• What type of immunization involves the host recieving antibodies produced by another host?
• How long does this protection last?

• passive immunizzation
• short lived (2-3 months) no long term protection generated

• rapid protection after potential exposure (needle stick)
• lessen severity of ongoing disease (necrotizing fasciitis)
• individuals unable to produce antibody

aka vaccine

cowpox virus (vaccinia) to prevent smallpox

Jenner

1. live attenuated
2. inactivated whole cell or subunit
3. toxoid

do not have to be by injection - may mimic natural route! 

mimic natural infection = give LONG TERM immunity; do not need booster!

• may be virulent for immunosuppressed or pregnant
• may revert to virulent form during infection in host
• must be handled properly to maintain viability until used

• BCG vaccine for Tb
• MMR (except my need booster!!)
• Sabin polio vaccine (but replaced by killed (salk) polio vaccine!!)

live attenuated

no longer used. it was used to eradicate polio in western hemisphere (cheap, gave IgA immunity in gut)

BUT, rarely, it reverted back to virulent form (as wild polio decreased, vaccine = more dangerous) so replaced by dead vaccine

Inactivated vaccines

often given with substance to increase immunogenicity (an "adjuvant", eg. alum)

given by injection 

- do not give local IgA response (mucosal immunity)

-require multiple doses 

-immunity wanes over time = reimmunization may be required

-- give ANTIBODY response but NOT CELL MEDIATED

FALSE

ONLY give antibody response - NO cell mediated

Subunit Vaccine

-- less prone to side effects than whole cell and effective, but expensive

• Hep B (outer coating - surface antigen used)
• Haemophilus influenza B, pneumococcal and meningococcal vaccine (bacterial polysaccharde capsular material) ((but not very immunogenic so now bound to protein - conjugated)
• pertussis vaccine

• multiple doses (adjuvant to increase immunogenicity)
• very effective
• ex. tetanus and diptheria toxoid vaccines

National advisory committee on immunizations (NACI) - MOH and other experts make up NACI

Government departments (dept of health and wellness in NS) implement recommendations - dependend on province  - affected by resources, policies, priorities, incidence

• many do not reach target of 95% (missed opportunities by health care workers and care giver and improper storage)
• not in routine use (incidence low, vaccine expensive)
• may occur in unvaccinated/undervaccinated (religion/culture, missed immunization, not all immunized become immune, misconception of risk of immunization)

• Diptheria toxoid, tetanus toxoid, and acellular pertussis vaccine
• also combined in pentavalent form (poliovirus and haemophilus B too = 5 total vaccines in 1)

given at 14-16 yrs age, boosters every 10 years

less diptheria toxoid (to decrease adverse effects)

• inactivated (IPV, Salk) and live oral (OPV, Sabin)
• primary: 2, 4, 6 moths, booster 18 months, and 4-6 years

What does the haemophilus type B vaccine consist of? 

Can it be given with other vaccines? 

• polysaccharide conjugated to a protein (4 preps exist)
• conjucation activates T-cell dependent immunity (immunogenic in infants and improves memory_
• Hib can be given in "conjunction" with DTaP and polio 

live attenuated

primary: 12-15 months

2nd dose: 18 months or 4-6 yrs

Have we eliminated indigenous transmission of MMR? 

inactivated whole or split-virus vaccine

- contians 2 A strain and one B strain

What is the Hep B vaccine?

How many doses are needed (how is it given)? Booster?

purified HBsAg (recombinant or plasma-derived)

- 3 doses at 0, 1, and 6 months IM

(vary from province to province)

- booster NOT recommended

1. polysaccharide vaccine (23 valent) = immunity against 90% pneumonia strains of S. pneumoniae 

2. 13 valent conjugated vaccine (conjugated to diptheria toxoid)

• 80% in healthy adults
• repeat every 5 years
• recommended for: over 65, spleen gon or disfunction, sickle cell, cerebrospinal fluid leaks, "high risk" persons who require influenza vaccine

• via cell mediated immunity
• given 2, 4, 12-15 months
• decrease carriage of covered pneumococci
• fewer infections in elderly (unexpected benefit; children are source of infection for grandparents!)

• live attenuated virus
• given at age 12 months
• if given at older age than 12 yrs requires 2 doses
• extremely safe (<5% get lesions)
• 95% effective in preventing sever infections
• has potential to make varicella uncommon in NA

• subunit vaccine containing protein of up to 4 HPV (6,11,16,18) or (16,18)
• girls age (9-13 or 14-26 also helpful)
• given in 3 doses (0,2,6 months IM)
• decrease cervical cancer and some genital warts