IMMUNIZATION

Bella, Elena Y.
IMMUNIZATION
• Immunization: the process by which an individual’s immune system
becomes fortified against an agent (known as the immunogen)
• Vaccination: is the use of vaccines to prevent/immunize against/
specific disease.

• Principles of Vaccination
• Protection from infectious disease
• Usually indicated by the presence of antibody
• Very specific to a single organism
• Active Immunity
• Protection produced by the person’s own immune system
• Usually permenant
• Passive Immunity
• Protection transferred from another person or animal
• Temporary protection that wanes with time
• Antigen
• A live or attenuated substance capable of producing an immune response
• Antibody
• Protein molecules produces by B lymphocytes to help eliminate an antigen
Classification of Vaccines
• Live attenuated
• Attenuated (weakened) form of the “wild” virus or bacterium
• Immune response is similar to natural infection
• Usually produce immunity with one dose
• Severe reactions is possible
• Examples:
• Viral – Measles, mumps, varicella/zoster, yellow fever, rotavirus, intranasal influenza,
vaccinia, oral polio
• Bacterial- BCG, oral typhoid
Classification of Vaccines
• Inactivated Vaccines
• Cannot replicate
• Generally not as effective as live vaccines
• Generally requires 3-5 doses
• Antibody titer may diminish with time
Examples:
• Whole
• Viral – inactivated polio, Hep A, rabies, influenza
• Bacterial – pertussis, typhoid, cholera, plague
• Protein-based
• Subunit – Hep B, influenza, acellular pertussis, HPV, anthrax
• Toxoid – Diptheria, tetanus
• Polysaccharide-Based Vaccines
• Pneumococcal
• Meningococcal
• Salmonella Typhi
• Conjugate polysaccharide
• H. influenza type b
• Pneumococcal
• meningococcal
Vaccines
• Interval
• Recommended intervals between doses of multidose antigens should be
followed to provide optimal protection.
• Accelerated schedule can be implemented using intervals between doses that
are shorter may be recommended (travel, rapid protection)
• Vaccines doses should not be administered at intervals less than these
minimum intervals less than minimum intervals or at an age that is younger
than the minimum age.
• Vaccine doses administered less than or equal to 4 days before the minimum
interval or age are considered valid.
• Doses administered too close together or at too young an age can lead to
suboptimal immune response.
• Doses of any vaccine administered greater than or equal to 5 days earlier than
the minimum interval or age should not be counted as valid doses and should
be repeated as age appropriate.
Active Immunization
BCG
• B- Bacillus, C- Calmette & G- Guerin
• as soon after BIRTH
• Dosage of 0.05 mL
• Protects only against severe form of TB e.g TB meningitis, dessiminated TB
• Special, live attenuated Mycobacterium Tuberculosis
• Freeze-dried, like measles vaccine
• Dry powder, needs reconstitution
• Administered INTRADERMAL RIGHT UPPER ARM
• Easily damaged by sunlight, heat
• BCG once reconstituted, lasts for 8 hrs
• In 2 to 6 weeks: site endurates, sometimes with pustular reaction/ulcer = scar
ADVERSE REACTIONS
• Severe
erythema nodosum / Delayed / Incidence not known
lupus-like symptoms / Delayed / Incidence not known
erythema multiforme / Delayed / Incidence not known

• Moderate
skin ulcer / Delayed / Incidence not known
lymphadenopathy / Delayed / Incidence not known
erythema / Early / Incidence not known

• Mild
arthralgia / Delayed / Incidence not known
myalgia / Early / Incidence not known
infection / Delayed / Incidence not known
anorexia / Delayed / Incidence not known
fever / Early / Incidence not known
injection site reaction / Rapid / Incidence not known
urticaria / Rapid / Incidence not known
rash / Early / Incidence not known
Contraindications
• Immunosuppression. BCG vaccination should not be given to persons
who are immunosuppressed (e.g., persons who are HIV infected) or
who are likely to become immunocompromised (e.g., persons who
are candidates for organ transplant).

• Pregnancy. BCG vaccination should not be given during pregnancy.

Even though no harmful effects of BCG vaccination on the fetus have
been observed, further studies are needed to prove its safety.