1. How Vaccines work

2. Agenda Overview How Vaccines Work Types of Vaccines
How Vaccines are Approved
Why are Vaccines Important
Agenda
Today we will be covering 8 vaccine-preventable diseases: smallpox, polio, measles….

3. OVERVIEW
Vaccines work by mimicking disease agents (pathogens) and stimulating the immune system to build up defenses against them

4. Important Terminology
Pathogen
The Immune System
Antigen
Helper Cell
Antibody
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

5. Terminology
Pathogen
Your health
Pathogen: an infectious agent such as a virus or bacteria that can cause a disease

6. Terminology
Antigen
Pathogen
Immune System
Immune System: the body’s defense against infectious pathogens and other invaders

7. Terminology
Antigen: a molecule that binds to a specific receptor in the body, but cannot induce an immune response in the body itself. They are usually proteins, peptides, and polysaccharides
Antigen
Pathogen

8. Terminology
Antigen
Helper Cell
Helper Cell: A T-cell that influences the differentiation or activity of other cells of the immune system

9. Terminology
Antibody
Antigen
Antibody: a large Y-shaped protein that is used by the immune system to neutralize pathogens

10. How Does a Disease Enter the Body
Pathogen
The Immune System
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

11. How Does a Disease Enter the Body
Pathogen
Your health

12. How Does a Disease Enter the Body
Antigen
Pathogen
Immune System

13. How Does a Disease Enter the Body
Antigen
Pathogen

14. How Does a Disease Enter the Body
Antigen
Helper Cell

15. How Does a Disease Enter the Body
Antigen

16. How Does a Disease Enter the Body
Antibody
Antigen
Protein Receptor

17. How Does a Disease Enter the Body
Antigen
Antibody
Protein Receptor

18. How Does a Disease Enter the Body
Pathogen
Antigen
Antibody

19. The Immune System How Vaccines Work Pathogen Antigen Helper Cell
Antibody
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

20. How Vaccines Work
Vaccine
Antigen
Pathogen

21. How Vaccines Work
Antigen
Vaccine

22. How Vaccines Work
Vaccine
Antigen

23. How Vaccines Work
Antigen

24. How Vaccines Work
Antigen

25. How Vaccines Work
Antigen
Antibody

26. How Vaccines Work
Antigen
Antibody

27. How Vaccines Work
Antigen

28. How Vaccines Work
Pathogen
Antigen

29. How Vaccines Work
Pathogen
Antigen
Antibody

30. How Vaccines Work
Antigen
Antibody
Pathogen

31. Sub-unit/Conjugate Inactivated Types of Vaccines Live-Attenuated
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

32. Types of Vaccines Live-Attenuated Inactivated Sub-unit/Conjugate
Toxoid (Inactivated Toxin)
Sub-unit/Conjugate

33. Live-Attenuated Vaccines
Live, attenuated vaccines contain a version of the living microbe that has been weakened in the lab so it can’t cause disease.
Examples: MMR (Measles, Mumps & Rubella) Varicella (“Chicken pox”), Zoster (“Shingles”), intranasal flu vaccine

34. Live-Attenuated Vaccines
Benefits
Closest thing to a natural infection
Often confer lifelong immunity with only one or two doses
Risks
An attenuated microbe in the vaccine could revert to a virulent form and cause disease
Not everyone can safely receive live, attenuated vaccines
Usually need to be refrigerated to stay potent

35. Inactivated Vaccines
Scientists produce inactivated vaccines by killing the disease- causing microbe with chemicals, heat, or radiation.
Examples: Most injected influenza vaccines (“flu shot”), Hepatitis A

36. Toxoid (Inactivated Toxins) Vaccines
When a toxin created by bacteria is the main cause of illness, a toxoid vaccine is created by “detoxifying” the toxins.
Examples: Tetanus, Diphtheria

37. Inactivated Vaccines Benefits Risks
More stable and safer than live vaccines.
Usually don’t require refrigeration
Risks
Stimulate a weaker immune system response than do live vaccines
Likely take several additional doses, or booster shots, to maintain a person’s immunity

