1. Vaccines

2. What are vaccines?
a substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease.
(WATCH How vaccines work you tube 1:58)
North Carolina is an innovative leader in vaccine research, development and manufacturing
Vaccines are one of the safest and most cost-effective tools in medicine despite the myths

3. History of vaccines Prevented millions of deaths and disabilities
Small pox vaccine was introduced in Europe in the 1700’s
Most u.s. children are vaccinated against 14 or more diseases

4. smallpox

5. Where are we at today?
Vaccine researchers are making exciting progress in developing new and improved vaccines, manufacturing processes and delivery methods

6. Key terms
Vaccination: is the introduction into the body of a weakened, killed or piece of disease-causing agent to prevent disease
Immunization: is the process by which the body becomes immune to a disease. A person can become immune by getting the disease or from a vaccination
Epidemic: is when more people in a particular population get a disease than typically expected

7. Key terms
Pandemic: is when a disease outbreak is global or over large areas of the world (CDC is attempting to prevent this with Ebola)
Pathogen: a disease-causing agent. It usually refers to a virus, bacteria, fungi or protozoan parasite
Virus: a small, infectious agent that only can replicate inside the cells of a living organism. It has a core of dna or rna surrounded by a protein coat and is not itself a living cell

8. Key terms Bacteria: a large group of microorganisms.
Antibodies: Special proteins produced by the body to attack foreign invaders such as pathogens
Antigens: substances, usually proteins or polysaccharides(carbs), that cause the body to produce antibodies

9. Questions to ask yourself?
Can you imagine eating a banana instead of getting a shot?
Using flu vaccine antigens produced by tobacco plants?
Ever heard of vaccine biodefense or nano-printing new vaccines?
!!!!!!All this and more is taking place in north Carolina!

10. History of pandemics
– a severe outbreak of a virulent strain of influenza (flu) virus killed between million people worldwide. Known as “Spanish flu”
500,000 people died in the u.s. from the flu
This flu killed a greater percentage of young healthy adults
2009 – a new strain of influenza emerged and had the same
characteristics similar to the 1918 flu
Think about how our world has changed since 1918, do these
changes make a deadly disease scenario more or less likely?

11. Pandemics
Smallpox, bubonic plague and HIV have caused deadly pandemics as well
However, the flu viruses have rapidly changing strains and circulate among animals as well as people – more chance of causing a pandemic
There have been several flu pandemics in the last 100 years, and the interconnected nature of our current global society only makes these more likely in the future!

12. Public health and pandemics
Public health (cdc) work hard everyday to prepare for future pandemics and help prevent them
One of their key weapons against disease is vaccination
Vaccination’s main goal is to prevent disease

13. Vaccinations
Scientists have developed vaccinations against many of the most threatening disease of the past: smallpox, polio, cholera, typhoid, yellow fever and influenza
North Carolina requires vaccination against 10 different diseases by the time children start school
The federal centers for diseases control and prevention (cdc) recommends 5 more to that 10
This not only protects the child, but protects the entire community “HERD IMMUNITY”

14. Polio and yellow fever

15. Vaccinations
Lowering the incidence of the disease in the population, vaccinations protects even those who are too young to be vaccinated, those who have an allergy to the vaccine or those who have a weakened immune system
However, not all diseases have vaccines at this time such as HIV, malaria and chlamydia

16. How vaccines work
Your immune system protects you from diseases caused by a wide variety of pathogenic organisms, including viruses, bacteria, protozoans and worms
This is done by a layered defense system: from mechanical barriers (such as skin and mucus) to specific attacks on invading organisms
The purpose of the vaccine is to “jump-start” a specific immune response by introducing the person (or animal) being vaccinated
There is enough of a specific, disease causing agent to cause an immune response but not enough to cause illness

17. How vaccines work **
The human immune system is able to recognize and distinguish between protein molecules that belong to its owner’s body (self) and those that come from outside attacker (foreign)

18. Types of vaccines Live by weakened “Attenuated” disease agents
Inactivated or killed disease agents
Subunit vaccines- subunit of disease
Toxoid vaccines- toxin secreted by disease
Conjugate vaccines- infants/young children
Dna vaccines- experimental
Recombinant vector vaccines- experimental

