ACTIVE & PASSIVE IMMUNIZATION (VACCINATION)

Immunization Natural: Artificial: Infection = active Antibodies from mother = passive (transplacentary only IgG, half a year protection) Artificial: Vaccination - active Antibodies dosage (immunoglobulins) - passive

History Edward Jenner investigated, that dairy maid infected with cowpox were resistant also against smallpox. 14. 5. 1796 first aplication of “vaccine”. 1885 - Louis Pasteur used attenuated rabies virus as vaccination Nobel prize 1901 - von Behring – antitoxic serum against diphteria 1. 1. 1980 WHO proclaimed eradication of smallpox.

Vaccination Toxoids Inactivated vaccines Chemovaccines Recombinant vaccines Attenuated live vaccines

Toxoids Modified form of the toxin that preserves its antigenicity but has lost its toxicity. We use adjuvants. Tetanus (Clostridium tetani ) Diphteria (Corynebacterium diphteriae) Staphylococci

Inactivated vaccines Bacterins = carefully killed bacterial suspension Against viruses = influenza, poliomyelitis, rabies, tick born encephalitis Autovaccines = microbial strain originate from ill (vaginal candidosis – C. albicans, S. aureus, E. coli, H. influenzae…) Stock vaccines – mixture from frequenced laboratory strains (UNIVAK, Acnevak, Staphyvak, Candivak)

Chemovaccines and recombinant vaccines Isolated protected antigens Bacterial: against Haemophilus influenzae type b, N. meningitidis A + C, S. pneumoniae (23 frequent serotypes) Viruses: influenza A, hepatitis A, tick born encephalitis Recombinant vaccines = „made in“ E.coli (hepatitis B)

Attenuated live vaccines Reproduction in area of giving – mild infection – high effectivity, longlasting, also stimulating cellular immunity Attenuation – pasaging on artificial media or on tissue cultures (viruses) – reducing of the virulence BCG (bacille Calmette-Guérin) – M. tuberculosis Live virus polio (Sabin) - p.o. Mumps, measles, rubella Yellow fever

Mixed vaccines Hexavalent vaccine: diphteria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b (conjugated) and polio (inactivated) Trivalent atenuated vaccine against measles, mumps, rubella.

Vaccinacion types Regular – this calendary depends on country Special – for person in risk (hepatitis A, rabies, influenza, meningococcus) Extraordinary – in epidemia/extraordinary situation In accidents – tetanus, rabies Protecting the traveller – yellow fever, hepatitis A and B, Japanes B encephalitis, tetanus, poliomyelitis, abdominal tyfus, cholera For request – influenza, tick born encephalitis, meningococcus (against meningitis)

Contra- indications Acute illnes Patients in reconvalescence Immuncompromised patients !!!! Patient with alergy, pregnant women – attention!!!

Artificial passive immunization Heterologous (animal) immunoglobulines: antigangrenous (low effectivity), against botulism, staphylococci infections, viperic poison, rabies - alergic reactions Homologous (human) immunoglobulines: various antibody defects, profylaxis of hepatitis A, against sepsis, hard absceding infections and difficult virosis (Ebola)

New trends Edible vaccines – tomato/banana producing antigens of diarrhea agens DNA vaccines – injected into muscle or skin, produce protective antigens and cytokins Intradermal or mucous aplication – contact with dendritic cells Ideal vaccine: Cheap, stable, safe, lifelong protection, effective immunity