H.S.Z.

H GOVT (AUTONOMOUS) UNANI MEDICAL

COLLEGE BHOPAL

Project on

IMMUNITY AND IMMUNIZATION

SCHEDULE

Submitted by
HAJRA KHAN
For the partial fulfillment of practical exams of
BUMS IInd Prof. in Tahaffuzi Wa Samaji Tibb

Under the Guidance Of

Dr. Mahfooz-Ur-Rahman (H.O.D)

Dr. Mohd. Farooque (Lecturer)
 ACKNOWLEDGEMENT
The success and final outcome of this project required a lot of guidance
and assistance from many people and I am extremely privileged to have
got this all along the completion of my project. All that I have done is
only due to such supervision and assistance.

I would like to express my sincere thanks to my respected Principle Dr.

Mehmooda Mam as well as my H.O.D Dr. Mehfooz Ur Rahman sir who
gave me this opportunity to do this wonderful project under the topic
of “Immunity And Immunization Schedules “which enabled me to
undergo and lot of research and helped me to lead to a better
understanding.

Furthermore, I owe my deep gratitude to our Lecturer Dr. Mohd

Farooque Sir for his valuable and constructive suggestions, useful
critiques, keen interest which has sustained my efforts at all the stages
of this work.

Any attempt at any level can’t satisfactorily be completed without the

constant encouragement and timely support from my parents and
friends who helped me in successfully completing this within the
limited time frame.

Thank you

Hajra Khan
2nd Proff.
 CONTENTS

 Immunity
 Innate immunity
 Acquired Immunity
 Antigen-Antibodies
 Immunization
 Passive immunization
 Active immunization
 Immunizing Agents
 Active Immunizing Agents
 Passive Immunizing Agents
 Adverse effects following
 Immunization Schedules
 IMMUNITY
It is defined as the capacity of the body to resist pathogenic agents. It is the ability
of body to resist the entry of different types of foreign bodies like bacteria, virus,
toxic substances, etc.

Immunity is of two types:

 Innate immunity
 Acquired immunity.
 A.INNATE IMMUNITY OR NON-SPECIFIC IMMUNITY
Innate immunity is the inborn capacity of the body to resist pathogens. By chance,
if the organisms enter the body, innate immunity eliminates them before the
development of any disease. It is otherwise called the natural or non-specific
immunity and represents the first line of defense against any type of pathogens.
Therefore, it is also called non-specific immunity.

B. ACQUIREDD IMMUNITY OR SPECIFIC IMMUNITY

Acquired immunity is the resistance developed in the body against any specific
foreign body like bacteria, viruses, toxins, vaccines etc. So, this type of immunity
is also known as specific immunity. It is the most powerful immune mechanism
that protects the body from the invading organisms or toxic substances.
Lymphocytes are responsible for acquired immunity

 Types of Acquired Immunity

Two types of acquired immunity develop in the body:

1. Cellular immunity

2. Humoral immunity.

Lymphocytes are responsible for the development of these two types of

immunity.

1. Cellular immunity

It is defined as the immunity developed by cell-mediated response, also called

cellular immunity or T cell immunity. It involves several types of cells such as T
lymphocytes, macrophages and natural killer cells and hence the name cell
mediated immunity and is the major defense mechanism against infections by
viruses, fungi and few bacteria like tubercle bacillus. It is offered by T lymphocytes
and it starts developing when T cells come in contact with the antigens. Usually,
the invading microbial or non-microbial organisms carry the antigenic materials.
These antigenic materials are released from invading organisms and are
presented to the helper T cells by antigen-presenting cell.

2. Humoral immunity

Defined as the immunity mediated by antibodies, secreated by B lymphocytes

which secrete the antibodies into the blood and lymph. Since the B lymphocytes
provide immunity through humors, this type of immunity is called humoral
immunity .These antibodies fight against the invading organisms. It is the major
defense mechanism against the bacterial infection.
Antigen-Antigens are the substances which induce specific immune reactions in
the body. They are of two types:

I. Autoantigens or self antigens present on the body’s own cells such as ‘A’
antigen and ‘B’ antigen in RBCs
II. Foreign antigen s or non-self antigens that enter the body from outside.

Antibodies and Immunoglobulins-An antibody is defined as a protein that is

produced by B lymphocytes in response to the presence of an antigen. These
gamma globulin in nature, also called immunoglobulin (Ig) and form 20% of the
total plasma proteins. They enter almost all the tissues of the body.

