1. IMMUNITY IMMYNIZATION IMMUNITY

2. Active immunity are defenses developed by the body that last many years or even a life time. Active immunity are defenses developed by the body that last many years or even a life time. 1. Active-natural immunity – means invasion of the body by microorganisms resulting in development of antibodies and sensitized lymphocytes. Examples: childhood diseases - chicken pox, measles. 1. Active-natural immunity – means invasion of the body by microorganisms resulting in development of antibodies and sensitized lymphocytes. Examples: childhood diseases - chicken pox, measles. 2. Active-artificial immunity is attained by inoculation or immunization with antigen of live or killed vaccines that are less virulent than contracting the disease. 2. Active-artificial immunity is attained by inoculation or immunization with antigen of live or killed vaccines that are less virulent than contracting the disease.

3. Passive immunity is temporary, trasmitted from another source that has developed immunity through previous disease or immunization. Passive immunity is temporary, trasmitted from another source that has developed immunity through previous disease or immunization. Passive-natural immunity is trasplacental and colostrum transfer from mother to child of antibodies. Immunity does not last. Passive-natural immunity is trasplacental and colostrum transfer from mother to child of antibodies. Immunity does not last. Passive-artificial immunity is injections with Gamma Globulin. Passive-artificial immunity is injections with Gamma Globulin.

4. Combined passive and active immunity Combined passive and active immunity In some diseases (e. g.. Tetanus, diphtheria, rabies) passive immunization is often undertaken in conjunction with inactivated vaccine products, to provide both immediate (but temporary) passive immunity. Both injections should be given at separate sites. In some diseases (e. g.. Tetanus, diphtheria, rabies) passive immunization is often undertaken in conjunction with inactivated vaccine products, to provide both immediate (but temporary) passive immunity. Both injections should be given at separate sites.

5. Specific immunoglobulins are available for passive immunization against tetanus (human tetanus immunoglobulin-HTIG), hepatitis B (HBIG), rabies (HRIG), varicella-zoster (ZIG) and vaccinia (AVIG). Specific immunoglobulins are available for passive immunization against tetanus (human tetanus immunoglobulin-HTIG), hepatitis B (HBIG), rabies (HRIG), varicella-zoster (ZIG) and vaccinia (AVIG). Antibodies – defend against foreign invaders. Produced on B-Lymphocytes are memory specific, have 2 molecule (Fab fragments) sites to combine with antigen to AGGLUTINATE-bind or clump together. Agglutination helps facilitate phagocytosis. Antibodies – defend against foreign invaders. Produced on B-Lymphocytes are memory specific, have 2 molecule (Fab fragments) sites to combine with antigen to AGGLUTINATE-bind or clump together. Agglutination helps facilitate phagocytosis.

6. Provide active life long immunity against disease Provide active life long immunity against disease 1. Recommended immunization Schedule for Healthy Infants and Children

9. USAUKRAINE Birth 1 month 2 month 3 month 4 month 5 month 6 month 12-15 month 18 month 3 years 4-6 years 7 years 11-12 years 14 years 15 years 16 years 18 years Hepatitis B IPV, DTaP, Hib ---------------------------- ---------------------------- Hepatitis B,IPV, DTaP, Hib Hib, MMR DTaP, Varicella zoster ---------------------------- IPV, DTaP, MMR ---------------------------- MMR(if not administered at 4-6 years) --------------------------------------------------------Td---------------------------- Hepatitis B tuberculosis tuberculosis-------------------------------------------------------- Hepatitis B, IPV, DTaP IPV, DTaP Hepatitis B, IPV, DTaP ----------------------------MMR IPV, DTaP OPV DTaP, OPV, MMR Tuberculosis DTaP, OPV, tuberculosis Rubella----------------------------Td

10. immunizations Immunization schedule General contraindications to immunizations 1. Severe febrile illness 2. Live virus vaccines are generally not administered to anyone with an altered immune system to anyone with an altered immune system 3. Allergic reaction to a previously administered vaccine or a substance in the vaccine vaccine or a substance in the vaccine

11. Hepatitis B vaccine 1. Protects against hepatitis B 2. The first dose of hepatitis B is administered between the ages of birth and 2 months, the second dose is administered between the ages of 1 and 4 months, and the third dose is administered between the ages of 6 to 18 months second dose is administered between the ages of 1 and 4 months, and the third dose is administered between the ages of 6 to 18 months 3. All children from birth through 18 years of age need three doses of hepatitis B vaccine if they need three doses of hepatitis B vaccine if they have not already received them have not already received them 4. Contraindication: Anaphylactic reaction

