Milestones in immunization

1
Milestones in immunization

• 1700AD
• Introduction of variolation in England and later
  in the US

• 3000BC
• Evidence of sniffing powdered small pox crust in
  Egypt

• 2000BC
• Sniffing of small pox crust in China

• 1780AD
• Edward Jenner discovers small pox vaccine

• 1500BC
• Turks introduce variolation

• 1885AD
• Pasteur discovers rabies attenuated vaccine

2
Introduction of variolation

• The wife of the British Ambassador in
• Turkey, in March 1717 wrote, following
• the variolation of her son, to a friend in
• England The small pox, so fatal, so general
• amongst us, is entirely harmless here
• by the invention of ingrafting.I am
• patriot enough to bring this invention into
• fashion in England.

3
Edward Jenner
Discovery of small pox vaccine
4
Edward JennerAmong patients awaiting small pox
vaccination
5
Modern era of the vaccine

• 1920s
• Diphtheria and Tetanus

• 1960s
• Mumps measles and rubella virus
• Sabin polio

• 1934
• Pertussis

• 1985
• Haemophilus

• 1955
• Salk polio

• 1990s
• Hepatitis and varicella

6
Pre- post-vaccine incidence of common
preventable diseases
7
Different modes of acquiring immunity
8
Passive Immunity

• Placental transfer of IgG

• Antibodies or immunoglobulins

• Colostral transfer of IgA

• Immune cells

9
Passive Immunization
10
Advantages and Disadvantages of Passive
Immunization

• no long term protection

• serum sickness

• immediate protection

• risk of hepatitis and Aids

• graft vs. host disease (cell graft only)

11
Active Immunization

• Attenuated organisms

• killed organisms

• exposure to sub-clinical infections

• sub-cellular fragments

• toxins

• others

12
Live Attenuated Vaccines

• hepatitis A
• not required in SC

• polio
• not used in std. schedule

• measles, mumps rubella

• yellow fever
• Military and travelers

• Varicella zoster
• children with no history of chicken pox

• tuberculosis
• not used in this country

13
Killed Whole-Organism Vaccines

• polio

• Q fever
• population at risk

• influenza
• elderly and at risk

• typhoid, cholera, plague
• epidemics and travelers

• pertussis
• replaced by the acellular vaccine

• rabies
• post exposure

14
Microbial Fragment Vaccines

• Bordetella. Pertussis
• virulence factor protein

• Haemophilus influenzae B
• protein conjugated polysaccharide

• Streptococcus pneumoniae
• Polysaccharide mixture

• Neisseria meningitidis
• polysaccharide

15
Microbial Fragment Vaccines

• Clostridium tetani (tetanus)
• inactivated toxin (toxoid)

• Corynebacterium diphtheriae
• inactivated toxin (toxoid)

• Vibrio cholerae
• toxin subunits

16
Modification of Toxin to Toxoid
Toxin
17
Future Vaccines

• anti-Idiotype Vaccine

• DNA

• Immuno-dominant peptide

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Recommended Childhood Immunization Schedule (2001)
19
Adverse Events OccurringWithin 48 Hours DTP of
Vaccination
20
Adverse event occurringwithin 48 hours DTP
vaccination