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• The word “vaccine” originates from the Latin

Variolae vaccinae (cowpox), which Edward Jenner
demonstrated in 1798 could prevent smallpox in
Vaccines humans.
• Today the term ‘vaccine’ applies to all biological
Topic 8 preparations, produced from living organisms, that
enhance immunity against disease and either
prevent (prophylactic vaccines) or, in some cases,
treat disease (therapeutic vaccines).
• Vaccines are administered in liquid form, either by
injection, by oral, or by intranasal routes.

Vaccine preventable bacterial diseases

1) Anthrax
2) Cholera
3) Meningococcal disease
4) Diphtheria
5) Tetanus
6) Pertussis
7) Tuberculosis
8) Pneumococcal disease
9) Typhoid fever
10) Haemophilus influenzae type b

Vaccine preventable viral diseases

1) Measles 9) Tick-borne
2) Rubella encephalitis
3) Influenza 10) Rabies
4) Mumps 11) Varicella and herpes
5) Hepatitis A zoster (shingles)
6) Hepatitis B 12) Human papilloma-
virus
7) Hepatitis E
13) Rotavirus
8) Poliomyelitis gastroenteritis
14) Yellow fever
15) Japanese encephalitis

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Types of vaccines i. Killed (inactivated) Vaccines

i. Killed (inactivated) vaccines • They contain killed, a) Influenza vaccine

ii. Live attenuated vaccines but previously
b) Cholera vaccine
iii. Toxoid vaccines virulent, micro-
organisms that have c) Bubonic
iv. Subunit vaccines been destroyed with d) Plague vaccine
v. Conjugate vaccines chemicals, heat, e) Polio vaccine
vi. Experimental vaccines radioactivity or f) Hepatitis A vaccine
vii. Valence vaccines antibiotics

ii. Live attenuated vaccines iii. Toxoid vaccines

• They are prepared with • Immunization with a live
organisms limited in their a live vaccine resembles
ability to cause disease the natural infection i.e.
the immune response
• They are helpful in agents
that require T-cell progresses through TH1
immune responses for and then TH2 immune
resolution of the responses, and humoral,
infection. cellular, and memory
immune responses are
developed
• Immunity is long term
• Toxoid vaccines are • Tetanus vaccines
made from inactivated
• Diphtheria vaccine
toxins that cause illness
rather than the micro-
organism.
• Toxoid vaccines are
known for their efficacy

iv. Subunit vaccines v. Conjugate vaccines

• Subunit vaccine against
Hepatitis B virus that is
• They are made from composed of only the • Made from the linkage • This approach is used in
components of the surface proteins of the (conjugation) of the Haemophilus
disease-causing virus. polysaccharides to influenza type B
organism, such as
specific proteins and • The virus-like particle proteins (this increases vaccine.
polysaccharides, or (VLP) vaccine against the effectiveness of
nucleic acids human papillo mavirus polysaccharide vaccines
(HPV) that is composed in young children)
of the viral major capsid
protein
• Hemagglutinin and
neuraminidase subunits
of the influenza virus

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vi. Valence vaccines

• Valence may be
- monovalent (also • A multivalent or
called univalent) or
- multivalent (also
called polyvalent
• A monovalent vaccine is
designed to immunize
against a single antigen
or single microorganism
Components of a vaccine
• Bulk antigen
polyvalent vaccine is
• Fluids (water or saline)
designed to immunize
against two or more • Additives or preservatives
strains of the same • Adjuvants
microorganism, or
against two or more • These ensure the quality and potency of the
microorganisms vaccine over its shelf-life.

Preservatives Preservatives commonly used in vaccine

• They ensure the sterility formulation
of the vaccine over the
period of its shelf-life. • Or, in some cases,
preservatives may be
• Preservatives may be
added during
used to prevent
manufacture to prevent
contamination of multi-
microbial contamination.
dose containers:
- when a first dose of • Preservatives used in
vaccine is extracted from vaccines are non-toxic in
a multi-dose container, a the amounts used and do
preservative will protect not diminish the potency
the remaining product of vaccines.
from any bacteria that
may be introduced into
the container.

