6-Immunity & Vaccines.pdf

IMMUNITY AND VACCINES CHAPTER 8 IMMUNITY • DEFINITION: • THE ABILITY OF AN ORGANISM TO RESIST A PARTICULAR INFECTION OR TOXIN BY THE ACTION OF SPECIFIC ANTIBODIES OR SENSITIZED WHITE BLOOD CELLS • SOURCE: NEW OXFORD AMERICAN DICTIONARY ANTIGEN VS. ANTIBODY • ANTIGEN—ANY SUBSTANCE THAT CAUSES THE...

IMMUNITY AND VACCINES CHAPTER 8 IMMUNITY • DEFINITION: • THE ABILITY OF AN ORGANISM TO RESIST A PARTICULAR INFECTION OR TOXIN BY THE ACTION OF SPECIFIC ANTIBODIES OR SENSITIZED WHITE BLOOD CELLS • SOURCE: NEW OXFORD AMERICAN DICTIONARY ANTIGEN VS. ANTIBODY • ANTIGEN—ANY SUBSTANCE THAT CAUSES THE IMMUNE SYSTEM TO PRODUCE ANTIBODIES • SUCH AS VIRUSES, BACTERIA, POLLEN • ANTIBODY—PROTEINS THAT BIND ANTIGENS THUS NEUTRALIZING THEM • PRODUCED BY B-LYMPHOCYTES TYPES OF ANTIBODIES • IgM—PRODUCED DURING THE FIRST EXPOSURE • IgG—PRODUCED IN FUTURE IMMUNE RESPONSES • IgA—LOCAL IMMUNITY • GI TRACT, RESPIRATORY TRACT, CONJUNCTIVA • IgE—ASSOCIATED WITH INFLAMMATORY REACTIONS AND PARASITIC INFECTIONS • TOO MUCH IgE CAN DAMAGE SELF—IE. ANAPHYLACTIC REACTIONS • IgD—ACTS AS AN ANTIGEN RECEPTOR FOR B CELLS PRIMARY VS. SECONDARY IMMUNE RESPONSE Primary Secondary When? 1st exposure to antigen Future exposures to antigen How long until response? Slow, takes several days Rapid, 1-2 days Which Abs produced? IgM IgG How strong is response? Weak, low antibody titer Strong, high antibody titer How long are Abs detected Not long Months to years Disease progression Longer and more severe Shorter and less severe ACTIVE VS. PASSIVE IMMUNITY • ACTIVE IMMUNITY • IMMUNE SYSTEM DEVELOPS ANTIBODIES TO ANTIGENS • ANTIGENS-VIRUSES, YEASTS, BACTERIA • EXPOSURE OCCURS NATURALLY FROM THE ENVIRONMENT OR BY INJECTION W/NONINFECTIOUS FORM IN A VACCINE • EXPOSURE TO PATHOGEN IN THE ENVIRONMENT ANIMAL MAY CONTRACT THE ILLNESS THEN MOUNT IMMUNE RESPONSE AFTER BEING SICK ACTIVE VS. PASSIVE IMMUNITY • PASSIVE IMMUNITY • OCCURS IN 3 WAYS • 1) IN UTERO-ANTIBODIES PASS THRU THE PLACENTA FROM DAM TO FETUS • MATERNAL ANTIBODIES • 2) NEWBORNS-CONSUMPTION ANTIBODY RICH COLOSTRUM • 3) IV INFUSION ANTIBODY RICH PLASMA • TYPICALLY FOALS THAT FAILED TO GAIN ANTIBODIES IN ABOVE MANNER ACTIVE VS. PASSIVE IMMUNITY • DOGS & CATS • ANTIBODIES TRANSFERRED ALMOST ENTIRELY VIA CONSUMPTION OF COLOSTRUM • MUST INGEST W/IN 1ST 24 HOURS AFTER BIRTH • PASSIVE IMMUNITY LASTS RELATIVELY SHORT TIME • VACCINES ADMINISTERED TO STIMULATE ACTIVE