VACCINATION

 

VACCINATION

Table of contact 

• Definition of vaccine 
• Antigen presentation of vaccine 
• Administration of vaccine 
• Types of vaccine 
• Catch-up vaccine 
• Contraindication of vaccine 

VACCINATION

Is the administration of any vaccine or toxoid for prevention of

disease.

Immunity

1. Natural :- immunity attained from birth to defined the body against pathogen’s  

• Active ( infection) infection causes production of antibodies  ( long lasting)
• Passive ( maternal) maternal transfer antibody

1. Artificial 

• active ( antibody transfer)
• Passive  ( immunisation)

Note

              - All actives talk about antigens 

              - All passive talk about antibody

IMMUNIZATION

Is The Process Of Inducing Immunity Artificially.

IT CAN BE ACTIVE OR PASSIVE

a. Active immunization 

involves stimulating the immune

system to produce antibodies and a cellular immune

response against infectious agent through the use of a

urine vaccine or toxoid.

b. Passive immunization 

provides temporary protection

through the administration of exogenous antibody or

maternal antibody transfer to the foetus.

Determinants of the Immune response

The nature and magnitude of the response to a vaccine or toxoid

depend on the following factors:

1. Age – presence of high concentration of maternal antibody and

immature response to some vaccines in the first four months of

life impair immunization. The measles vaccine is given at 9

months of age to reduce this effect.

2. Route of administration.

Vaccines given orally induce mucosal secretary IgA

e.g. OPV vaccine

Using an improper route to administer the vaccine may

reduce the immune response e.g. where BCG is administered IM

rather than intradermal

3. Nature of vaccine

Live attenuated vaccines induce immunity with a single dose

which lasts longer than inactivated ones

4. Genetic

Individuals genetically vary in their ability to respond to the

same vaccine.

5. Potency

Ensuring the potency of a vaccine, especially live attenuated,

requires keeping the cold chain.

The main antigenic preparations

Administrations of vaccines 

Type Of Vaccination

1. ROUTINE IMMUNIZATION

The Expanded Programme on Immunization in Ethiopia

The Expanded Programme on Immunization (EPI) was established by the

World Health Organization in 1974 to control vaccine preventable diseases.

• EPI in Ethiopia covers
• BCG (Bacillus-Calmette-Guerin)
• Diphtheria
• Hib (Haemophilus influenza type B)
• Hepatitis B
• Measles
• Pertussis
• PCV (Pneumococcal Conjugated Vaccine)
• Oral polio virus (OPV)
• Rotavirus
• Tetanus

2. CATCH-UP VACCINATION

For children below 5yr but not vaccinated in the first one year (catch-up

vaccination) the following should be administered:

Table 4: catch up vaccination

1. Outreach (Mobile schedule for remote areas):

This service gives coverage for people living within 20 km radius of the

health facility.

2. Mass campaigns:

National immunization days (NIDs) for polio (currently active) and

measles.

Side effects of vaccines

BCG:

• Kochs phenomenon – self limiting acute inflammatory reaction four days

after vaccination.

• Indolent ulcer – ulcer persisting 12 wk after vaccination or ulcer more than

10mm, mainly resulting from deep injection or secondary infection.

• Deep abscess – abscess at site of injection or draining lymph nodes due to

subcutaneous or deep injections.

• Disseminated disease with BCG – 1 per million vaccines results in BCG causing active disease especially in immunosuppressed children.

OPV: Paralytic polio from vaccine strain polio-virus

DPT: The major side effect is from the pertussis component

• Superficial injection can cause injection site abscess a week later.
• Encephalopathy ( 0.3 – 3/100,000 vaccines)
• Convulsion (0.3 – 90/100,000)
• Shock like state or collapse (hypotonic – hypo responsiveness episode)

(0.5 –30/100,000)

• Permanent brain damage (0.2 – 0.6/100,000)

MEASLES: May have mild reaction likes low grade fever irritability and allergic

reactions.

• Major side effects include (per 100,000 vaccinations):
• Encephalopathy (0.1)
• Convulsions (0.02 – 100)
• Sub acute sclerosing panencephalitis (0.01 – 0.05)Contraindication

The general contraindications for all vaccines include:

• Anaphylactic reaction
• Moderate to severe illness
• Live-attenuated vaccines for severely immunosupressed patient (exception is measles) Not contraindications
• Moderate fever after prior vaccine dose
• Moderate local reaction after inject able vaccine
• Mild acute illness
• Prematurity (same dose as for full-term infants)
• Severe malnutrition (rather strong indication)
• Penicillin allergy (personal or family