the French microbiologist Louis Pasteur and Emile Roux developed the
firstvaccine against rabies.

TYPES OF VACCINE
Whole-Organism Vaccines

Killed

Attenuated
Purified Macromolecules as Vaccines

Toxoids

Conjugated Vaccine

Subunit Vaccine

DNA vaccine
Multivalent Subunit Vaccines

Live Attenuated vaccine

Vaccines contain live, attenuated microorganisms.

These are live viruses that have been cultivated under conditions that
disable their virulent properties.

Advantages:

Close to nature

In live attenuated vaccine we use closely related but less dangerous

organisms to produce a broad immune response.

They produce lifelong immunity with only one or two booster doses.

Live Attenuated vaccine

Drawbacks:

Microbe may return to its virulent form.

Cannot given to immunocompromised patients.

Need to be refrigerated to stay potent ( major problem in under develop countries).

Examples:

OPV

MMR

Varicella (chickenpox)

Influenza (nasal spray)

Rotavirus

Inactivated Vaccines

Produced by Inactivating a pathogen , by using heat or chemicals (formaldehyde or formalin) and

radiations. This destroys the pathogens ability to replicate.

They tend to provide a shorter length of protection than live vaccines, and require booster dose
to create long-term immunity.

Can be given to immunocompromised patients.

Usually dont need refrigeration and can be transported in lyophilized form.

Disadvantages:

Needs booster dose which increases cost of treatment.

Does not stimulate IgA which has important role in mucosal defense.

Example:

Hepatitis A

Influenza

Rabies

Purified Macromolecules as Vaccines

Toxoids

Diphtheria toxoid.

Tetanus toxoid

Capsular polysaccharides

Pneumonia

Sub unit vaccines

Hepatitis B.

Toxoids

Toxoids are vaccines which consist of exotoxins that have been inactivated, either by
heat or chemicals. These vaccines are intended to build immunity against the toxins,
but not necessarily the bacteria that produce the toxins.

Toxoid

Combined prophylaxis:

Sometimes active and passive immunization is done simultaneously in severe cases,

So tetanus toxoid and Tetanus immunoglobulin are administered together at

different sites to produce a strong response.

Advantages:

Very safe

Derived from natural source

Disadvantages:

Manufacturing procedure is costly.

Required booster doses.

Subunit Vaccine

Instead of the entire microbe, subunit vaccines include only the

antigens that best stimulate the immune system.

Manufacturing:

Grow the microbe in the laboratory and then use chemicals to break it apart
and gather the important antigens.

Manufacture the antigen molecules from the microbe using recombinant

DNA technology. Vaccines produced this way are called recombinant
subunit vaccines.

Subunit Vaccine

Advantages:

We use specific epitope so very rare adverse effects

Safe to use in pregnancy and immunocompromised patients.

Cannot cause disease

Simplified large scale production.

Disadvantages:

Comparative to other vaccines requires extensive research to find out which molecules are
easiest for immune system to recognize.

Multiple doses required.

Examples:

Hepatitis B

Conjugated vaccine

Some Bacteria has polysaccharide coating to disguise our immune

system.

Conjugated vaccine is prepared by using fragments of this coating

combined with a protein.

Fragments itself cannot produce immune response, but with protein

they produce a response even stronger than the whole bacterial
organism.

Examples:

Haemophilus influenzae type B (Hib)

Pneumococcal pneumonia

DNA Vaccine

DNA vaccine is DNA sequence used as vaccine.

This DNA Sequence code for antigenic protein of pathogen.

We insert that DNA is inserted in the host using special delivery system.

Host cells take up that DNA sequence and translate it to form proteins.

Proteins shown up on surface of cells and produce immune response.

DNA vaccines Vs Traditional

vaccines
DNA vaccines

Traditional vaccines

Uses weakened or killed form of

infectious organism.

Create possible risk of the vaccine

being fatal.

Provide primarily Humoral immunity

Usually requires Refrigeration.

Uses only the DNA from infectious organisms.

Avoid the risk of using actual infectious organism.

Provide both Humoral & Cell mediated immunity

Refrigeration is not required

DNA Vaccine

Advantages

Elicit both Humoral & cell mediated immunity

Focused on Antigen of interest

Long term immunity

Refrigeration is not required

Disadvantage

Limited to protein immunogen only.

Extended immunostimulation leads to chronic inflammation

Overview

Live attenuate

Inactivated vaccine

Subunit vaccine

Toxoids

NATIONAL IMMUNIZATION SCHEDULE

Routes of Administration

Intramuscular:

Sub cut:

MMR, Meningococcal Polysacchride. Polio inactivated ,varicella zoster.

Intradermal:

DPT, Hepatitis A and B, Influenza inactivated , meningococca l,

Influenza (Fluzone)

Oral:

OPV

Rotavirus

General Considerations

Precautions

Contraindications

Pregnancy

Breast feeding

Neurological considerations

General Considerations

Precautions:

Postpone vaccine if patient suffering from acute illness (systemic infection,fever)

Allow to evaporate the disinfectant from skin before administering vaccine, it may
kill live attenuated vaccine.

When 2 or more vaccines are required (and are not available as a combined
preparation), they should be given simultaneously at different sites.

When 2 live vaccines cannot be given at the same time, they should be separated
by an interval of at least 4 weeks.

Contraindications:

History of anaphylactic reaction to any component of vaccine.

Hypersensitivity to Egg: Yellow fever vaccine.

General Considerations

Live vaccines:

Contraindicated in HIV infection, immunocompromised patients, pregnancy and breast

feeding.

Pregnancy:

Inactivated vaccines and toxoids are safe.

Live vaccine can cause damage to fetus.

Breast Feeding:

Vaccine can be given to Breast feeding mothers when significant risk of disease is
there.

Inactivated vaccine and toxoids are safe to use.

Consult product literature of vaccine

General Considerations

Neurological Problems:

if there is history of convulsions due to fever without neurological

deterioration vaccine can be given, by giving dose of paracetamol before
vaccination.

If child has uncontrolled epilepsy, then vaccine is contraindicated.

Vaccination And HIV

Live attenuated vaccines indicated:

Patient can take these vaccines, if immunity is not significantly impaired

MMR

Rotavirus

Vericella zoster

Inactivated vaccine indicated:

Anthrax, cholera (oral), diphtheria, HIB, hepatitis A, hepatitis B, influenza , meningococcal,

pertussis, pneumococcal, poliomyelitis, rabies, tetanus, typhoid.

Contraindicated Vaccine:

BCG

Oral vaccines

Side Effects

Local Reactions:

Pain, inflammation and redness.

Sterile abscess for short time.

Systemic Reactions:

Anaphylaxis

GIT disturbance and loss of appetite.

Irritability, fever and tiredness.

Post immunization Pyrexia:

Infants may suffer from this.

Use Paracetamol and ibuprofen to treat pyrexia.

Reasons For vaccination Failure

Primary Failure:

Individual fails to make an adequate immune response to initial vaccine.

Cause: Interfering level of maternal antibody

Example: Measle and mumps vaccine (10 % cases)

Secondary Failure:

Individual Shows adequate immune response initially but then immunity

wanes with time

Cause: Didnt received booster dose

Example: inactivated vaccines

THANKS