Types of Antibodies-Five types of antibodies are identified:

1. IgA (Ig alpha)

2. IgD (Ig delta)

3. IgE (Ig epsilon)

4. IgG (Ig gamma)

5. IgM (Ig mu).

Among these antibodies, IgG forms 75% of the antibodies in the body.
Defined as the procedure by which the body is prepared to fight against a specific
disease. It is used to induce the immune resistance of the body to a specific
disease.It is of two types:

1. Passive immunization

2. Active immunization.

PASSIVE IMMUNIZATION
Passive immunization or immunity is produced without challenging the immune
system of the body. It is done by administration of serum or gamma globulins
from a person who is already immunized (affected by the disease) to a non-
immune person. Passive immunization is acquired either naturally or artificially.

 Passive Natural Immunization

Passive natural immunization is acquired from the mother before and after birth.
Before birth, immunity is transferred from mother to the fetus in the form of
maternal antibodies (mainly IgG) through placenta. After birth, the antibodies
(IgA) are transferred through breast milk. Lymphocytes of the child are not
activated. In addi tion, the antibodies received from the mother are metabolized
soon. Therefore, the passive immunity is short lived. The significance of passive
immunity that is obtained before birth is the prevention of Rh incompatibility in
pregnancy.
  Passive Artificial Immunization

Passive artificial immunization is developed by injecting previously prepared

antibodies using serum from humans or animals. Antibodies are obtained from
the persons affected by the disease or from animals, particularly horses which
have been immunized artificially. The serum containing the antibody (antiserum)
is administered to people who have developed the disease (therapeutic). It is also
used as a prophylactic measure. Prophylaxis refers to medical or public health
procedures to prevent a disease in people who may be exposed to the disease in
a later period. This type of immunity is useful for providing immediate protection
against acute infections like tetanus, measles, diphtheria, etc. and for poisoning
by insects, snakes and venom from other animals. It is also used as a prophylactic
measure. However, this may result in complications and anaphylaxis. There is a
risk of transmitting HIV and hepatitis.

ACTIVE IMMUNIZATION
Active immunization or immunity is acquired by activating immune system of the
body. Body develops resistance against disease by producing antibodies following
the exposure to antigens. Active immunity is acquired either naturally or
artificially.

 Active Natural Immunization

Naturally acquired active immunity involves activation of immune system in the

body to produce antibodies. It is achieved in both clinical and subclinical
infections.

 Active Artificial Immunization

Active artificial immunization is a type of immunization is achieved by the

administration of vaccines or toxoids.
 IMMUNIZING AGENTS
 ACTIVE IMMUNIZING AGENTS

1. Vaccines

Vaccine is a substance that is introduced into the body to prevent the disease
produced by certain pathogens. Vaccine consists of dead pathogens or live but
attenuated (artificially weakened) organisms. The vaccine induces immunity
against the pathogen, either by production of antibodies or by activation of T
lymphocytes. Edward Jenner produced first live vaccine. He produced the vaccine
for smallpox from cowpox virus. Nowadays, vaccines are used to prevent many
diseases like measles, mumps, poliomyelitis, tuberculosis, smallpox, rubella,
yellow fever, rabies, typhoid, influenza, hepatitis B, etc.

 Live vaccines

Live vaccines(e.g., BCG,measles,oral polio)are prepared from live(generally

attenuated)organisms.In general,live vaccines are more potent immunizing
agents than killed vaccines,the reason being live organisms multiply in the host
and the resulting antigenic dose is larger than what is injected,among many
others.These should not be administered to persons with immune deficiency
 diseases or to persons whose immune response may be suppressed because of
leukaemia,lymphoma,or malignancy etc.In the case of live vaccines,
immunization is generally achieved with a single dose,exception being polio
vaccine which needs three or more doses to be given at spaced intervals to
produce effective immunity.

 Inactivated or killed vaccines

Organisms killed by heat or chemicals, when infected into the body stimulate
active immunity.They are usually safe but generally less efficacious than live
vaccines.They usually require a primary series of 2 or 3 doses of vaccine to
produce an adequate antibody response, and in most cases “booster”
injections are required.The duration of immunity following the use of
inactivated vaccines varies from months to many years.These are usually
administered by subcutaneous or intramuscular route.

2. Toxoids

Toxoid is a substance which is normally toxic and has been processed to destroy
its toxicity but retains its capacity to induce antibody production by immune
system. Toxoid consists of weakened components or toxins secreted by the
pathogens. Toxoids are used to develop immunity against diseases like diphtheria,
tetanus, cholera, etc. The active artificial immunity may be effective lifelong or for
short period. It is effective lifelong against the diseases such as mumps, measles,
smallpox, tuberculosis and yellow fever. It is effective only for short period against
some diseases like cholera (about 6 months) and tetanus (about 1 year).

