Note to presenter: The National Immunization Program can provide a videotape with animated sequences illustrating the biology of active and passive immunity and vaccination with live and inactivated vaccines. Contact us by Email at <[e-mail]> if

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Note to presenterThe National Immunization
Program can provide a videotape with animated
sequences illustrating the biology of active and
passive immunity and vaccination with live and
inactivated vaccines. Contact us by Email at
ltnipinfo_at_cdc.govgt if you with to obtain a copy of
this tape.
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• Principles of Vaccination

Epidemiology and Prevention of Vaccine-Preventable
Diseases National Immunization Program Centers
for Disease Control and Prevention
Revised March 2002
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Principles of Vaccination
Immunity

• Self vs. non-self
• Protection from infectious disease
• Usually indicated by the presence of antibody
• Very specific to a single antigen

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Principles of Vaccination
Active Immunity

• Protection produced by the person's own immune
  system
• Usually permanent
• Protection transferred from another person or
  animal as antibody

Passive Immunity
A2
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Principles of Vaccination
Antigen

• A live or inactivated substance (e.g., protein,
  polysaccharide) capable of producing an immune
  response
• Protein molecules (immunoglobulin) produced by B
  lymphocytes to help eliminate an antigen

Antibody
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Passive Immunity

• Transfer of antibody from an exogenous source
• Transplacental most important source in infancy
• Temporary protection

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Sources of Passive Immunity

• Almost all blood or blood products
• Homologous pooled human antibody (immune
  globulin)
• Homologous human hyperimmune globulin
• Heterologous hyperimmune serum (antitoxin)

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Antibody for Prevention of RSV

• RSV-IGIV
• Human hyperimmune globulin
• Contains other antibodies
• Palivizumab (Synagis)
• Monoclonal
• Contains only RSV antibody

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Vaccination

• Active immunity produced by vaccine
• Immunity and immunologic memory similar to
  natural infection but without risk of disease

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Classification of Vaccines

• Live attenuated
• viral
• bacterial
• Inactivated

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Inactivated Vaccines
Whole

• virus
• bacteria
• protein-based
• subunit
• toxoid
• polysaccharide-based
• pure
• conjugate

Fractional
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• Principles of Vaccination

General Rule
The more similar a vaccine is to the natural
disease, the better the immune response to the
vaccine.
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Live Attenuated Vaccines

• Attenuated (weakened) form of the "wild" virus or
  bacteria
• Must replicate to be effective
• Immune response similar to natural infection
• Usually effective with one dose

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Live Attenuated Vaccines

• Severe reactions possible
• Interference from circulating antibody
• Unstable

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Live Attenuated Vaccines

• Viral measles, mumps, rubella, vaccinia,
  varicella, yellow
• fever (oral polio) (rotavirus)
• (influenza)
• Bacterial BCG, oral typhoid

Vaccines in (parenthesis) are not available in
the United States.
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Inactivated Vaccines

• Cannot replicate
• Minimal interference from circulating antibody
• Generally not as effective as live vaccines
• Generally require 3-5 doses
• Immune response mostly humoral
• Antibody titer falls over time

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Inactivated Vaccines
Whole cell vaccines

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

Vaccines in (parenthesis) are not available in
the United States.
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Inactivated Vaccines
Fractional vaccines

• Subunit hepatitis B, influenza,
• acellular pertussis,
• typhoid Vi (Lyme)
• Toxoid diphtheria, tetanus

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Polysaccharide Vaccines
Pure polysaccharide

• pneumococcal
• meningococcal
• Haemophilus influenzae type b
• Haemophilus influenzae type b
• pneumococcal

Conjugate polysaccharide
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Pure Polysaccharide Vaccines

• Not consistently immunogenic in children lt2 years
  of age
• No booster response
• Antibody with less functional activity
• Immunogenicity improved by conjugation

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National Immunization Program

• Hotline [phone]
• Email nipinfo_at_cdc.gov
• Website www.cdc.gov/nip