MBBS Batch 17

CAN WE FOLLOW A PLAN?

Wrong groups

Wrong timings

Worshipping wrong doings

Attitude is most important

Self assessment Eva KW, Regehr G Self-assessment in the health professions: a reformulation and research agenda. Acad Med 80:S46-54.

Lecture 13: Principles of Immunization & Immunization schedule OBJECTIVES: The objectives of this lecture are to briefly review the history of immunization briefly review the history of immunization reinforce prior knowledge regarding primary and secondary immune response reinforce prior knowledge regarding primary and secondary immune response explain principles, advantages and disadvantages of active, passive and combined immunization. explain principles, advantages and disadvantages of active, passive and combined immunization. categorize the types of vaccines available for human use categorize the types of vaccines available for human use underline the significance of universal and national immunization schedules. underline the significance of universal and national immunization schedules. explain the role of adjuvants explain the role of adjuvants

Learning Outcomes At the end of the lecture, student should be able to: recall the history of immunization with respect to Edward Jenner and the small pox vaccine recall the history of immunization with respect to Edward Jenner and the small pox vaccine analyze the advantages and disadvantages of active immunization and passive immunization analyze the advantages and disadvantages of active immunization and passive immunization categorize the types of vaccines available into live attenuated, inactivated, subunit, recombinant, naked DNA etc. categorize the types of vaccines available into live attenuated, inactivated, subunit, recombinant, naked DNA etc. assess the significance of universal and national immunization schedules assess the significance of universal and national immunization schedules recall primary and secondary immune response recall primary and secondary immune response recognize the role of adjuvants recognize the role of adjuvants

Prevention of Infectious diseases PRIMORDIAL-Eradication/Elimination/Health education/Mass screening/Vaccines PRIMARY-Health education/Mass screening Vaccines SECONDARY-Early diagnosis and treatment TERTIARY- Disability limitation REHABILITATION-Rehabilitation

Dr.P.K.Rajesh.M.D. ACTIVE VS PASSIVE Produced actively h.i.s Infection,Immunogen Durable,effective Lag period Immunological mem+ Negative phase occurs Not applicable in immunodeficient Received passively Readymade antibodies Transient lesseffective Effective immediately Immune elimination No negative phase Applicable in immunodeficient.

Smallpox Safe effective vaccine Life long immunity Subclinical cases rare No animal reservoir One Variola serotype Smallpox is the first eradicated disease As a result, after a world-wide effort Smallpox was eradicated in 1978.

TYPES OF VACCINES

Vaccine typeExamples Live, attenuated Measles, mumps, rubella (MMR combined vaccine) Varicella (chickenpox) Influenza (nasal spray) Rotavirus Inactivated/Killed Polio (IPV) Hepatitis A Toxoid (inactivated toxin)Diphtheria, tetanus (part of DTaP combined immunization) Subunit/conjugate Hepatitis B Influenza (injection) Haemophilus influenza type b (Hib) Pertussis (part of DTaP combined immunization) Pneumococcal Meningococcal

Live attenuated means weakened. Unable to replicate enough to cause illness, but will still provoke an immune response Inactivated = Organism killed and can’t cause disease but still provoke immnune response Toxoids = Inactivated toxins produced by certain bacteria Subunit/ conjugate vaccine = merely segments of the pathogen 2 points : Vaccines must STIMULATE IMMUNE RESPONSE Vaccines must not cause disease.

Diphtheria and Tetanus 1934 Pertussis 1954 Salk polio Modern era of the vaccine 1885 Rabies vaccine (Pasteur) 1960s Mumps measles and rubella virus Sabin polio 1985 Haemophilus 1990s Hepatitis and varicella  2000 Human Papillomavirus (HPV)

Why Do Children Need So Many Shots? –Diphtheria –Haemophilus Influenzae type b –Hepatitis B –Measles –Mumps –Pneumococcal Disease –Polio –Pertussis (Whooping Cough) –Rubella –Tetanus (lockjaw) –Varicella (Chickenpox) 11 potentially serious vaccine-preventable diseases:

National Immunization Schedule: 2010 Vaccine Age (in months)Age (in years) Std 1Form 1Form 3 BCG 1If no scar Hep B 123 DTaP 1234 Hib 1234 IPV 1234 Measles SABAH ONLY MMR 12 HPV NEW TT 1 Ministry of Health, Malaysia

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