38. Sub-Unit/Conjugate Vaccines
Instead of the entire microbe, sub-unit vaccines include only the antigens that best stimulate the immune system.
Examples: Hepatitis B, HPV

39. Sub-Unit/Conjugate Vaccines
Benefits
chances of adverse reactions to the vaccine are lower
Risks
Likely take several additional doses, or booster shots, to maintain a person’s immunity

40. How Vaccines are Approved
Clinical Trials
Annual Review
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

41. How Vaccines Are Approved
Food and Drug Administration (FDA) sets rules for the three phases of clinical trials to ensure the safety of the volunteers.
The vaccine is only licensed if:
It’s safe and effective.
The benefits outweigh risks.

42. How Vaccines Are Approved
Is this vaccine safe?
Does this vaccine seem to work?
Are there any serious side effects?
How is the size of the dose related to side effects?

43. How Vaccines Are Approved
What are the most common short-term side effects?
How are the volunteers’ immune systems responding to the vaccine?

44. How Vaccines Are Approved
How do people who get the vaccine and people who do not get the vaccine compare?
Is the vaccine safe?
Is the vaccine effective?
What are the most common side effects?

45. Advisory Committee on Immunization Practices
Founded in 1964
Develops written recommendations on vaccinations for infancy through geriatric care
Develops the CDC Vaccine Schedule
Contains fifteen regular members, each an expert in one of the following fields:
immunization practices and public health
use of vaccines and other immunobiologic agents in clinical practice or preventive medicine
clinical or laboratory vaccine research
assessment of vaccine efficacy and safety
consumer perspectives and/or social and community aspects of immunization programs
Meets 3 times a year to review data and maintain or make new recommendations based upon the latest data

46. National Vaccine Advisory Committee (NVAC)
Established in 1986
Advises the Assistant Secretary for Health at Health and Human Services
Image:

47. Unvaccinated Community
Herd Immunity
Unvaccinated Community
Vaccinated Community
The Importance
This is a timeline of significant vaccination and disease dates. Events associated with smallpox are colored in medium blue, flu is in dark blue, measles is in aqua, polio in green, meningitis in orange, and diphtheria, tetanus, and pertussis covered in the DTaP vaccine are in pink.
First on the timeline is the creation of the vaccine by Edward Jenner - *click for animation* Some of our other smallpox timelines dates are 1949, the year of the last reported case in the US and 1980 when the World Health Organization declared smallpox officially eradicated.

48. Unvaccinated Community

49. Unvaccinated Community + Disease

50. Unvaccinated Community = Widespread Disease Outbreak

51. Vaccinated Community

52. Vaccinated Community + Disease

53. Vaccinated Community = Minimal Disease Outbreak

54. Unvaccinated> Vaccinated

55. Unvaccinated> Vaccinated + Disease

56. Widespread Outbreak Occurs

57. Vaccinated > Unvaccinated

58. Vaccinated > Unvaccinated + Disease

59. The vaccinated protect the unvaccinated!

60. COMMUNITY IMMUNITY ACHIEVED !

61. Exemption Rates in Texas
Number of Personal Belief Exemptions
It’s important to note that even though these exemption rates are increasing, it is NOT safe to assume that these families reject vaccines altogether. Researchers have varied greatly in how they have both studied and defined vaccine hesitancy. But generally speaking, people are not often placed into definitive categories of “anti-vaccine” or “pro-vaccine.” Instead, it is more like a spectrum, where some families have more doubts and modify the schedule to a greater degree than others.
School Year
Source: Texas Dept. of State Health Services Annual Report of Immunization Status, through

62. Immunization Rates - Texas
Healthy People 2020 Objective

63. Vaccine Coverage, 2016
Healthy People 2020 Objective

64. Vaccine Coverage by County, 2016
Healthy People 2020 Objective

65. 2017 Adolescent Immunization Rates (13-17 Year Old)
Healthy People 2020

66. Thank You
Thanks for taking the time to listen to the history and details of vaccines that help prevent diseases around us every day. We will now move on to policy regarding vaccination.