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Vaccination changes from nation to nation, but the principle behind the immunisation remains the same. The immune system defends the individual from infections with microbes such as bacteria, viruses, fungi and protozoa. Immune system also impedes the development of autoimmune and malignant diseases. There are 4 essential parts of protective immune system of the body namely humoral or antibody related immunity, cell-mediated immunity, phagocytosis, and complement system.

  • Types of immunity:
  1. Protection produced by the person’s own immune system which is usually permanent
  2. Protection transferred from another person or animal as antibody and is temporary protection that wanes with time

Principles of vaccination:

  1. Self verses no self
  2. Protection from infectious disease
  3. Usually indicated by the presence of antibody
  4. Very specific to a single antigen immunity
  • Advantage of vaccination:
  1. Active immunity produced by vaccine 
  2. Immunity and immunologic memory similar to natural infection but without risk of disease
  • Classification of Vaccines 
Classification TypesLive attenuated InactivatedProtein-basedPolysaccharide-based
1.Viral Virus SubunitPure
2.Bacterial  BacterialToxoidConjugate

Characteristic features of Live Attenuated Vaccines 

  1. Attenuated (weakened) form of the “wild” virus or bacteria
  2. Must replicate to be effective
  3. Immune response similar to natural infection
  4. Usually effective with one dose except those administered orally
  5. Severe reactions possible 
  6. Interference from circulating antibody 
  7. Unstable

E.g. of Live Attenuated Vaccines 

Viral measles, mumps, rubella, varicella, yellow fever, rubella, influenza, oral polio, Bacterial BCG, oral typhoid

  • Characteristic features of Inactivated Vaccines 
  1. Cannot replicate
  2. Minimal interference from circulating antibody
  3. Generally not as effective as live vaccines
  4. Generally require 3-5 doses
  5. Immune response mostly hum oral
  6. Antibody titre diminishes with time

E.g. of Inactivated Vaccines 

Viral polio, hepatitis A, rabies (influenza) 
Bacterial (pertussis) (typhoid) (cholera) (plague) 

  • Polysaccharide Vaccines 

Salmonella Typhi (Vi)
Haemophilus influenza type b

  • Types of polysaccharide:

Pure polysaccharide
Conjugate polysaccharide
Pure Polysaccharide Vaccines

  1. Not consistently immunogenic in children <2 years of age
  2. No booster response
  3. Antibody with less functional activity
  4. Immunogenicity improved by conjugation

Vaccination in Children:

