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Updated: Nov 20 2019

Immunization

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  • Introduction

    • Immunization allows for individuals to be protected against disease
    • Immunity can be conferred in two ways including
      • active immunity that is maintained by the immune system
      • passive immunity that is given transiently from outside
    • Vaccinations are a major source of conferring immunity outside normal infection and include
      • viral vaccines divided into
        • killed vaccines
        • live attenuated vaccines
      • bacterial vaccines
    • Often vaccinations require an adjuvent that
      • enhances the immune reaction against the vaccine provided
      • increases the development of memory to non inflammatory antigens
      • can be of several types including
        • aluminum potassium sulfate
        • muramyl dipeptide
        • LPS/polyribonucleotides
    • Though vaccines are generally safe, contraindications to their use include
    • people with egg allergies who should avoid
      • yellow fever vaccine and other vaccines made in eggs
    • pregnant women who should avoid
      • rubella vaccines
    • immunocompromised individuals who should avoid
      • all live vaccines
  • Active vs Passive Immunity
    • Immunity can be either active or passive with several notable differences
      • Differences Between Active and Passive Immunity
      • Feature
      • Passive
      • Active
      • Acquisition method
      • Receiving preformed antibodies
      • Exposure to infection or to foreign antigens
      • Examples
      • Maternal IgG crossing placenta
      • Babies getting IgA in breast milk
      • Administration of antitoxin
      • Infection with the specific pathogen
      • Administration of a vaccine
      • Onset
      • Immediate upon administration
      • Slow to allow for development of full immune response
      • Duration
      • Very short with a half life between two weeks and four weeks
      • Long or even lifetime
      • Due to generation of memory
  • Viral Vaccines
    • Viral vaccines can either be live attenuated or killed with several notable differences
      • Differences between Live and Killed Vaccines
      • Feature
      • Live
      • Killed
      • Production method
      • Design a nonpathogenic version of a virus that can still grow transiently in the host
      • Inactive pathogen or pathogen antigens by treatment with heat or chemicals
      • Pros
      • Induce both cellular and humoral responsesnduces lifelong immunity (usually)
      • Induces lifelong immunity (usually)
      • Safer than live vaccines because they cannot revert to pathogenic state
      • Cons
      • Cannot give to immunocompromised patients
      • Small chance of reverting to pathogenic state
      • Weaker response (usually only humoral)
      • May require booster shots
      • Examples
      • Everything else
      • MMR
      • VZV
      • Polio (Sabin)
      • Etc
      • Rest In Peace Always
      • Rabies
      • Influenza
      • Polio (Salk)
      • HepatitisA
  • Bacterial Vaccination
    • Bacterial vaccination involves administration of characteristic protein which can be
      • inactivated toxin produced by pathogen called a toxoid
      • coat protein that surrounds the pathogen called a capsule
      • other important proteins that are conserved by the pathogen
    • Select examples of vaccines against pathogenic bacteria include
      • DTaP that is composed of
        • C. diptheriae toxoid
        • C. tetani toxoid
        • B. pertussis toxoid
      • H. influenzae capsular type B
      • S. pneumoniae that comes in two forms including
        • a pediatric version with
          • 7 capsule types
          • think: a 7 year old gets PCV
        • an adult version with
          • 23 capsular types
      • N. meningitidis with 4 capsular proteins
    • Parenterally delivered vaccines are not effective against mucosal bacteria due to inferior secretory IgA response
      • Examples of mucosal bacteria
        • E. coli
        • V. cholerae
      • Orally delivered vaccines are allow direct antigen contact with mucosa, generating a strong secretory IgA response
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