A list of commonly adjuvanted childhood

Adjuvants
vaccines
• Adjuvants enhance the immune effect of the
vaccine antigen
• Aluminum salts are the most commonly used
adjuvant for vaccines
• Adjuvanted vaccines may have a slightly
higher rate of adverse reactions, including
pain at the injection site, malaise and fever

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Types of immunization
• Passive immunization
- consists of administration of exogenously
produced antibody to provide temporary
protection from disease.
- Antibodies provided by this route are usually
short-lived and protection is temporary
compared to active immunization
• Active immunization
- Active immunization consists of inducing the
body to develop defenses against an infectious
agent.
- This is accomplished by stimulating the
production of antibodies or inducing cell-
mediated immunity, or both.
• Active immunization employs either live-
attenuated vaccines or inactivated vaccines

How do vaccines work? Temporal course of the response to active

immunization
• The components of the disease-causing • The primary response
organisms or the vaccine components that trigger after first exposure to a
vaccine antigen occurs
the immune response are known as “antigens”. after a latent period of
• These antigens trigger the production of several days.
“antibodies” by the immune system • Afterwards humoral
(antibody) and cell-
• Antibodies bind to corresponding antigens and mediate immunity can be
detected.
induce their destruction by other immune cells
• The first antibodies to
• Memory against antigens is stored. appear are usually IgM
class
• Two or more weeks after
vaccination the IgG
antibody titers rise
• As the titer of IgG rises,
the IgM titer falls
• IgG antibodies are
produced in large
amounts and function in
the neutralization,
precipitation, and fixation
of complement
• The response to a vaccine
is usually measured by
the antibody titer (easier
to measure) in the host

Impact of vaccines in society

Host determinants of response to active • Vaccines are provided to • Vaccine efficacy:
individuals to protect - It is the reduction in
immunization them from disease incidence of a disease
• Two factors contribute to amongst those who have
1. The genetics of the individual being vaccinated the ability of a vaccine to been vaccinated relative
control or eliminate a to the incidence in the
2. Age and immune status of the individual being vaccinated unvaccinated
disease:
3. Type of vaccine - the effectiveness of the • The most effective
4. Dose of the vaccine vaccine; and vaccines induce a
- the level of vaccination protective immune
5. Route of administration
coverage achieved in a response in > 95% of
6. Adjuvants given population individuals

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• If a high level of
vaccination coverage is
achieved with an
effective vaccine, • This effect is known as
herd immunity • The level of vaccination (i) The ease with which
disease transmission coverage required to a disease is transmitted;
can be interrupted • Smallpox was
eradicated by achieving interrupt disease and,
• When disease transmission will
transmission is sufficient immunization
coverage to prevent depend on: (ii) the effectiveness of
interrupted, even those
individuals who were transmission of disease the vaccine at
not vaccinated, or who to unvaccinated non- stimulating immunity.
were vaccinated and did immunes (susceptible)
not develop immunity,
will be protected from
disease

Safety of vaccines

• The vast majority of • Some individuals may

adverse events
associated with
vaccines are minor and
transient.
• These are typically pain
at the injection site, or
mild fever
be sensitive to some
components or trace
elements in some
vaccines, such as eggs,
antibiotics, or gelatin.

Safety testing of vaccines (3 phases)

Global Vaccine Initiative 2011 - 2020

• The Global Vaccine • Mission:

Action Plan (GVAP) is a
framework approved by
the World Health
Assembly in May 2012
to achieve the Decade
of Vaccines vision by
delivering universal
access to immunization
- improve health by
extending by 2020 and
beyond the full benefits
of immunization to all
people, regardless of
where they are born,
who they are, or where
they live.

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Goals of the decade of vaccines (2011-2020)

1. Achieve a world free of 4. Exceed the Millennium

poliomyelitis Development Goal 4
2. Meet vaccination target for reducing
coverage targets in child mortality
every region, country 5. Develop and introduce
and community new and improved
3. Meet global and vaccines and
regional elimination technologies
targets