1. Antimicrobial vaccines List the main types of immunization List the main types of vaccines Describe the advantages and disadvantages of different types of vaccines

2. 'Never in the history of human progress has a better and cheaper method of preventing illness been developed than immunization at its best'. P athologist Geoffrey Edsall

3. Immunization major means by which infections may be controlled and in some cases, eradicated

4. Antimicrobial vaccines Prevent or Lessen the serious symptoms of disease Blocks the spread of bacterium, bacterial toxin, virus to its target cell or Acts rapidly at the site of infection Personal immunity and herd immunity (immunity of the population ) is aimed by vaccination.

5. Immunization programs National and international Smallpox in the World and wild-type poliomyelitis in the Western Hemisphere are eradicated. Spread of measles,mumps and rubella are controlled(elimination is aimed in 2015)

6. Last polio case in Turkey 26 November 1998 Ağrı

8. 8 DÜNYADA DURUM- 2002 Polio endemik ülkeler Endemik olmayan ülkeler Poliosuz olarak sertifikalandırıldı DSÖ Avrupa bölgesi “Poliosuz” olarak sertifikalandırıldı 1918 VAKA 2002

9. Immunization Passive immunization: -purified antibody-containing serum -from mother through placenta or by milk Active immunization: -Natural: by infection -Vaccines

10. Passive immunization Immune serum globulin: from seropositive people or animals (horses) (Human immunoglobulin is preferred.) Measles,HAV Spesific immunoglobulins: -Hepatitis B(HBIg) -Rabies(Rıg) -Varicella zoster(VZIg) -Tetanus (TIG) Botulinum antitoxin -Diphteria antitoxin Monoclonal antibodies(RSV)

11. Passive immunization Provides immediate But short term protection For long term protection Vaccination Therefore sometimes:passive-active immunity is necessary: Tetanus HBV Rabies prevention

12. Active immunization Live-attenuated vaccines Inactivated-killed vaccines Subunit vaccines New vaccines: Hybrid virus vaccines DNA vaccines

13. Disadvantages of inactivated vaccines Immunity is not usually lifelong Immunity may only be humoral not cell- mediated The vaccine does not elicit a local IgA response (does not mimic natural infection) Booster shots are required Larger doses must be used Adjuvant is required

14. Inactivated-killed vaccines Toxoid:diphtheria vaccine, tetanus vaccine Inactivated viral vaccines: polio(Salk),hepatitis A, influenza, rabies Subunit vaccines: Hepatitis B Capsular polisaccharides :Haemophilus influenzae B, Streptococcus pneumoniae Inactivated bacteria: Bacillus anthracis Acellular(purified protein): Bacillus anthracis

15. Human papilloma virus vaccine Quadrivalent HPV vaccine, targets HPV types 6, 11, 16, and 18 bivalent vaccine, targets HPV types 16 and 18 Recombinant vaccine

16. HBV vaccine 0,1,6 month For health care personel after 1 month Quantitative anti-HBs detection 10IU/ml: immune for lifelong

17. Live vaccines Viral vaccines: Polio(Sabin) Measles Mumps Rubella Rotavirus Bacterial vaccines: Calmette-Guerin bacillus vaccine: Mycobacterium bovis (BCG)

18. Downloaded from: StudentConsult (on 4 May 2011 01:21 PM) © 2005 Elsevier

20. Live vaccines Viral vaccines: Polio(Sabin) Measles Mumps Rubella Bacterial vaccines: Calmette-Guerin bacillus vaccine: Mycobacterium bovis (BCG)

21. Salmonella typhi Vibrio cholerae Yersinia pestis Bacillus anthracis Francisella tularensis Rickettsia prowazekii Coxiella burnettii Yellow fever Japanese encephalitis Adenovirus Vaccines in special conditions

22. Vaccination in immunocompromised patients Vaccination of adults(health care personel) Vaccination of travellers Vaccination of pregnant women Uptodate knowledge !!! ( web sites of -saglik.gov.tr -cdc -who -uptodate)