AL-QUDS UNIVERSITY

Faculty of Medicine
Public Health

National Vaccination Program

Presented to: Dr. khuloud khayyat Dajani

Prepared by: . Shibli Yousef Shoukri Alsleibi

. Sakha Mahmoud Yousef Abu Hannoun

Index:
 Introduction
 Type of vaccination
 How vaccination program works
 Side effects
 How safety is vaccination
 National vaccination program schedule
 Vaccine-Preventable Diseases in Palestine

Introduction:
Since the introduction of vaccination programs, millions of lives have been saved and protected
from several fatal diseases. Vaccines boost our immune system, and create immunity that
protects us from an infection without having to experience the disease or its symptoms.

Vaccination is the administration of a vaccine that improves immunity to a particular disease. In

fact, vaccines contain a disease-causing organism which is made from a killed or weakened form
of the pathogen. So vaccinated people are in no danger of developing the disease.

Vaccines allow us to fight diseases due to the presence of the immune system ‘memory cells’
that remembers the infectious organisms. Sometimes vaccine boosters are required because the
memory of the immune system gets weaker over time.

Types of Vaccines:
When scientists try to design vaccines against a microbe, they should know fundamental
information about this microbe, such as how it affects cells and how our immune system
responds to it.

There are several types of vaccines. These types represent different strategies used in order to
reduce risk of illness, and to induce the immune response. In fact, the way in which the body
responds to a vaccine depends on the type of vaccine being used.

The basic types of vaccines are: live attenuated and inactivated, each type has its own
characteristics, and these characteristics determine how the vaccine is used.

Live attenuated vaccines are produced from a disease-producing virus or bacteria that have been
attenuated or weakened so that they don’t cause the disease. The resulting vaccine retains the
ability to grow and produce immunity. Usually this type of vaccines does not cause illness.

Inactivated vaccines are produced by growing the virus or bacteria, and then inactivating or
killing it by using heat or chemicals. These vaccines are safer and can’t cause the disease but
they are not as good as the live vaccines. There are other types of vaccines such as subunit,
toxoid, conjugate, DNA, recombinant vector vaccines, but there is one general rule that include
all the types: The more similar a vaccine is to the natural disease, the better the immune
response to the vaccine.
How a vaccination program works:
Vaccination program introduce everyone in certain age or risk group, it aims to get an immune
response against antigen that works when the individual is again exposed to the antigen and it
gives a specific vaccine to try to decrease the spread of diseases among people and number of
infected cases.
Vaccination programs often concentrate on young children because they are Susceptible to many
dangerous infections. Some vaccination programs are targeted at older people or certain risk
groups. Number of people catching the disease decrease When a vaccination programs against a
disease starts, but it’s important to keep vaccinating, because the disease can spread again.
Vaccination is also important for people who cannot get vaccinated or who did not get
vaccinated because it makes it harder for the diseases to spread between people. This is called
"herd immunity".
Herd immunity is particularly important in protecting people who can't get vaccinated because
they're too ill, or they are having treatment that damages their immune system.
Public Health England (PHE) records the vaccinations that adults and children receive. PHE also
records the number of cases of each disease each year. This way, PHE can work out the impact
that each vaccination has on a particular disease. This data helps the Joint Committee on
Vaccination and Immunization (JCVI) considers whether the routine vaccination program needs
to be changed.
Side Effects:
Vaccines are designed to protect from disease. However, they can cause side effects, just like any
medication.

The risk of a vaccine to cause serious damage or death is very small. In fact, most of the side
effects are mild and go away in a few days.

A possible side effect resulting from a vaccination is known as an adverse event. According to
the CDC mild side effects are reported within two weeks of vaccination. These side effects can
include soreness, swelling, or redness at the injection site. Vaccine can also cause headaches,
cough, nausea, upper respiratory tract infection, abdominal pain, diarrhea. In addition, they may
cause fatigue, muscle and joint pain.

Serious problems are rare and are reported within 6 months of getting the vaccine. The sever
problems include inflammation of the stomach or intestines, pneumonia, blood in the urine or
stool. These problems are dramatic and may be life-threatening. However, they are completely
reversible if treated immediately by healthcare staff.

How safety is vaccination:

vaccination is a safe and effective way to reduce the spread of diseases but some vaccination are
not completely safe and many risk factor will result from vaccination ,Although most adverse
events are minor (e.g. redness at injection site, fever), more serious reactions (e.g.
seizuresSeizureUncontrolled electrical activity in the brain, resulting in convulsion, physical
signs, thought disturbances, or a combination of symptoms.,anaphylaxisAnaphylaxisAn acute,
multi-system, allergic reaction (IgE mediated) to a substance, such as vaccination, drugs, and
food. Symptoms of anaphylaxis may include breathing difficulties, loss of consciousness, and a
drop in blood pressure. This condition can be fatal and requires immediate medical attention.)
can occur albeit at a very low frequency.

