VACCINES AND SERA

Dr. RAGHU PRASADA M SMBBS,MDASSISTANT PROFESSOR DEPT. OF PHARMACOLOGYSSIMS & RC.

1

Basic terms

Immunity Antigen-capsules ,cell walls ,toxins

viral capsids, flagella,pollen Vaccines - Serum Antiserum –rabbit,horse ,goat Serum sickness Toxoids

Vaccines

Vaccines are immunobiological substances designed to produce specific protection against a given disease. It stimulates production of protective antibody and other immune mechanism

VACCINES

HISTORY-SMALL POX-1798 RABIES-1885 TYPHOID -1896 CHOLERA- 1896 PLAGUE-1897 POLIO-1955 HEPATITIS-1981

Vaccines

LIVE ATTENUATED VACCINES

Bacterial –bcg, typoid oral ,plague

Viral –polio yellow fever, measles

-rubella ,mumps ,influenza

KILLED VACCINES Bacterial -

Typhoid ,cholera ,Pertusis ,plague

Viral –rabies,salk(polio),

Influenza, hepatitis B,

Japanese encephalitis

LIVE ATTENUATED

Vaccine dose-low Antibody persistence-

long Booster needed -

infrequently Revaccination –

possible Latency-possible Oncogenicity-

KILLED VACCINES

High Short Frequently

None None none

IMMUNISATION SCHEDULE

Birth –bcg +opv+hepatitis B At 6 wks-DPT+OPV+HEP-B At 10, 14 wks-DPT+OPV At 6 months-hepatitis B At 9 months-measles At 15 months-DPT+OPV+MMR At 4-5 years-DT-DA+OPV At 10 years-TT+TAB/Ty21a At 16 years-TT

BACCILUS CALMETTE GUERIN(BCG) VACCINE

-attenuated live vaccine Bovine strain of M.Tuber 0.5-1mg -1-2.5*107 colony forming units injected

intracutaneously Partial immunity C/I—compromised host defence

ORAL POLIO VACCINE

-produces active immunity Induces systemic and intestinal immunity Simultaneous administration to all infants -avoid in vomiting and diarrhea INACTIVATED POLIO VACCINE -primary immunization in adults persons with compromised immune system

Hepatitis –B vaccine

-prepared in yeast cells by recombinant DNA technique

three injections -0,1,6 months -20µg in 1ml amp HEPATITIS A VACCINE -human diploid cell culture 0.5ml im Booster after 6 months

DPT

Mixed antigen – of Alum pptd toxoids of tetanus and diptheria available in 0.5 ml ampule and 5 ml vial

-diptheria toxoid is modified diptheria exotoxin adsorbed on to aluminium hydroxide

Tetanus toxoid is formalin treated exotoxin of tetanus baccilli

Diptheria toxoid 25 lf Tetanus toxoid -5 lf Pertusis-20000 million in 0.5 ml ampule

MEASLES MUMPS RUBELLA

Measles vaccine is grown on chick embryo ,-single dose 1000tcid

Mumps virus is grown in chick embryo ,single dose -5000 tcid . Clinical disease may occur if vaccinated after infection

Live attenuated rubella virus wistar RA 27/3 strain 1000 tcid per 0.5 ml inj

Single dose sc over deltoid >12 mnth children C/I- pregnancy

Rabies vaccine

Antirabies vaccine carbolised (semple) Neural tissue vaccine(NTV), is 5% suspension of

sheep brain tissue Need 14 daily painful large volume 2-5ml injectn-

AAW PCEV(purified chick embryo cell vaccine) Rabies virus grown on chick fibroblast and

inactivated by B-propiolactone available as 2.5IU in 1ml amp

Human diploid cell vaccine (HDCV) Lyophilised inactivated rabies virus – Grown on human diploid cell culture Purified vero cell vaccine (PVRV)

Typhoid –paratyphoid –AB(TAB vaccine)

Sterile suspension -1ml containing 1*109 S.typhi and 7.5*108 each of S.paratyphi A and B dose- 0.5ml sc

TYPHOID TY21A ORAL VACCINE Newer live oral typhoid vaccine prepared from Ty21a

attenuated strain of S.typhi Absence of enzyme uridine di phosphate galactose 4

epimerase

ANTI SERA

From horse-tetanus antitoxin(ATS) -gas gangrene antitoxin(AGB) -diphtheria antitoxin (ADS)Immunoglobins (humans )Normal human gamma globinAnti-D immunoglobinTetanus immunoglobinRabies immunoglobinHepatitis B immunoglobin

Normal human gamma globulin

Concentrated Ig from human plasma Viral hepatitis A and B ,measles ,mumps Agammaglobulinemia Augument the response to antibodies ANTI-D IMMUNOGLOBULIN Tetanus immunoglobulin indicated for

prophylaxis in non-immunised persons Better than equine ATS Treatment of clinical tetanus Dose-3000-6000 IU

Rabies

Anti rabies serum(ARS) Equine Rabies Immunoglobin (ERIG) after suspected exposure Dose- 40 IU /kg infiltration around the wound RABIES IMMUNOGLOBULIN HUMAN -superior to ARS with longer t1/2 Passive protection is needed as active immunity

takes 2 weeks

Hepatitis B immunoglobin

Antibodies to hep-b surface antigen Better than human gamma globulin Used in individuals acutely exposed to Hbs Ag

positive blood Hep B vaccine should be given concurrently

dose -1000-2000 IU 32-48 IU/kg

ANTI SNAKE VENOM

Serum polyvalent purified ,concentrated equine globulins in

lyophilised vials each ml neutralises 0.6 mg of Std.cobra venom 0.6 mg of Std.Russel viper 0.45 mg of Std saw scaled viper 0.45 mg of Std .Krait