7/29/2019 Principles 8 p

1/22

Note to presenter:The National Immunization Program canprovide a videotape with animated sequencesillustrating the biology of active and passiveimmunity and vaccination with live andinactivated vaccines. Contact us by Email at if you wish to obtain a copyof this tape.

7/29/2019 Principles 8 p

2/22

Principles of Vaccination

Epidemiology and Prevention of Vaccine-

Preventable Diseases

National Immunization Program

Centers for Disease Control and Prevention

Revised December 2004

7/29/2019 Principles 8 p

3/22

Principles of Vaccination

Self vs. nonself

Protection from infectious disease

Usually indicated by the presenceof antibody

Very specific to a single antigen

Immunity

7/29/2019 Principles 8 p

4/22

Principles of Vaccination

Protection produced by the person'sown immune system

Usually permanent

Protection transferred from anotherperson or animal as antibody

Temporary protection that waneswith time

Active Immunity

Passive Immunity

A2

7/29/2019 Principles 8 p

5/22

Principles of Vaccination

A live or inactivated substance(e.g., protein, polysaccharide)capable of producing an immuneresponse

Protein molecules(immunoglobulin) produced by Blymphocytes to help eliminate anantigen

Antigen

Antibody

7/29/2019 Principles 8 p

6/22

Passive Immunity

Transfer of antibody produced byone human or other animal toanother

Transplacental most importantsource in infancy

Temporary protection

7/29/2019 Principles 8 p

7/22

Sources of Passive Immunity

Almost all blood or bloodproducts

Homologous pooled humanantibody (immune globulin)

Homologous human

hyperimmune globulin Heterologous hyperimmune

serum (antitoxin)

7/29/2019 Principles 8 p

8/22

Monoclonal Antibody

Derived from a single type, orclone, of antibody-producing cells(B cells)

Antibody is specific to a singleantigen or closely related group ofantigens

Used for diagnosis and therapy ofcertain cancers, autoimmuneconditions, and infectious diseases

7/29/2019 Principles 8 p

9/22

Antibody for Prevention of RSV

RSV-IGIV

Human hyperimmune globulin

Contains other antibodies

Palivizumab (Synagis)

Monoclonal

Contains only RSV antibody

7/29/2019 Principles 8 p

10/22

Vaccination

Active immunity produced byvaccine

Immunity and immunologicmemory similar to naturalinfection but without risk of

disease

7/29/2019 Principles 8 p

11/22

Classification of Vaccines

Live attenuated

viral

bacterial

Inactivated

7/29/2019 Principles 8 p

12/22

Inactivated Vaccines

virus

bacteria

protein-based

subunit

toxoid polysaccharide-based

pure

conjugate

Whole

Fractional

7/29/2019 Principles 8 p

13/22

Principles of Vaccination

General Rule

The more similar a vaccine is tothe natural disease, the better the

immune response to the vaccine.

7/29/2019 Principles 8 p

14/22

Live Attenuated Vaccines

Attenuated (weakened) form ofthe "wild" virus or bacteria

Must replicate to be effective

Immune response similar tonatural infection

Usually effective with one dose*

*except those administered orally

7/29/2019 Principles 8 p

15/22

Live Attenuated Vaccines

Severe reactions possible

Interference from circulatingantibody

Unstable

7/29/2019 Principles 8 p

16/22

Live Attenuated Vaccines

Viral measles, mumps,rubella, vaccinia,varicella, yellow fever,

influenza, (oral polio)(rotavirus)

Bacterial BCG, oral typhoid

Vaccines in (parenthesis) are not available in the United States.

7/29/2019 Principles 8 p

17/22

Inactivated Vaccines

Cannot replicate

Minimal interference fromcirculating antibody

Generally not as effective as livevaccines

Generally require 3-5 doses Immune response mostly humoral

Antibody titer diminishes with time

7/29/2019 Principles 8 p

18/22

Inactivated Vaccines

Viral polio, hepatitis A,rabies (influenza)

Bacterial (pertussis) (typhoid)(cholera) (plague)

Whole cell vaccines

Vaccines in (parenthesis) are not available in the United States.

7/29/2019 Principles 8 p

19/22

Inactivated Vaccines

Subunit hepatitis B, influenza,acellular pertussis,

(Lyme)

Toxoid diphtheria, tetanus

Fractional vaccines

Vaccines in (parenthesis) are not available in the United States.

7/29/2019 Principles 8 p

20/22

Polysaccharide Vaccines

pneumococcal

meningococcal

Salmonella Typhi (Vi)

Haemophilus influenzae type b

pneumococcal

Pure polysaccharide

Conjugate polysaccharide

7/29/2019 Principles 8 p

21/22

Pure Polysaccharide Vaccines

Not consistently immunogenic inchildren

7/29/2019 Principles 8 p

22/22

National ImmunizationProgram

Hotline 800.232.2522

Email nipinfo@cdc.gov

Website www.cdc.gov/nip