12. DTaP (diphtheria, tetanus, acellular pertussis) DTaP (diphtheria, tetanus, acellular pertussis) and Td 1. Protects against diphtheria, tetanus, and pertussis 2. DTaP is administered at 2 months, 4 months, 6 months, between 15 and 18 months of age, and between 4 and 6 years of age 3. The fourth dose of DTaP can be given at 12 months of age if 6 months have elapsed since the previous dose and if the child might not return for follow-up by 18 months of age 4.Td (tetanus, diphtheria booster) is given at 11 to 12 years of age if at least 5 years have passed since the last dose of DTaP/DTP (DTP = diphtheria, tetanus, pertussis) 5. Contraindication: Encephalopathy within 7 days of administration of previous dose of DTP

13. Hib (Haemophilus influenzae type b) vaccine Hib (Haemophilus influenzae type b) vaccine 1. Protects against Haemophilus influenzae type b 2. Hib is administered at 2 months, 4 months, 6 months, and between 12 and 15 months of age 3. Depending on the brand of Hib vaccine used for the first and second doses, a dose at 6 months of age may not be needed 4. Contraindication: None identified

14. IPV (inactivated poliovirus vaccine) 1. Protects against polio 2. IPV is administered at 2 months, 4 months, 6 months, and between 4 and 6 years of age 3. The third dose of IPV is administered between 6 and 18 months of age 4. Contraindication: Anaphylactic reaction to neomycin or streptomycin

15. MMR (measles, mumps, rubella) 1. Protects against measles, mumps, and rubella (German measles) 2. The first dose of MMR is administered between 12 and 15 months of age; the second dose is administered at 4 to 6 years of age (if the second dose was not given by 4 to 6 years of age, it should be given at the next visit) 12 and 15 months of age; the second dose is administered at 4 to 6 years of age (if the second dose was not given by 4 to 6 years of age, it should be given at the next visit)

16. 3. MMR contains minute amounts of neomycin; measles and mumps vaccines, which are grown on chick embryo tissue cultures, are not believed to contain significant amounts of egg cross- reacting proteins. 3. MMR contains minute amounts of neomycin; measles and mumps vaccines, which are grown on chick embryo tissue cultures, are not believed to contain significant amounts of egg cross- reacting proteins. 4. Contraindications a.Pregnancy a.Pregnancy b.Known altered immunodeficiency b.Known altered immunodeficiency c.Allergy to contents of immunization (prior to the administration of MMR vaccine, assess for a known history of allergy to neomycin or related antibiotics) c.Allergy to contents of immunization (prior to the administration of MMR vaccine, assess for a known history of allergy to neomycin or related antibiotics)

17. d. Presence of recently acquired passive immunity through blood transfusions, immu­noglobulin, or maternal antibodies (MMR should be postponed for a minimurn of 3 months after passive immunization with immunoglobulins or blood transfusions, except washed blood cells, which do not interfere washed blood cells, which do not interfere with the immune response) with the immune response)

18. Varicella zoster vaccine Varicella zoster vaccine 1. Protects against chickenpox 2. Varicella zoster vaccine is administered between 12 and 18 months of age 3. Susceptible children 13 yean of age and older (who have not had chickenpox or have not been previously vaccinated) need two doses given 4 to 8 weeks apart 4. Contraindications a.Pregnancy a.Pregnancy b.Immunocompromised individuals b.Immunocompromised individuals c.Children receiving corticosteroids c.Children receiving corticosteroids

19. OPV (oral poliovirus vaccine) OPV (oral poliovirus vaccine) 1. No longer recommended for routine vaccination 2. Not administered to anyone with an altered immune system or to any household contacts of an immunosuppressed child (the virus multiplies in the gastrointestinal tract and is excreted in the stool)

20. 2. ADULT BOOSTER IMMUNIZATIONS ADULT BOOSTER IMMUNIZATIONS provides exposure of immunized host to the same or similar antigen in the form of vaccine or natural disease. Antibody production occurs much sooner and attains a much higher level of antibody due to recall phenomenon. ADULT BOOSTER IMMUNIZATIONS provides exposure of immunized host to the same or similar antigen in the form of vaccine or natural disease. Antibody production occurs much sooner and attains a much higher level of antibody due to recall phenomenon.

21. 3. FLU VACCINATION PROGRAMS “ PERSONS AT RISK” WHO SHOULD BE ADVISED IMMUNIZATION AGAINST FLU Very young and the elderly with waning immunity Very young and the elderly with waning immunity Persons with debilitative disease: Persons with debilitative disease: - cardiac; - cardiac; - diabetes; - diabetes; - Hemolytic Anemias; - Hemolytic Anemias; - parsons over 50. - parsons over 50. CONTRAINDICATIONS TO FLU VACCINES: Persons with febrile illness Persons with febrile illness History of Guillain Barre Syndrome History of Guillain Barre Syndrome Allergies to eggs Allergies to eggs pregnancy pregnancy