Vaccines have to be thoroughly tested for safety before they're made routinely available.

Each vaccine's safety is continually monitored, even after it's been introduced. This is because
not all side effects are picked up during the vaccine's development, especially if they're very rare.
All vaccines in general use are continually and carefully monitored, so that any side effects are
identified.
  PRE-LICENSURE VACCINE SAFETY
Vaccines undergo extensive testing and review for safety, immunogenicity

 POST-LICENSURE VACCINE SAFETY

Conducted after a product has been licensed and introduced for use in a population.
National vaccination program schedule:
Vaccine-Preventable Diseases in Palestine:

The vaccination program in Palestine is one of the best worldwide. The expanded program of
immunization (EPI) includes not only vaccination supplies and coverage, but also vaccination
cold chain equipment, vaccine efficacy, side effects, adverse events (complications), monitoring
and supervision and disease surveillance and safety injections.

More than 100,000 newborns are provided yearly with all the different antigens (vaccines)
according the Palestinian EPI schedule. Around 1,200,000 injections and 300,000 doses are
administered on a daily basis with no serious adverse events following immunization.
In 1995, when the Palestinian Authority took over, a national EPI committee was established
from both the West Bank and Gaza. This committee included experts from the Medical Pediatric
Association in addition to one observer from the World Health Organization (WHO) and another
observer from the United Nations Children’s Fund (UNICEF). The main role of the committee is
monitoring and evaluating the EPI’s activities and planning for any other activities that should be
implemented, including the introduction of new vaccines, outbreak response, campaigns for
global goal achievement and recommendations to improve the performance indicators of
vaccine-preventable disease surveillance.

 Main Polio Achievements:

No cases of polio were reported since 1988. The combined vaccination program of Oral Polio
Vaccine (O.P.V.) and Inactivated Polio Vaccine (I.P.V.) has been implemented since 1978. The
national vaccination coverage is almost 100%.

 Measles:

Palestine is considered by WHO to be in the phase of eliminating this disease.

Measles elimination means that no measles cases should occur inside the country but cases could
be imported from other countries and the virus could circulate inside the country without
infection. The serosurvey of 2005 showed that more than 98% of children had high immunity
against measles. Only sporadic cases were reported in the last ten years. Measles diagnosis,
hospitalization and treatment are offered free of charge, as for other vaccine-preventable
diseases.
  Neonatal tetanus:

The global goal set by WHO to eliminate Neonatal Tetanus (NT) was achieved in Palestine since
1990, as was recognized by two expert missions from WHO/EMRO that visited Palestine.
Elimination means that NT cases should be one case or less reported for every 1,000 newborns
per year per district.
Two booster doses are given to all children, one at school entry level and the other at age 15.
Tetanus toxoid is given to every pregnant woman more than 28 years of age, with no
documentation of previous immunization for six doses. The situation was aided by hospital
deliveries that reached 95% of all births.

 Hepatitis B:

The prevalence of Hepatitis B in Palestine was dramatically reduced after the introducing of the
Hepatitis B vaccine in the national immunization schedule in early 1992. The incidence of
Hepatitis B in 1989 was around 7% and in 2000 it was around 3.4%. Expectation for 2006
should not exceed 2%, meaning that Palestine passed from an intermediate to a low endemic
country.

As for other diseases, no diphtheria cases were reported in the past 20 years.

Tuberculosis is reported in adults only and sporadic cases of pertussis are reported yearly. A
huge mumps outbreak was averted following the Measles, Mumps and Rubella (MMR)
campaign that targeted the group of 6-25 years old in 2005.

Building a computerized networking system for all districts for better data monitoring and
surveillance of diseases at the Ministry of Health, with the help of a Management Information
System has improved and harmonized data collection and reporting between Gaza, the West
Bank and UNRWA.
References:
1. http://www.nhs.uk/Conditions/vaccinations/Pages/How-vaccines-work.aspx
2. http://vaccine-safety-training.org/how-vaccines-work.html
3. http://www.cdc.gov/vaccines/
4. http://vaccine-safety-training.org/vaccine-safety-in-immunization-programmes.html
5. http://vaccine-safety-training.org/types-of-vaccine-overview.html
6. http://thisweekinpalestine.com/details.php?id=1586&ed=111&edid=111
7. http://www.historyofvaccines.org/content/articles/vaccine-side-effects-and-adverse-events