19. Live attenuated weakened disease agent
Many vaccines are made from live attenuated weakened disease agent
This includes live virus vaccines
Even though viruses are not considered living organisms, functional virus particles are called “live”
Examples: Flu Mist, the nasal flu vaccine, mmr, chickenpox
Advantages: very effective in including full protection against their diseases

20. Problems with live viruses vaccine
Can mutate to a more dangerous form
Some people, especially those with weak immune systems (such as cancer or hiv patients) , get sick even from the weakened form of the disease BECAUSE THEIR IMMINE SYSTEMS ARE ALREADY WEAKENED OR “COMPRIMISED”
To remain effective, a live vaccine usually needs constant refrigeration all the way from the manufacturing stage until it is injected into the patient
Vaccines that require refrigeration can be difficult to distribute, particularly in poor countries

21. Inactivated or killed disease agents
Polio Hepatitis a The advantages of these vaccines are that they can’t cause the actual disease and that the purified forms can be stored without refrigeration, which makes them cheaper and easier to distribute globally Disadvantage: The immune response they cause is weaker than the immune response caused by live, attenuated viruses. This weaker immune response means that more booster shots are required to maintain immunity

22. Subunit/conjugate vaccines
subunit and conjugate vaccines help the immune systems of infants and young children recognize the virus by helping their system see it. Hepatitis B Influenza (injection) Pertussis (part of DTaP combined immunization) Pneumococcal Meningococcal HPV

23. Toxoid (inactivated toxin)
Toxoid vaccines help the body develop antibodies to toxins released by bacteria rather than antibodies to the bacteria themselves examples: Diphtheria, tetanus(part of DTaP combined immunization)

24. DNA Vaccines
is a technique for protecting an organism against disease by injecting it with genetically engineered DNA to produce an immunological response.
There are many advantages to the DNA vaccination method. For example, it is much cheaper to produce and distribute large amounts of DNA than it is to produce and distribute large amounts of protein.
There are many DNA vaccines in clinical and pre-clinical trials, including vaccines for HIV, herpes, hepatitis and influenza.

25. Recombinant vector vaccines
are experimental vaccines similar to DNA vaccines, but they use an attenuated virus or bacterium to introduce microbial DNA to cells of the body. “Vector” refers to the virus or bacterium used as the carrier.
Recombinant vector vaccines closely mimic a natural infection and therefore do a good job of stimulating the immune system.
Researchers are working on both bacterial and viral- based recombinant vector vaccines for HIV, rabies, and measles.

26. History of live virus vaccines
1700 – Edward jenner was interested in the belief of farmers that cowpox infection prevented smallpox
Jenner deliberately infected people with cowpox, a mild disease related to smallpox
After they recovered from cowpox, he attempted to infect them with smallpox
What he found: they were immune to smallpox
Today his efforts would be considered unethical, but his work saved countless lives

27. Vaccine fears: fact vs fiction
Smallpox vaccineS “eradicated” smallpox. The last case was recorded in 1977
If vaccines were to be stopped, diseases would re-emerge
The resurgence in vaccine-preventable diseases is due to the fears many people have about vaccination.
Also, increases in immigration and unvaccinated people

28. Vaccine fears: fact vs fiction
Vaccination does have risks, but these risks are far out weighed by the risks of the disease they prevent
Example: Risk of death from measles vaccination is less than 1 in 1,000,000
Risk of death from contracting measles is 1 in 1,000 cases
In addition, individuals suffer
serious complications such as
pneumonia and ear infections
after contracting the disease

29. Autism in young children
The myth arose from a fraudulent study published in a British medical journal claiming that the mmr (measles/mumps/rubella) vaccine caused autism
After this study was published, vaccination rates began to fall
Two large studies since have shown there is no connection between vaccination and autism spectrum disorders
Further research found that the researchers in the British article actually Changed their results to fit their conclusion

30. Human papilloma virus (HPV)
Gardasil and cervarix – vaccines against hpv, EXCEPT ONES THAT YOU MAY HAVE ALREADY BEEN EXPOSED TO.
Hpv is a sexually transmitted disease that causes genital warts (HSV2) and cervical cancer. It has also be linked in vaginal cancers in women and penile cancers in men.
Hpv is the most common sexually transmitted disease in the u.s., but most women fight the infection off without treatment

