VACCINATIONS AND IMMUNISATIONS Science Group, Buxton U3A 20 th September 2013 Dr Marion Overton

VACCINATION ACTIVE IMMUNITY ANTIGEN ANTIBODIES (Immunoglobulins) (IgM >IgG) T and B LYMPHOCYTES

ANTIGENS/PATHOGENS Viruses eg influenza, hepatitis, mumps, measles, rubella, polio, encephalitis, HPV, rabies, shingles, yellow fever Bacteria –cocci eg streptococci, meningococci, haemophilus, whooping cough

-bacilli eg typhoid, tuberculosis, anthrax, diphtheria, tetanus -Vibrio Eg cholera

History of vaccination 1796 first smallpox vaccination 1840 universal vaccination 1853 compulsory vaccination 1948 compulsion withdrawn 1955 polio vaccine 1988 MMR vaccine 2008 HPV vaccine

Smallpox- Success! Endemic in Europe until vaccination Last large epidemic 1967 World Health Organisation campaign started 1977 Last naturally occurring case of smallpox 1980 WHO declared smallpox virus to be extinct

Polio- a challenge 1988 Global eradication programme -annually hundreds of thousands diagnosed 65% chance of permanent paralysis Still endemic in Nigeria, Pakistan and Afghanistan

Eradication Programmes Significant disease Humans only host of infection Diagnostic tools Vaccine Distribution mechanism for vaccine Ethos

Mumps/Measles/Rubella vaccine Measles complications in 1:15 notified cases -encephalitis 1:5000 >15% mortality 1968 measles vaccine 1988 MMR 1995 Dr Wakefield claimed link between MMR vaccine, autism and bowel disease

Flu vaccine Types A, B and C H and N subtyping of Type A Antigenic shift and drift Swine flu A/Swine/Taiwan/2/87(H3N2) >bronchitis in 20% Seasonal flu in UK kills 3-4,000 each winter

Concerns re flu vaccine “Causes flu” allegation – NO! Side effects of vaccine Guillain-Barre polyneuritis in1-2/100,000 per year (same as background risk) Vaccine gives inadequate protection Given annually to all (including children over 6 months) with chronic diseases, over 65s, pregnant women, carers etc

Live vaccines NOT for immunodepressed patients: BCG, yellow fever, oral typhoid and live polio vaccines, MMR Concept of Herd Immunity

Cancer of the cervix 2 nd most important cancer in women 2006 worldwide 200,000 deaths and 400,000 new cases each year,of which 80% in 3 rd world ,200 deaths; 3,200 new cases in UK Cause: Human Papilloma viruses 16,18 and 33

Future challenges Resistance to vaccines or treatment Disillusion with vaccination programmes Cost Targeting of vaccines Vaccines against cancer and autoimmune disease; “lifestyle” vaccines