IMMUNITY IMMYNIZATIO

N

IMMUNITY

Active immunityActive immunity are defenses developed by the are defenses developed by the

body that last many years or even a life time.body that last many years or even a life time.

11. . Active-natural immunityActive-natural immunity – means invasion of the body by – means invasion of the body by microorganisms resulting in development of antibodies and microorganisms resulting in development of antibodies and sensitized lymphocytes. Examples: childhood diseases - chicken sensitized lymphocytes. Examples: childhood diseases - chicken pox, measles.pox, measles.

2.2. Active-artificial immunityActive-artificial immunity is attained by inoculation or is attained by inoculation or immunization with antigen of live or killed vaccines that are less immunization with antigen of live or killed vaccines that are less virulent than contracting the disease.virulent than contracting the disease.

Passive immunityPassive immunity is temporary, trasmitted is temporary, trasmitted from another source that has developed from another source that has developed immunity through previous disease or immunity through previous disease or immunization.immunization.

• Passive-natural immunity is trasplacental and Passive-natural immunity is trasplacental and colostrum transfer from mother to child of antibodies. colostrum transfer from mother to child of antibodies. Immunity does not last.Immunity does not last.

• Passive-artificial immunity is injections with Gamma Passive-artificial immunity is injections with Gamma Globulin. Globulin.

Combined passive and active immunityCombined passive and active immunity

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

• Specific immunoglobulinsSpecific immunoglobulins are available for passive are available for passive immunization against tetanus (human tetanus immunization against tetanus (human tetanus immunoglobulin-HTIG), hepatitis B (HBIG), rabies immunoglobulin-HTIG), hepatitis B (HBIG), rabies (HRIG), varicella-zoster (ZIG) and vaccinia (AVIG).(HRIG), varicella-zoster (ZIG) and vaccinia (AVIG).

• AntibodiesAntibodies – defend against foreign invaders. Produced – defend against foreign invaders. Produced on B-Lymphocytes are memory specific, have 2 on B-Lymphocytes are memory specific, have 2 molecule (Fab fragments) sites to combine with antigen molecule (Fab fragments) sites to combine with antigen to AGGLUTINATE-bind or clump together. to AGGLUTINATE-bind or clump together.

Agglutination helps facilitate phagocytosisAgglutination helps facilitate phagocytosis ..

Provide active life long immunity against Provide active life long immunity against diseasedisease

1. 1. Recommended immunization Recommended immunization Schedule for Healthy Infants and Schedule for Healthy Infants and

ChildrenChildren

USAUSA UKRAINEUKRAINE

BirthBirth

1 month1 month

2 month2 month

3 month3 month

4 month4 month

5 month5 month

6 month6 month

12-15 month12-15 month

18 month18 month

3 years3 years

4-6 years4-6 years

7 years7 years

11-12 years11-12 years

14 years14 years

15 years15 years

16 years16 years

18 years18 years

Hepatitis BHepatitis B

Hepatitis BHepatitis B

IPV, DTaP, HibIPV, DTaP, Hib

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IPV, DTaP, HibIPV, DTaP, Hib

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Hepatitis B,IPV, DTaP, Hepatitis B,IPV, DTaP, HibHib

Hib, MMRHib, MMR

DTaP, Varicella zosterDTaP, Varicella zoster

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IPV, DTaP, MMRIPV, DTaP, MMR

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MMR(if not administered MMR(if not administered at 4-6 years)at 4-6 years)

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TdTd

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Hepatitis BHepatitis B

tuberculosistuberculosis

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Hepatitis B, IPV, Hepatitis B, IPV, DTaPDTaP

IPV, DTaPIPV, DTaP

Hepatitis B, IPV, Hepatitis B, IPV, DTaPDTaP

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MMRMMR

IPV, DTaPIPV, DTaP

OPVOPV

DTaP, OPV, MMRDTaP, OPV, MMR

TuberculosisTuberculosis

DTaP, OPV, DTaP, OPV, tuberculosistuberculosis

RubellaRubella

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TdTd

immunizationsimmunizationsImmunization schedule Immunization schedule

General contraindications to immunizationsGeneral contraindications to immunizations

1. Severe febrile illness1. Severe febrile illness

2. Live virus vaccines are generally not 2. Live virus vaccines are generally not administeredadministered

to anyone with an altered immune systemto anyone with an altered immune system

3. Allergic reaction to a previously administered3. Allergic reaction to a previously administered

vaccine vaccine or a substance in the vaccineor a substance in the vaccine

Hepatitis B vaccineHepatitis B vaccine

1. Protects against hepatitis B1. Protects against hepatitis B

2. The first dose of hepatitis B is administered between 2. The first dose of hepatitis B is administered between the the ages of birth and 2 months, theages of birth and 2 months, the

second dose is administered between the ages of 1second dose is administered between the ages of 1 and 4 and 4 months, and the third dose is administered between the months, and the third dose is administered between the ages of 6 to 18 monthsages of 6 to 18 months

3. All children from birth through 18 years of age3. All children from birth through 18 years of age

need three doses of hepatitis B vaccine if theyneed three doses of hepatitis B vaccine if they

have not already received them have not already received them

4. Contraindication: Anaphylactic reaction4. Contraindication: Anaphylactic reaction

DTaP (diphtheria, tetanus, acellular DTaP (diphtheria, tetanus, acellular pertussis) pertussis)

and Tdand Td1. Protects against diphtheria, tetanus, and pertussis1. Protects against diphtheria, tetanus, and pertussis

2. DTaP is administered at 2 months, 4 months, 6 months, 2. DTaP is administered at 2 months, 4 months, 6 months, between 15 and 18 months of age, and between 4 and 6 between 15 and 18 months of age, and between 4 and 6 years of ageyears of age

