IMMUNIZATION

A PRESENTATION BY
Ridwan Oladipo
CLI/2015/077
 OUTLINE
 INTRODUCTION
 BRIEF HISTORY OF IMMUNIZATION
 IMMUNE SYSTEM: CONCEPT AND TYPES
 IMMUNITY: CONCEPT AND TYPES
 VACCINATION: CONCEPT, TYPES, EXAMPLES, DOSES OF VACCINES AND
ROUTES AND TIME OF ADMINISTRATION
 COLD CHAIN SYSTEM: CONCEPT, ELEMENTS, EQUIPMENTS, LEVELS AND
SENSITIVITY OF VACCINES
 VACCINE VIAL MONITOR (VVM): CONCEPT, FORMAT AND DIMENSION, AND
STAGES
 CONCLUSION
 REFERENCES
INTRODUCTION
According to the World Health Organization
(WHO), immunization is an act of making a person
immune to infections, typically by the
administration of vaccines. It has shown to be a
proven tool for controlling and eliminating life-
threatening infectious diseases and has been
estimated to avert between 2 and 3 million deaths
each year.
BRIEF HISTORY OF IMMUNIZATION
 The World Health Organization (WHO) formulated and launched the EXPANDED
PROGRAM ON IMMUNIZATION (EPI) in 1974, the aims were to
1. Assist nations to carry out immunization of their 0-2 years child population against
6 vaccine preventable communicable and dangerous diseases- Tuberculosis,
pertussis, Diphteria, measles, poliomyelitis and tetanus
2. Get all women of child bearing age (15- 35yrs) vaccinated against tetanus.
3. Enhance national self- reliance in vaccine production distribution and
administration.
 The National Programme on Immunization(NPI) is the Nigerian programme. It
started in 1995. The NPI has in addition to the EPI vaccines for Hepatitis B,
yellow fever, cerebrospinal meningitis.
 IMMUNE SYSTEM: CONCEPT AND
TYPES
The immune system is the body's or host's defense system (this
includes organs and processes) that protect the body against infectious
organisms and other invaders. Any inefficiencies in fighting these
invaders result in illnesses and infections.
TYPES
Innate immune system: These are the innate responses and processes
to invading pathogens, such as inflammasome, cytosolic receptors,
toll-like receptors, surface barriers, leukocytes, inflammation,
complement system, among others.
 IMMUNE SYSTEM: CONCEPT AND
TYPES
Adaptive immune system: These responses and processes are antigen-
specific. This specificity allows the generation of responses that are specific to
antigens related to pathogens. When antigens (foreign substances) invade the
body, they are recognized and this triggers the production of antibodies that
fights it off. Once produced, antibodies stay body. If they encounter that
antigen again, the antibodies are already there to do their usual job. This is
why when one contract chickenpox, the person won't fall sick from it again.
This is the same way immunization helps to prevent certain diseases.
Immunization introduces the body to an antigen in a way that doesn't make
someone sick but does allow the body to produce antibodies that, in the future,
will protect the person from future attack by the germ or substance that
produces that particular disease.
 IMMUNITY: CONCEPT AND TYPES
CONCEPT
Immunity is simply, PROTECTION, which is the body's ability to tolerate materials
that are indigenous "self" to it and eliminate materials that are foreign "non-self".
TYPES
ACTIVE IMMUNITY: Here, the protection is provided by the individual's immune
system. This immunity or resistance is developed in response to a stimulus by an
antigen of an infecting agent and vaccine. It is important to state, active immunity
usually, last for many years and it is often permanent.
PASSIVE IMMUNITY: Here, the protection is 'borrowed', usually from another
source and lasts for a short time. Common forms of passive immunity include, a fetus
receiving antibodies (IgG, it is the only antibody that significantly crosses the human
placenta) from its mother during pregnancy through the placenta, an infant receiving
antibodies through sucking breast (secretory immunoglobulin A, Ig A), also,
following the administration of immunoglobulins or antisera.
 VACCINATION: CONCEPT

Vaccination is a method of administering antigen to

stimulate an immune response that is aimed towards
active immunity.
Vaccines are immuno-biological substances that are
designed to produce active immunity or protection
against certain diseases. Vaccines are "antigenic", but
not "pathogenic".
VACCINATION: TYPES AND EXAMPLES
Live vaccines
Live attenuated or avirulent vaccines
Inactivated (or killed) vaccines
Toxoids
Polysaccharide and polypeptide (cellular fraction)
vaccines
Surface antigen (recombinant vaccines)
VACCINATION: TYPES AND EXAMPLES
 Live vaccines: These are vaccines that are made from life infectious agents, without any
modification or alteration. A good example of which is Variola small-pox vaccine, that is
made from life 'vaccinia' cow-pox virus. These vaccines are usually antigenic and not
pathogenic.

 Live attenuated or avirulent vaccines: These vaccines are made from infectious agents that
have already been 'attenuated', that is weakened under regulatory conditions in the laboratory.
Consequently, they are avirulent and cause no disease or mild form of diseases.
 It is important to state that only a dose of these vaccines is required to provide life-long active
immunity, except the Oral Poliomyelitis vaccine (OPV). Also, these vaccines should not be
administered to persons with suppressed immune responses
 Viral examples: Measles vaccine, Rubella vaccine, Yellow Fever vaccine, Oral Poliomyelitis
vaccine (OPV), Mumps vaccine, and Intranasal Influenza vaccine.
 Bacterial examples: Bacille Calmette Guerin (BCG) vaccine for tuberculosis, Typhus vaccine,
typhoid vaccine, and plague vaccine.
VACCINATION: TYPES AND EXAMPLES
Inactivated (or killed) vaccines: Here, the vaccines are made from dead or inactivated
infectious agents. They can not cause diseases since they are dead, yet antigenic.
It is important to state that they are not as effective as live attenuated vaccines. Hence, multiple
doses are required for full protection
Viral examples: Rabies vaccine, Intramuscular influenza vaccine, inactivated poliomyelitis
vaccine (IPV), and Japanese encephalitis vaccine.
Bacterial examples: Pertussis vaccine, cholera vaccine, and plague vaccines