3. Cellular Fractions

Polysaccharides of bacterial cell wall is used as immunizing agent.

E.g.:- Meningococcal vaccine.
 4. Combinations

If more than one kind of immunizing agent is included in the vaccine,it is called a
mixed or combined vaccine.Their aim is to simplify administration,reduce costs
and minimise the number of contacts of the patient with the health
system.Following are some of the well-k own combinations:

 DPT(Diphtheria-pertussis-tetanus)
 DT(Diphtheria-tetanus)
 DP(Diphtheria-pertussis)
 DPT and typhoid vaccine
 MMR(Measles,mumps and rubella)
 DPTP(DPT plus inactivated polio)
 Hepatitis A, and B
 Hepatitis A,and typhoid

 PASSIVE IMMUNIZING AGENTS

1. Anti serum/Anti toxin-Host blood is used as anti-sera. Administration of

antisera may occasionally give rise to serum sickness and anaphylactic
shock due to abnormal sensitivity of the recipient.
2. Immunoglobulins-There are 5 types of immunoglobulins and represent
different functional groups that are required to meet different types of
antigenic challenges.
 IgM-Accounts about 6% of normal serum Igs.Its presence is indicative of
recent infection.Half-life:7 days
 IgG-Major Ig,comprising 80% of total serum Igs and can cross through
placenta.Half-life:21 days
 IgA-13% found in large quantity in body secretion.Half-life:6-8 days
 IgE-Responsible for immediate allergy reactions.Half-life:2 days
 IgD-Acts as an antigen receptor when present on surface of B lymphocytes.
 Half-life: 2 days.

Normal Ig-Preparation containing 80% of intact(complete)igG with it’s all subunits

is called as Normal Ig .There should be low IgA concentration.Live vaccines should
not normally be given for 12 weeks after an injection of normal human If,and if a
live vaccine has already been given,NHIg injection should be deferred for 2
weeks.It is used to prevent measles in highly susceptible individuals and to
provide temporary protection (upto 12weeks)against hepatitis A infection for
travellers to endemic area.

Specific Ig-Specific If react on specific antigen and should contain at least 5 times
more potential of the standard preparation per unit volume.These preparations
are made from the plasma of patients who have recently recovered from an
infection or are obtained from individuals who have been immunized against a
specific infection.They therefore have a high antibody content against an
individual infection and provide immediate protection e.g., specific human igs are
used for chickenpox.
Vaccines used in national immunization programmes are extremely safe and
effective. However, no immune response is entirely free from the risk of adverse
reactions.

AEFI is a medical incident that takes place after immunization, causes concern and
is believed to be caused by immunization.Reported adverse events can either be
true adverse events i.e. really a result of the vaccine or immunization process or
coincidental events that are not due to vaccine or immunization process but are
temporarily associated with immunization.They are classified into five categories:

1. Vaccine reactions-They can be classified into common,minor reactions or

rare,more serious reactions.Most vaccine reactions are minor and settle on
their own.More serious reactions are very rare and in general do not result
in long-term problems.
2. Reactions due to programme error-Faulty techniques may relate to faulty
production of vaccine, too much vaccine given in one dose, improper
immunization site or route among many others.
3. Coincidental events-Occasionally following immunization there may occur a
disease totally unconnected with the immunizing agent. Vaccines are
normally scheduled early in life, when infections and other illness are
common.
4. Injection reaction-Fainting is relatively common and usually affects children
over five years of age.Hyperventilation as a result of anxiety about
immunization leads to dizziness etc.
5. Others-These may comprise damage to the foetus (e.g., with rubella
vaccination); displacement in the age-distribution of a disease (e.g., a
potential problem in Mass vaccination against measles, rubella and
mumps).
 IMMUNIZATION SCHEDULES

Age of Child Vaccine

OPV-0

0-15 Days BCG

HEPATITIS-B-O
DPT-1/OPV-1

1 ½ MONTHS HEPATITIS-B-1
HIB-1

DPT-2/OPV-2

2 ½ MONTHS HEPATITIS-B-2
HIB-2
DPT-3/OPV-3

3 ½ MONTHS HEPATITIS-B-3
HIB-3
9 MONTHS MMR+OPV
10 MONTHS TYPHOID TCV
15 MONTHS MMR
18 MONTHS DTwP / DTaP BOOSTER+OPV
HIB BOOSTER
2 YEARS TYPHOID TCV
4-6 YEARS DTaP BOOSTER+OPV
 MMR
10 YEARS DTaP
TYPHOID TCV
16 YEARS DTaP

9 YEARS + For Cervarix 0

Girls Only (For cervical cancer) 1
0,1,6 MONTHS
6