IMMUNE RESPONSE • START VACCINE BETWEEN 6-8 WEEKS OF AGE • PROTECTIVE LEVEL PASSIVE IMMUNITY DETERMINED BY: • AMOUNT OF COLOSTRUM INGESTED/ABSORBED • CONCENTRATION OF MATERNAL ANTIBODIES IN COLOSTRUM – WAS DAM/QUEEN PROPERLY VACCINATED? • RATE AT WHICH MATERNAL ANTIBODIES DEGRADED IN PUPPY/KITTEN – DEPENDS ON SEVERAL FACTORS ACTIVE VS. PASSIVE IMMUNITY • DOGS & CATS • HIGH LEVELS PASSIVELY ACQUIRED ANTIBODIES MAKE IMMUNIZATION INEFFECTIVE EARLY ON B/C MATERNAL ANTIBODIES LIMIT ABILITY TO MOUNT ACTIVE IMMUNE RESPONSE • GENERALLY ABLE TO MOUNT ACTIVE IMMUNE RESPONSE BY 6-12 WEEKS OF AGE • DIFFICULT TO KNOW WHEN PASSIVE IMMUNITY IS LOST & WHEN IMMUNE SYSTEM IS MATURE ENOUGH TO MOUNT ACTIVE RESPONSE TO IMMUNIZATION (VACCINE) • THEREFORE VACCINES GIVEN EVERY 3-4 WEEKS UNTIL 16 WEEKS OF AGE • GOAL VACCINATE AT EARLIEST POSSIBLE TIME TO STIMULATE ACTIVE IMMUNITY THEREFORE PROTECTING ANIMAL FROM DISEASE • ONLY 1-2 VACCINATIONS NEEDED TO STIMULATE IMMUNE RESPONSE IN OLDER ANIMALS B/C PASSIVE IMMUNITY NO LONGER INTERFERING W/ACTIVE IMMUNE RESPONSE VACCINE TYPES • GOAL: STIMULATE ACTIVE IMMUNE RESPONSE SO ANIMAL DEVELOPS IMMUNITY AGAINST DISEASE • MUST NOT CAUSE HOST TO DEVELOP DISEASE ITSELF • CLASSIFIED INTO 2 MAJOR CATEGORIES • 1) NONINFECTIOUS • 2) INFECTIOUS VACCINE TYPES • NONINFECTIOUS • INCLUDE WHOLE PATHOGENS WHICH ARE KILLED OR SUBUNITS (PARTS OF PATHOGENS) • CONTENTS UNABLE TO INFECT ANIMAL • LIMITATION: AMOUNT OF ANTIGEN MAY NOT BE ADEQUATE TO STIMULATE STRONG IMMUNE RESPONSE TO PRODUCE PROTECTIVE IMMUNITY FOR ANIMAL • HYPERSENSITIVITY REACTION POSSIBLE • ADJUVANTS-SUBSTANCED ADDED TO HELP STIMULATE STRONGER IMMUNE RESPONSE TO ANTIGENS W/IN A VACCINE • HAS NO IMMUNOLOGIC EFFECT OF ITS OWN • TENDS TO BE THE CAUSE OF “REACTIONS” TO VACCINATION • ADVANTAGES NONINFECTIOUS VACCINES: • INABILITY TO CAUSE DISEASE • MORE STABLE THAN INFECTIOUS VACCINES • EXAMPLE: RABIES VACCINE VACCINE TYPES • INFECTIOUS • PATHOGES ARE ALTERED SO UNABLE TO CAUSE DISEASE BUT ABLE TO INFECT HOST CELLS TO STIMULATE IMMUNITY • TYPES • MODIFIED LIVE • ATTENUATED • RECOMBINANT • STIMULATE IMMUNITY IN A WAY SIMILAR TO IF NATURALLY EXPOSED TO DISEASE • IMMUNITY IS MORE EFFICACIOUS/LONGER DURATION • DISADVANTAGES • MAY CAUSE DISEASE IF NOT ALTERED ENOUGH • NEW TECHNOLOGY MAKES THIS LESS LIKELY • EXAMPLE: CANINE DISTEMPER VIRUS VACCINE STORAGE, RECONSTITUTION, DOSING • STORE PER MANUFACTURER’S DIRECTION • TYPICALLY INVOLVES