31. HPV

32. Human papilloma virus (HPV)
Each vaccination requires 3 doses and is relatively expensive, there is no time frame of how long the vaccine will last
Cervical cancers affect 11,000 women a year in the u.s. and kills almost 4,000
Worldwide 275,000 women die each year from cervical cancer
Most of the cases would be prevented by the vaccination

33. Female cervix

34. Gardasil and cervarix
Vaccination can prevent abnormal and precancerous cells in the cervix
These abnormal cells are found by pap smears
Cells are taken from a woman's cervix and examined
an abnormal pap smear results in the need for a biopsy
The hpv vaccines also can reduce the number of biopsies required

35. Gardasil and cervarix
The vaccination is most effective in young adolescents because they have stronger immune response
It is important to be vaccinated before exposure to the disease ,
IE: BEFORE YOU BECOME SEXUALLY ACTIVE

36. Gardasil and cervarix
Parents and politicians continue to claim it is a dangerous vaccine
The fda and government agencies around the world continue to monitor the safety and effectiveness of all vaccines

37. Vaccine development process
Fda must approve vaccines for use in the united states To get approval each new vaccine goes through an extensive development and testing process that builds on lessons from previous vaccination development It must include in vitro testing, animal testing and several phases of clinical trials in humans

38. Manufacturing vaccines
Vaccine antigens are produced under highly regulated conditions Manufacturers follow required good manufacturing practices This ensures the product is the exact dose each time and safe Each phase of the manufacturing must be carefully documented

39. Manufacturing vaccines
There are 3 methods to manufacturing vaccines
Eggs
Cell culture
Plant culture

40. Eggs- From chicken egg to syringe: how a flu vaccine is made
Since the 1940’s influenza has been made by injecting
fertilized chicken eggs with live but weakened
strains of influenza virus
The virus replicates in the egg for several days
Then the virus is separated from the egg and exposed to chemicals – this inactivates the virus dna
It is tested for sterility and then packaged into vials then tested one last time
It takes 5-6 months from the time the new strains of influenza are identified until the vaccine is available for use

41. Problems with eggs in vaccines
Threat of egg shortage due to diseases in chickens
The fact that some strains of virus grow more slowly in eggs or have much lower yield of antigen than other strains, will take much longer to make the vaccine
If a new deadly strain of pandemic flu emerges, many people might become ill before the vaccine could be ready – researchers are working hard to develop new manufacturing methods

42. Cell culture-you tube A look inside cell-culture influenza vaccine manufacturing at Holly Springs
Antigen is grown in large vats of cells
The cells are grown in vats called bioreactors, which are completely closed from any contact with the outside environment to ensure no contamination occurs
After they are grown, they are infected with the virus
The virus replicates in the cells producing lots of antigen and kill the cells
Next the antigen is harvested and purified, tested and then packaged to ship
This is a faster process than the egg process

43. Pharming-youtube Tobacco plants help Fight ebola, flu and more
Using plants for the production of vaccines
Medicago in research triangle park, nc
dedicated to the production of plant-based vaccines
Using tobacco plants to make the influenza vaccine
This is faster than traditional influenza production
This is also safer because they lack dna and is more stable for distribution

44. Challenges in vaccine research
Some disease organisms pose particularly
complex problems to vaccine developers
We need rapid and economical manufacturing techniques to produce large amounts of vaccine in order to be prepared for the possibility of a rapid emerging pandemic disease
Researchers are working on techniques that parents may be able to feed their child a banana instead of a shot!

45. Virus mutations and vaccines
The disease causing virus mutates frequently
The mutations cause changes in the antigen proteins found on the surface of the virus
Even if a person is vaccinated, changes in these proteins mean that the immune system doesn’t recognize the changeD virus immediately – the immune system can’t fight the virus effectively
(SAME IN CANCER CELLS THAT RECUR, THEY HAVE MUTATED AND DON’T RESPOND TO THE SAME CHEMO DRUGS)

46. The common cold
It is impossible to develop a vaccine for the common cold because there is more than 200 strains of viruses that cause the common cold