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

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

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

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

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of vaccination 1796 first smallpox vaccination 1840 universal vaccination 1853 compulsory vaccination 1948 compulsion withdrawn 1955 polio vaccine 1988 MMR vaccine 2008 HPV vaccine

7. Smallpox- Success! Endemic in Europe until vaccination 1901-2 Last large epidemic 1967 World Health Organisation campaign started 1977 Last naturally occurring case of smallpox 1980 WHO declared smallpox virus to be extinct

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

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

12. 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

13. 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

14. 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

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

16. 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 2006 1,200 deaths; 3,200 new cases in UK Cause: Human Papilloma viruses 16,18 and 33

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