REFRIGERATION • INFECTIOUS VAX LACK STABILITY • FREEZE DRIED (LYOPHILIZED) TO SUPPORT VAX EFFICACY/EXTEND STABILITY • DILUENT PROVIDED TO RECONSTITUTE PRODUCT • RECONSTITUTE VAX • DILUENT DRAWN UP INTO SYRINGE • MIXED GENTLY INTO VIAL CONTAINING LYOPHILIZED PRODUCT THEN RE-DRAW INTO SYRINGE • ADMINISTER W/IN 1 HOUR OF RECONSTITUTING STORAGE, RECONSTITUTION, DOSING • NONINFECTIOUS VAX • SOLD/STORED IN LIQUID FORM • GENTLY MIX VIAL BEFORE DRAWING UP INTO SYRINGE • SOME COME IN MULTIDOSE VIALS • MIX GENTLY • ISSUE OF STERILITY • ASEPTIC TECHNIQUE • DOSAGE BASED ON MANUFACTURER RECOMMENDATION • TYPICALLY 1mL ROUTES OF ADMINISTRATION • FOLLOW INSTRUCTIONS • MOST GIVEN SUBCUTANEOUSLY (SQ) • RARELY INTRAMUSCULARLY (IM) IN SMALL ANIMALS • CERTAIN VACCINES ADMINISTERED VIA INTRANASAL ROUTE (IN) TO STIMULATE LOCAL IMMUNITY • CANINE INFECTIOUS TRACHEOBRONCHITIS (KENNEL COUGH) • IMPROVE IMMUNE DEFENSE IN REGION BODY WHERE DISEASE CONTRACTED • NEVER GIVE INTRANASAL VACCINES SUBCUTANEOUSLY/INTRAMUSCULARLY • INFECTION OR MORE SERIOUS SIDE EFFECTS CAN OCCUR • ALSO DON’T GIVE SQ/IM VACCINES INTRANASALLY OR ORALLY ROUTES OF ADMINISTRATION • TRANSDERMAL • UNCOMMONLY USED • REQUIRES SPECIAL EQUIPMENT • DOESN’T USE A NEEDLE • EXAMPLE: CANINE ORAL MELANOMA/SOME FELINE LEUKEMIA VACCINES ROUTES OF ADMINISTRATION • SITE OF ADMINISTRATION ALWAYS RECORDED IN MEDICAL RECORD • AVOID ADMINISTERING MULTIPLE VACCINES IN SAME AREA • ADVERSE VACCINE EVENTS CAN OCCUR • TRY TO DETERMINE WHICH VAX CAUSED EVENT • VACCINE INDUCED SARCOMAS • INVASIVE NATURE OF VACCINE INDUCED SARCOMA (ADMINISTER VAX ON DISTAL LIMB) • IN EVENT OF SARCOMA FORMATION LIMB SHOULD BE AMPUTATED ROUTES OF ADMINISTRATION • AAFP FELINE VACCINE ADVISORY PANEL RECOMMENDS: Vaccination Route Body Region Location on limb FVRCP SQ RIGHT FRONT LEG Lateral side, distal to elbow FeLV SQ LEFT HING LEG Lateral side, distal to stifle Rabies SQ RIGHT HIND LEG Lateral side, distal to stifle ***Note: FIV vaccine taken off the market in the US/ Giardia vaccine questionable efficacy ROUTES OF ADMINISTRATION • NO OFFICIAL PROTOCOL FOR LOCATION OF VACCINES IN DOGS • SHOULD BE NOTED IN RECORD • STANDARDIZED IN EACH PRACTICE IF POSSIBLE • COMMONLY • RABIES SQ RIGHT REAR • DA2PP +/- LEPTO SQ LEFT REAR CORE VS NONCORE VACCINES • CORE VACCINES • RECOMMENDED FOR ALL ANIMALS OF A SPECIES • STIMULATE IMMUNITY AGAINST DISEASES HIGHLY CONTAGIOUS/PREVALENT IN THE ENVIRONMENT • AAHA (AMERICAN