Immunization In Practice PDF
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Baghdad College of Medicine
Dr. Ali Hussein Al-Khafaji
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Summary
This document provides an overview of immunization practices, including different types of vaccines, disease prevention strategies, and the process of immunization. The document also discusses the importance of understanding how to implement these practices in a real-world setting.
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Vaccines DR. Ali Hussein AL-Khafaji EPI Manager Disease prevention Prevention Actions that prevent disease occurrence. Actions aimed at - Eradicating - Eliminating, or minimizing the impact of disease and disability, or if none of these is feasible: - Retarding the pr...
Vaccines DR. Ali Hussein AL-Khafaji EPI Manager Disease prevention Prevention Actions that prevent disease occurrence. Actions aimed at - Eradicating - Eliminating, or minimizing the impact of disease and disability, or if none of these is feasible: - Retarding the progress of disease and disability. Primary prevention denotes an action taken to prevent the development of a disease in a person who is well and does not (yet) have the disease, e.g. immunization, and reducing exposure to a risk factor. Primary prevention is our ultimate goal. Secondary prevention (screening) involves identifying people in whom a disease process has already begun but who have not yet developed clinical signs and symptoms of the illness. This period in the natural history of a disease is called the preclinical phase of the illness. Tertiary prevention denotes preventing complications in those who have already developed signs and symptoms of an illness and have been diagnosed. Levels of prevention Edward Jenner (1749-1823) In 1796 he inserted pus taken from Sarah Nelmes, a milkmaid with cowpox, into a cut made in the arm of a local boy, James Phipps. Six weeks later, Jenner exposed the boy to smallpox. He was found to be immune. Jenner called his new method 'vaccination' after the Latin word for cow (vacca). Immunization The process whereby a person is made immune or resistant to an infectious disease. This may be either active or passive. Active immunization is the administration of a vaccine in order to stimulate production of an immune response. Passive immunization is the administration of antibodies in order to provide temporary immunity. Immunoglobulin: Human immunoglobulin is that fraction of human blood plasma that contains antibodies, notably those against infectious agents. Antitoxin is a solution of antibodies derived from the serum of animals immunised with specific antigens (e.g. diphtheria antitoxin) used to achieve passive immunity or for treatment. Toxoid: is a modified bacterial toxin that has been rendered non-toxic but has the ability to stimulate the formation of antitoxin. Vaccine: any preparation intended to produce immunity to a disease by stimulating the production of antibodies. Vaccines include, for example, suspensions of killed or attenuated microorganisms, or products or derivatives of micro-organisms. Vaccine Types There are several different types of vaccines. Each type is designed to teach your immune system how to fight off certain kinds of germs — and the serious diseases they cause. When scientists create vaccines, they consider: - How your immune system responds to the germ. - Who needs to be vaccinated against the germ. - The best technology or approach to create the vaccine. Based on a number of these factors, scientists decide which type of vaccine they will make. There are 4 main types of vaccines: - Live-attenuated vaccines - Inactivated vaccines (killed) - Subunit, recombinant, polysaccharide, and conjugate vaccines - Toxoid vaccines Live attenuated vaccine is a vaccine that contains a weakened strain of live bacteria or viruses that replicate in the body e.g. BCG, oral polio, and MMR vaccines. Because these vaccines are so similar to the natural infection that they help prevent, they create a strong and long-lasting immune response. Just 1 or 2 doses of most live vaccines can give you a lifetime of protection against a germ and the disease it causes. But live vaccines also have some limitations. For example: people with weakened immune systems, long-term health problems, people who’ve had an organ transplant. Live vaccines are used to protect against: - Measles, mumps, rubella (MMR combined vaccine) - Rotavirus - Smallpox - Chickenpox - Yellow fever - Oral polio Inactivated vaccine Inactivated vaccines use the killed version of the germ that causes a disease. Inactivated vaccines usually don’t provide immunity (protection) that’s as strong as live vaccines. So you may need several doses over time (booster shots) in order to get ongoing immunity against diseases. Inactivated vaccines are used to protect against: - Hepatitis A - Flu - Polio (injectable type) - Rabies Subunit, recombinant, polysaccharide, and conjugate vaccines Subunit, recombinant, polysaccharide, and conjugate vaccines use specific pieces of the germ — like its protein, sugar, or capsid (a casing around the germ). Because these vaccines use only specific pieces of the germ, they give a very strong immune response that’s targeted to key parts of the germ. They can also be used on almost everyone who needs them, including people with weakened immune systems and long-term health problems. One limitation of these vaccines is that you may need booster shots to get ongoing protection against diseases. These vaccines are used to protect against: - Hib (Haemophilus influenza type b) - Hepatitis B - HPV (Human papilloma virus) - Whooping cough (part of the DTaP combined vaccine) - Pneumococcal disease - Meningococcal disease - Shingles Toxoid vaccines Toxoid vaccines use a toxin (harmful product) made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself. That means the immune response is targeted to the toxin instead of the whole germ. Like some other types of vaccines, you may need booster shots to get ongoing protection against diseases. Toxoid vaccines are used to protect against: - Diphtheria - Tetanus Vaccine Administration Vaccine Dose Route DTwP-Hep B-Hib (PENTA) 0.5 mL IM DT, Td, DTwP 0.5 mL IM Polio (IPV) 0.5 mL IM or Subcut MCV 0.5 mL Subcutaneous Men ACWY 0.5 mL IM Hep A ≤18 years: 0.5 mL IM ˃18 years: 1.0 mL Hep B ≤16 years: 0.5 mL IM ˃ 16 years: 1.0 mL MMR 0.5 mL Subcutaneous PCV13 0.5 mL IM Rotavirus (RV1 or RV5) (1.0 mL or 2.0 mL) Orally Polio (OPV) 2 drops Orally Iraq EPI Review The Expanded Program of Immunization (EPI) in Iraq was well established in 1985 by delivering immunization services to targeted groups. The long term vision of Iraq EPI is that every child born and present in Iraq should receive complete, safe and high quality EPI services and all at-risk groups should be protected from vaccine preventable diseases. Iraq 2024 Area= 437,072 Km2 Governorates= 18 DsOH = 19 Health Districts = 150 Total Population = 43324018 Children < 5 Y = 6356624 Infants