Toxoids: These vaccines are made from the exotoxins (toxins secreted by some bacteria into the
surrounding medium) usually, by detoxifying them. Adjuvant like Alum precipitation is used to
increase the potency of the vaccine. The antibodies formed in response to the administration of
toxoids act on the toxic moiety produced an invading infectious agent.
Example include: Tetanus-Diptheria (TD) vaccine.
VACCINATION: TYPES AND EXAMPLES
Polysaccharide and polypeptide (cellular fraction) vaccines:
They are formed from extracted cellular fractions of infectious
agents. They are very effective.
Examples: Meningococcal vaccine from polysaccharide antigen
of the cell wall, pneumococcal vaccine from the polysaccharide
contained in the capsule of the organism, and hepatitis B
polypeptide vaccine
Surface antigen (recombinant vaccines): These are very strong
and effective vaccines. A common example is the Hepatitis B
vaccine that is prepared by cloning Hepatitis B surface antigen
gene in yeast cells where it is expressed.
 ROUTES OF ADMINISTRATION
Intramuscular route: Most vaccines are administered through this
route. They are injected at angle 90 degrees.
Oral route: Oral Poliomyelitis Vaccine (OPV)
Subcutaneous route: Measles (left upper arm), Yellow fever
(right upper arm), and Japanese encephalitis vaccines. They are
injected at angle 45 degrees.
Intradermal route: BCG vaccine (left upper arm). They are
injected at angle 10 to 15 degrees.
Scarification: Smallpox vaccine
Intranasal route: live attenuated influenza vaccine
ROUTES OF ADMINISTRATION
TIME OF ADMINISTRATION
 DOSES
All vaccines that are not administered orally are
administered in 0.5ml except the BCG vaccine
that is administered in 0.05ml.
The OPV is administered orally, in 2 drops.
Vitamin A is, also, administered orally. It is in 2
doses. The amount of the first dose is 100, 000
International Unit (IU)
COLD CHAIN SYSTEM: CONCEPT, ELEMENTS, EQUIPMENTS,
LEVELS AND SENSITIVITY OF VACCINES

The cold chain is a chain system of

production, storage, and transportation of
vaccines at the point of manufacture to the
site of use where it is administered at
strictly low temperatures. The cold chain
helps to maintain the potency of the
vaccine.
 ELEMENTS, EQUIPMENTS, AND
LEVELS OF COLD CHAIN
ELEMENTS:
Personnel to manage vaccine distribution
Equipments for vaccine storage and transport
Maintenance of equipments
EQUIPMENTS
Solar Direct Drive Vaccine Refrigerators, Compression Icelined refrigerators and
freezers, Vaccine Transport boxes, Temperature Dataloggers, Health Centre kits, Ice
packs, Cold rooms, among others
LEVELS OF COLD CHAIN
Manufacturer, Airport, Central vaccine store, Regional store, District store, and
Immunizing staff
 SENSITIVITY OF VACCINES

It is important to state that different vaccines are stored in various

compartments.
Poliomyelitis and measles vaccines are to be stored in the freezer
compartment and allowed to freeze.
Typhoid, DPT, tetanus toxoid and BCG should be stored in a cold
compartment, but not allowed to freeze.
 VACCINE VIAL MONITOR (VVM): CONCEPT, FORMAT AND
DIMENSION, AND STAGES

CONCEPT
This is a thermochemical label placed on vaccine vials to register the cumulative
heat effect overtime. It helps to know which vaccine has expired or the ones that
can be used. It also helps to know vials that have been exposed but can still be
used. The first idea about VVM was conceived by the World Health Organization
(WHO) in 1979. In 1996, it was introduced by the UNICEF after various research
and trials.
FORMAT AND DIMENSION
The VVM is a circle of colour minimum diameter, 7.0mm with a square of colour,
minimum dimensions of 2.0 x 2.0mm positioned in the centre of the circle. The
ratio of the area of the square to the area of the circle including the square is to be
at least 0.1: 1.
 STAGES
There are four stages of the VVM, depending on the exposure of
vaccine vials to heat.
The first two stages can be used while the last 2 stages are to be
discarded.
Stage 1: the square or circle within is clear white and can still be
stored and/or used.
Stage 2: the square or circle within has started darkened, but still
lighter than the other circle. It should be used earnestly.
Stage 3: The square or circle is the same colour as the external
circle. It should be discarded immediately.
Stage 4: The square or circle within is darker than the external
circle. It should be discarded immediately.
APPLICATION OF ACTIVE IMMUNIZATION

Infants and children expanded immunization program (schedule)

Active immunization for adult females
Vaccination for special occupation
Vaccination for special lifestyles and special environmental
situations
Vaccinations in travel
Vaccines against bioterrorism
 CONCLUSION

In the end, good health can be underated. No protection from disease is

too much. This -protection, immunization helps to give. The
immunization coverage in Nigeria can be better achieved by
1. Creating health awareness and seeking the cooperation of the public
2. Organizing outreach programs in rural and nomad areas, and home
visits
3. Periodic mass immunization campaigns and tracking, to cover those
who missed regular immunizations
4. Efficient immunization service; urban and rural
Gracias, Ciao