ANIMAL HOSPITAL ASSOCIATION) CANINE CORE VACCINES • CANINE DISTEMPER VIRUS (CDV) • CANINE ADENOVIRUS TYPE-2 (CAV-2) • CANINE PARVOVIRUS TYPE-2 (CPV-2) • +/-PARAINFLUENZA (NOT CORE BUT OFTEN INCLUDED IN THE DA2PP/DHPP VACCINE • RABIES CORE VS NONCORE VACCINES • CORE VACCINES • AAFP (AMERICAN ASSOCIATION OF FELINE PRACTITIONERS) FELINE CORE VACCINES • FHV-1(HERPES VIRUS)/RHINOTRACHEITIS • FCV (CALICIVIRUS) • FPV (PANLEUKOPENIA VIRUS) • RABIES • FELV (*CATS LESS THAN 1 YEAR) (LEUKEMIA VIRUS) CORE VS NONCORE VACCINES • CORE VACCINES • AAEP (AMERICAN ASSOCIATION OF EQUINE PRACTITIONERS) • EASTERN/WESTERN/+/-VENEZUELAN EQUINE ENCEPHALOMYELITIS • RABIES • TETANUS • WEST NILE VIRUS CORE VS NONCORE VACCINES • CORE VACCINES FOR CATTLE • VIRAL DISEASES (INFECTIOUS BOVINE RHINOTRACHEITIS (IBR), BOVINE VIRAL DIARRHEA VIRUS (BVDV), PARAINFLUENZA 3 (PI3), BOVINE RESPIRATORY SYNCYTIAL VIRUS (BRSV) • LEPTOSPIROSIS • BRUCELLOSIS • CLOSTRIDIAL DISEASES • CORE VACCINES FOR SMALL RUMINANTS • CLOSTRIDIAL DISEASES CORE VS NONCORE VACCINES • NONCORE VACCINES (ELECTIVE) • NOT RECOMMENDED FOR EVERY ANIMAL • BASED ON EXPOSURE/LIFESTYLE • RISK OF DISEASE VS. RISK OF ADVERSE EFFECTS OF VACCINE • AAFP AND AAHA • CLASSIFIED A FEW VACCINES AS NOT RECOMMENDED AT ALL • VACCINES HAVE LITTLE TO NO INDICATION FOR USE • ASSOCIATED W/ADVERSE EVENTS • FAILED TO INDUCE ADEQUATE PROTECTION AGAINST DISEASE CORE VS NONCORE VACCINES • NONCORE VACCINES • DOGS • BORDETELLA bronchiseptica +/- CANINE PARAINFLUENZA VIRUS • LEPTOSPIRA 4-SEROVAR • BORRELIA burgdorferi (CANINE LYME DISEASE) • CANINE INFLUENZA VIRUS-H3N8 • CANINE INFLUENZA VIRUS-H3N2 • CANINE CORONAVIRUS (CCoV) • CROTALUS ATROX (WESTERN DIAMONDBACK RATTLESNAKE) CORE VS NONCORE VACCINES • NONCORE VACCINES • CATS • FELINE LEUKEMIA VIRUS (FELV) – AFTER ONE YEAR OF AGE • FELINE IMMUNODEFICIENCY VIRUS (FIV) – HAS BEEN TAKEN OFF THE MARKET • BORDETELLA bronchiseptica • CHLAMYDOPHILA felis • FELINE CORONAVIRUS (FCoV) – NOT RECOMMENDED EVEN IN HIGH RISK CATS • GIARDIA lamblia CORE VS NONCORE VACCINES • NONCORE VACCINES • ACCORDING TO AAEP • EQUINE HERPESVIRUS • EQUINE INFLUENZA • STRANGLES • EQUINE VIRAL ARTERITIS (NOT DISCUSSED HERE) • POTOMAC HORSE FEVER (NOT DISCUSSED HERE) • BOTULISM (NOT DISCUSSED HERE) • ANTHRAX (NOT DISCUSSED HERE) CORE VS NONCORE VACCINES • NONCORE • CATTLE • CAMPYLOBACTERIOSIS • BACTERIAL RESPIRATORY DISEASES • ROTAVIRUS & CORONA VIRUS • SMALL RUMINANTS • ORF (SORE