MICROBIO 1.6

Prevention Strategies & Vaccines

• Vaccines are crucial for preventing infectious diseases
• Preventing infectious diseases saves healthcare costs and reduces poverty
• The immune system has two components—innate and adaptive—that work together to fight infection
• The top 10 medical costs of skin diseases in the US (2013) varied, with cutaneous infections, noncancerous skin growths, wounds, burns, and ulcers, amongst the largest costs.

Disease Prevalence

• Endemic: constant infection level within a group
• Epidemic: rise in diseases above baseline
• Pandemic: widespread epidemic across multiple countries

Types of Transmission

• General Transmission
• Abiotic environmental factors (e.g. fomites, soil & water)
• Animal/insect vectors (e.g. arthropods, farm animals)
• Human-to-Human Transmission
• Vertical: mother-to-offspring (e.g., Zika)
• Horizontal: other human-transmission (e.g., direct contact—HIV, indirect contact—norovirus, droplets—HIV, respiratory, airborne—influenza, fecal-oral—norovirus)

Standard Clinical Precautions

• Hand Hygiene: wash with soap and water or use alcohol-based hand rub
• Personal Protective Equipment (PPE): use gloves, masks, and gowns when appropriate
• Respiratory Hygiene and Cough Etikette: cover coughs and sneezes
• Proper Patient Placement: separate infected and non-infected patients
• Clean Environment: clean and disinfect regularly
• Careful Handling of Laundry: take precautions to protect mucous membranes
• Safe Injection Practices: use injection paraphernalia carefully; don't reuse needles
• Sharps Safety: handle needles and sharp tools correctly and safely

Definitions

• Antisepsis: Use of chemical agents on living tissue to inhibit or eliminate microbes.
• Disinfection: Use chemical agents or physical procedures to destroy most microbial forms (may leave some spores viable).
• Germicide: Chemical agent that kills microbes (ex: virucide, bactericide, sporicide).
• High-level disinfectant: Kills all microbial pathogens except large numbers of bacterial spores
• Intermediate-level disinfectant: Kills all microbial pathogens except bacterial endospores
• Low-level disinfectant: Kills most vegetative bacteria, lipid-enveloped & medium-sized viruses
• Sterilization: use of chemical or physical procedures to kill all microbial forms, including bacterial spores

Pathogen Elimination

• Disinfection: eliminates/kills most microorganisms, a process applied to non-living surfaces like surgical instruments or equipment
• Antiseptic: eliminates/kills microbes on living tissue/skin
• Sterilization: kills all microorganisms like instruments, tools, or equipment, using heat or methods like filtration and/or gas

What is an Adjuvant?

• An adjuvant is an ingredient in some vaccines that creates a stronger immune response in people.
• Adjuvants can sometimes be components of the vaccine itself (but not always)
• Adjuvants can cause injection site soreness, redness, and swelling.
• Examples of ingredients used as adjuvants: Aluminum salts (hydroxide, phosphate, and potassium sulfate), and Pertussis component (Bordetella pertussis).

Why Boosters?

• Vaccines frequently use boosters to refresh the immune system's memory and create additional protection.

How Vaccines Work

• Vaccines have varied methods of functioning, such as using weakened pathogens, inactivated organisms, selected pieces (or components) of a pathogen-germ, or mRNA codes that teach the body to fight specific pathogens
• There is a broad range of effectiveness and safety depending on the method used.

Vaccine Types

• Live-attenuated Vaccines: Use live pathogens with reduced virulence
• Inactivated Vaccines: Use inactivated pathogens to stimulate the immune response.
• Subunit, recombinant, polysaccharide, and conjugate vaccines: Use specific pieces of the pathogen instead of the entire pathogen.

DNA and RNA Vaccines

• DNA vaccines: Introduce DNA to create pathogen proteins that stimulate the immune response.
• RNA vaccines: Introduce mRNA to produce pathogen proteins, creating immune response. mRNA is often quicker and easier to create.

How Do We Know if a Vaccine Is Effective?

• Vaccine effectiveness (VE) relies on several factors:
• Characteristics of the vaccinated person (age and health)
• Similarity of the vaccine's target virus to the circulating virus.
• Both factors help ensure that those who receive a vaccine produce a strong and sustained immune response
• Vaccines must satisfy specific criteria to be regarded as effective, including generating sufficient protection against the intended pathogen, with minimal chance of causing any severe side effects or danger, and protecting against the disease for an extended period of time.

Characteristics of Vaccines

• Effective protection without significant danger or severe side effects.
• Long-lasting protection.
• Effective immune responses across a broad range of individuals
• Stimulate neutralizing antibodies to minimize reinfection
• Economically feasible to produce
• Suitably stable for storage, transport, and use.

What About Aborted Fetal Tissue?

• Viruses need living cells to replicate.
• VZV, Rubella, Hep A, and Rabies are grown in certain fetal cells.

Do Vaccines Cause Autism?

• Extensive studies prove that vaccines do not cause autism

COVID-19 Racial Data Tracker

• COVID-19 disproportionately affects Black, Indigenous, Latinx, and other people of color.

Racial Inequities in Vaccination Rates

• Significant disparities exist in willingness and rates of vaccination across racial and ethnic groups

Follow Up Resources

• Provide follow up resources as required, for example, linked educational websites, social media handles, and videos from credible organizations/individuals.

Why Boosters

• Boosters help the body remember how to make the antibodies to fight a particular virus, especially when the original virus mutates or changes.

The Biopharmaceutical Research and Development Process

• Drug discovery to FDA approval takes a minimum of ten years
• Each phase of clinical testing involves increasing test groups and longer testing times of the vaccine and then potential approval.

The Journey of Your Child's Vaccine

• Process of testing and approval for a new vaccine, including the Food and Drug Administration (FDA) protocols and procedures, and the necessity for volunteers of different ages and health statuses.