  • BCG vaccine: Bacillus Calmette Guerin (BCG) is an attenuated strain of Mycobacterium tuberculosis var. bovis, used as a live vaccine against tuberculosis. The vaccine is given from birth to two weeks.
    In order to maintain its potency, the vaccine is supplied in freeze-dried at 4 degree C. BCG is administered intradermally over the deltoid muscle. The dosage is 0.05 ml for newborns and 0.1ml for all other ages. The vaccine is given from birth to two weeks. BCG does not protect from other mycobacterial disease such as leprosy. In neonate and young infant, tuberculin testing is unnecessary before giving BCG.
  • Tetanus Toxoid(Adsorbed): It is used to immunise children from age of 3 months onwards. Risk of tetanus neonatorum in infant is avoided by immunising pregnant woman.
    For active primary immunisation : 2doses at an interval of 4to 6 weeks.
    Reinforcing dose should be given 9 to 12 months later to increase the level of immunity.
    Booster dose should be given every 5 years to maintain adequate level of immunity even if they do not suffer from any injury.
  • Hepatitis B vaccine:
    Hepatitis B is an infection of the liver thats caused by a virus and can result in liver damage or failure. Some babies can develop Hepatitis B if their mothers are infected with it before or during pregnancy.
  • Diphtheria, tetanus, and pertussis (DTP) vaccine:
    This vaccine protects against three diseasesdiphtheria, tetanus, and pertussis or whooping cough:
  • Diphtheria is a serious infectious disease caused by bacteria that produce toxins which inflame the nervous system and heart and can result in heart failure and paralysis.
  • Tetanus results from bacteria that grow in wounds and that produce a toxin which affects the nervous system and causes muscle spasms and paralysis, especially in the jaw area. Its also called lockjaw.
  • Pertussis or whooping cough, another infectious disease caused by bacteria, is especially dangerous for babies under the age of 1. Its most well-known symptom is a debilitating racking cough.
    The vaccine should be given in five doses at 2 months, 4 months, 6 months, around 18 months, and before the child enters school, between 4 and 6 years of age. A sixth dose of diphtheria and tetanus vaccine is recommended between 11 and 16 years of age.
    Baby may have a mild reaction to this vaccine including a slight fever (under 102 degrees F), fussiness, and redness in the thigh area where the shot is given. These symptoms typically last up to 2 days and doctor may suggest giving the child some baby acetaminophen to ease the fever.
  • Haemophilic influenza type B (HIB) vaccine:
    Haemophilus influenzae type b isnt the viral infection that everybody calls the flu. Instead, its a fast-moving bacterial infection that can cause baby to have ear and bronchial infections. HIB also can lead to meningitis in children under the age of 2, so it is important that protect the child with the HIB vaccine.
    Before the age of six months: At 6, 10, 14 weeks followed by a booster12 months after last injection.
    Children not vaccinated before 6 months of age: 2 dose and booster 12 months after 2nd dose.
    Children not vaccinated before 1year of age: 1dose.
  • Poliomyelitis vaccine (oral) i.e. OPV:
    Polio, short for poliomyelitis, is a serious viral disease that starts with a fever and can lead to paralysis, muscle atrophy, and permanent disability. In its most severe forms, polio can cause death. Oral polio vaccine developed by sabin and is given by mouth at birth to 2 months, 2,4, 6, 6-9 months, 18 months, 4-6years, 6years.
  • Heptavalent Conjugate Pneumococcal (PCV) vaccine:
    This vaccine protects your child against the pneumococcal bacteria which can cause meningitis, pneumonia, and serious infections in a child’s brain, blood stream, and ears.
    First vaccination: A single injection confirms protection against pnuemococcal types contained in the vaccine. Revaccination should not be carried before 5 years, unless the subject is particularly exposed.
  • Measles, Mumps, and Rubella (MMR) vaccine:
    This vaccine provides coverage for three diseases in a single shotmeasles, mumps, and rubella or German measles:
    Measles is a viral infection that causes distinctive red spots and is characterized by cold-like symptoms and a high fever.
    Mumps is an infectious viral disease that results in swelling of the parotid gland thats just in front of the ear and the salivary glands. The swelling can occur on the sides of one or both cheeks. Mumps usually is accompanied by a fever and pain when the patient opens his mouth or eats.
    Rubella or German measles is similar to measles in that its a viral infection that results in a fever, swollen glands, and a rash.
    The first MMR vaccine is usually recommended between 12 and 15 month of age and seldom has any serious side effects. Baby, however, may be more sleepy than usual and have a mild rash, slight fever, or slight swelling in the neck or diaper area. The second shot (booster) is recommended between 4 to 6 years of age.
  • Varicella (Var) vaccine:
    vaccine protects against chicken pox, a viral infection which is highly contagious and results in a blister like rash thats very itchy. Varicella vaccine is indicated for active immunisation against varicella in healthy subjects from the age of 12 months onward.
    12 months12 years: 1dose
    13 years and above: 2dose with an interval of 6-10 weeks.
  • Influenza vaccine:
    The influenza vaccine is more commonly known as the flu shot. The flu is more serious than the common cold and can be very dangerous in young children, especially those with certain medical conditions. For this children 6 months of age or older with certain risk factors receive the influenza vaccine yearly. It can also be given to other children. If you aren’t sure if your child should receive this vaccine, ask your child’s doctor.
    Children 6months to 3years of age: 1injection of 0.25ml
    Children 3years and all ages: 1injection of 0.5ml.
    Children under 8 years of age who have not been infected or Vaccinated previously should be given a 2nd dose after an interval of at least 4 weeks.
  • Measles Vaccine: It is a lyophilized preparation of the highly attenuated Schwarz strain of measles virus, obtained by propagation of the virus, obtained by propagation of virus in chick embryo tissue cultures. The optimal age for active vaccination is 15 months. The vaccine pellet should be completely dissolved in the diluent. The entire contents of a reconstituted monodose vial or 0.5 ml of reconstituted vaccine from a multi dose vial should be injected subcutaneously.
  • Hepatitis A vaccine: It is a sterilesuspension containing formaldehyde-inactivated hepatitis A virus adsorbed onto aluminium hydroxide. First dose should be given at elected date and second one month later. Booster dose is recommended at any time between 6and 12 months after initiation of primary course. Vaccine should be used intramuscularly and the dose is 0.5ml/not less than 360 ELISA units.
Vaccination In Children→ Hepatitis BBC GOral PolioDTPHaemophilic influenza type B (HIB)Measles(M-Vac)Measles, Mumps, and Rubella (MMR)TyphoidVaricellaHepatitis ATetanus (TT-SP)
Age ↓
Birth-2Weeks1st Dose1 dose1st Dose  1 Dose     
6 Weeks2nd Dose 2nd Dose1st Dose1st Dose      
10 Weeks  3rd Dose2nd Dose2nd Dose      
14 Weeks3rd Dose 4th Dose3rd Dose3rd Dose      
9 Month      1 Dose    
12-15 Month        1st Dose1st Dose 
18 Months  5th DoseBooster Dose1stBooster Dose      
2 Years       1st Dose 2nd Dose 
5 Years  6th Dose2nd Booster Dose   Booster Dose 1st   
8Years       Booster Dose 2nd   
10 Years         1st Booster Dose1st dose
15-16 Years      Rubella Vaccine   2nd Booster Dose

Tetanus Toxoid (Adsorbed) 1.    In Pregnant mothers: Immunisation should be done by injecting 2 dose of TT starting in 7th month with an interval of 4 weeks.2.    In General: In case of all persons actively immunized booster dose should be given every 5 years to maintain adequate level of immunity even if they do not suffer from any injury. 0.5 ml by intramuscular route.
CholeraIt is recommended only in times of outbreaks of cholera.In adult: 0.5 ml after 4 to 6 weeks. In case of emergency, a single dose of 1ml may be given.
Meningococcal VaccineProphylaxis against cerebrospinal meningitis due to meningococcal of A and C groups.0.5 ml subcutaneous or intramuscular
Hepatitis A vaccineActive immunisation against hepatitis A virus infection.Adults: 1ml/not less than 720 ELISA units.
Antisnake Venom SerumIndicated in snake bite. 
Rabies VaccineFor immunisation against rabies after exposure and for prophylactic vaccination against rabies before exposure.Vaccine should be given by intramuscular route. Dosage:1.    Pre-exposure: 3 doses injections on day 0, day 7, day28. A booster dose after 1 year and 1dose after every 5 years.2.    Post-exposure: After exposure start immediately a full course of treatment for both adults and children consists of 5 injections on day of exposure(0 day), 3, 7, 14, 30. A booster dose on day 90 is optional.

Last updated on March 5th, 2021 at 09:45 am

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