MOUTH) • RABIES ONSET & DURATION OF IMMUNITY • ONSET OF IMMUNITY GENERALLY TAKES LONGER FOR NONINFECTIOUS VACCINES • DURATION OF IMMUNITY • LENGTH OF TIME AN ANIMAL RETAINS ADEQUATE LEVEL OF IMMUNITY TO PROTECT ITSELF FROM DISEASE OR INFECTION IF IT WERE NATURALLY EXPOSED TO PATHOGEN • REVACCINATION INTERVALS ARE HIGHLY DEBATED CURRENTLY • • • • AAHA/AAFP RECOMMENDATIONS CURRENTLY ARE AS FOLLOWS AFTER INITIAL PUPPY/KITTEN SERIES AND A 1-YEAR BOOSTER 3-YEAR REVACCINATION INTERVALS RECOMMENDED FOR DA2PP & FVRCP SOME VACCINES MUST BE GIVEN YEARLY TO BE EFFECTIVE • IE LEPTOSPIROSIS VAX ADVERSE VACCINE EVENTS • IMMEDIATELY CONTACT VETERINARIAN • FACIAL SWELLING • DIFFICULTY BREATHING • VOMITING/DIARRHEA • URTICARIA (HIVES) • SEIZURES • MOST SEVERE CASES-ANAPHYLAXIS • SEVERE ALLERGIC/HYPERSENSITIVITY RESPONSE TO FOREIGN SUBSTANCE • CARDIOVASCULAR COLLAPSE, RESPIRATORY ARREST, DEATH ADVERSE VACCINE EVENTS • MOST TRANSIENT, LAST FEW DAYS, NOT LIFE THREATENING • USUALLY DO NOT REQUIRE TREATMENT • LETHARGY, MILD FEVER, SORENESS AT INJECTION SITE, +/- DECREASED APPETITE • CONTACT VETERINARIAN IF SIGNS PERSIST LONGER THAN 2-3 DAYS • NOT UNCOMMON W/INTRANASAL VACCINES • MILD UPPER RESPIRATORY DISEASE • TRANSIENT SNEEZING, NASAL DISCHARGE, COUGHING VACCINE REACTION ADVERSE VACCINE EVENTS • TREATMENT (IF SWELLING, HIVES, DIFFICULTY BREATHING) • INJECTABLE ANTIHISTAMINE • +/- INJECTABLE STEROID • MORE SEVERE CASES (ANAPHYLAXIS) • EPINEPHRINE • IV FLUIDS • SORENESS, FEVER, MALAISE • NSAID ADVERSE VACCINE EVENTS • OTHER ADVERSE EVENTS (RARE BUT POTENTIALLY MORE SEVERE) • IMMUNE-MEDIATED HEMOLYTIC ANEMIA/THROMBOCYTOPENIA • IMMUNOSUPPRESSION • HYPERTROPHIC OSTEODYSTROPHY • THYROIDITIS ADVERSE VACCINE EVENTS • OTHER ADVERSE EVENTS • MASS AT INJECTION SITE • SARCOMA AT LOCATION OF INJECTION • CATS • RARE • INJECTION NOW GIVEN OVER DISTAL LIMB SO AMPUTATION OPTION IF DEVELOPS • BENIGN INFLAMMATORY MASS (GRANULOMA) • RESOLVE W/IN SEVERAL WEEKS • DOCUMENT-SIZE, SHAPE, LOCATION, 1ST OBSERVED • REPORT ALL ADVERSE EVENTS TO MANUFACTURER VACCINE INDUCED FIBROSARCOMA ADVERSE VACCINE EVENTS • TYPICALLY IMMUNIZATION PROTECTION OUTWEIGHS RISK OF ADVERSE EVENT • ANIMALS W/SUSPECTED OR KNOWN VACCINE REACTIONS • PRETREAT ANIMAL • ANTIHISTAMINE +/- STEROID • CHECK ANTIBODY TITER LEVELS • SPREAD OUT VACCINATIONS INSTEAD OF ADMINISTERING ALL AT SAME TIME • FOREGO VACCINATION – IF REACTIONS ARE SEVERE OR LIFE THREATENING QUESTIONS?