3. The fourth dose of DTaP can be given at 12 months of age if 6 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 months have elapsed since the previous dose and if the child might not return for follow-up by 18 months of agemight not return for follow-up by 18 months of age

4.Td (tetanus, diphtheria booster) is given at 11 to 12 years of 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 age if at least 5 years have passed since the last dose of DTaP/DTP (DTP = diphtheria, tetanus, pertussis)DTaP/DTP (DTP = diphtheria, tetanus, pertussis)

5. Contraindication: Encephalopathy within 7 days of 5. Contraindication: Encephalopathy within 7 days of administration of previous dose of DTPadministration of previous dose of DTP

Hib (Haemophilus influenzae Hib (Haemophilus influenzae

type b) vaccinetype b) vaccine

1. Protects against 1. Protects against Haemophilus influenzae Haemophilus influenzae type btype b

2. Hib is administered at 2 months, 4 months, 6 2. Hib is administered at 2 months, 4 months, 6 months, and between 12 and 15 months of agemonths, and between 12 and 15 months of age

3. Depending on the brand of Hib vaccine used for 3. Depending on the brand of Hib vaccine used for the first and second doses, a dose at 6 months of the first and second doses, a dose at 6 months of age may not be neededage may not be needed

4. Contraindication: None identified 4. Contraindication: None identified

IPV (inactivated poliovirus IPV (inactivated poliovirus vaccine)vaccine)

1. Protects against polio1. Protects against polio

2. IPV is administered at 2 months, 4 months, 2. IPV is administered at 2 months, 4 months, 6 months, and between 4 and 6 years of age6 months, and between 4 and 6 years of age

3. The third dose of IPV is administered 3. The third dose of IPV is administered between 6 and 18 months of agebetween 6 and 18 months of age

4. Contraindication: Anaphylactic reaction to 4. Contraindication: Anaphylactic reaction to neomycin or streptomycinneomycin or streptomycin

MMR (measles, mumps, MMR (measles, mumps, rubella)rubella)

1.1. Protects against measles, mumps, and Protects against measles, mumps, and rubella (German measles)rubella (German measles)

2.2. The first dose of MMR is administered The first dose of MMR is administered betweenbetween

12 and 15 months of age; the second dose is 12 and 15 months of age; the second dose is administered at 4 to 6 years of age (if the administered at 4 to 6 years of age (if the second dose was not given by 4 to 6 years of second dose was not given by 4 to 6 years of age, it should be given at the next visit)age, it should be given at the next visit)

3.3. MMR contains minute amounts of neomycin;MMR contains minute amounts of neomycin;measles and mumps vaccines, which are grownmeasles and mumps vaccines, which are grownon chick embryo tissue cultures, are not believedon chick embryo tissue cultures, are not believedto contain significant amounts of egg cross-to contain significant amounts of egg cross-reacting proteinsreacting proteins..

4.4. Contraindications Contraindications

a.a. PregnancyPregnancy

b.b. Known altered immunodeficiencyKnown altered immunodeficiency

c.c. Allergy to contents of immunization (prior toAllergy to contents of immunization (prior to the administration of MMR vaccine, assess forthe administration of MMR vaccine, assess for a known history of allergy to neomycin ora known history of allergy to neomycin or related antibiotics)related antibiotics)

d.d. Presence of recently acquired passive Presence of recently acquired passive immunity immunity through blood transfusions, through blood transfusions, immu noglobulin, or maternal antibodies immu noglobulin, or maternal antibodies (MMR should be postponed for a minimurn of (MMR should be postponed for a minimurn of 3 months after passive immunization with 3 months after passive immunization with immunoglobulins or blood transfusions, immunoglobulins or blood transfusions, exceptexcept

washed blood cells, which do not interferewashed blood cells, which do not interfere

with the immune response) with the immune response)

Varicella zoster vaccineVaricella zoster vaccine1.1. Protects against chickenpoxProtects against chickenpox

2.2. Varicella zoster vaccine is administered betweenVaricella zoster vaccine is administered between112 2 and 18 months of ageand 18 months of age

3.3. Susceptible children 13 yean of age and olderSusceptible children 13 yean of age and older(who have not had chickenpox or have not been(who have not had chickenpox or have not beenpreviously vaccinated) need two doses given 4 topreviously vaccinated) need two doses given 4 to8 weeks apart8 weeks apart

4.4. Contraindications Contraindications

a.a. PregnancyPregnancy

b.b. Immunocompromised individualsImmunocompromised individuals

c.c. Children receiving corticosteroidsChildren receiving corticosteroids

OPV (oral poliovirus OPV (oral poliovirus vaccine)vaccine)

1.1. No longer recommended for routine vaccinationNo longer recommended for routine vaccination

2.2. Not administered to anyone with an alteredNot administered to anyone with an alteredimmune system or to any household contacts ofimmune system or to any household contacts ofan immunosuppressed child (the virus multipliesan immunosuppressed child (the virus multipliesin the gastrointestinal tract and is excreted in in the gastrointestinal tract and is excreted in thethestool)stool)

2. ADULT BOOSTER IMMUNIZATIONS2. ADULT BOOSTER IMMUNIZATIONS

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

3. FLU VACCINATION PROGRAMS 3. FLU VACCINATION PROGRAMS “ “ PERSONS AT RISK” WHO SHOULD BE ADVISED PERSONS AT RISK” WHO SHOULD BE ADVISED

IMMUNIZATION AGAINST FLUIMMUNIZATION AGAINST FLU• Very young and the elderly with waning immunityVery 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:CONTRAINDICATIONS TO FLU VACCINES:

• Persons with febrile illnessPersons with febrile illness

• History of Guillain Barre SyndromeHistory of Guillain Barre Syndrome

• Allergies to eggs Allergies to eggs

• pregnancypregnancy