Imunisasi: Bambang Mulyawan
Imunisasi: Bambang Mulyawan
Imunisasi: Bambang Mulyawan
Bambang Mulyawan
FK-UMM
Pendahuluan
Maksud : cara
untuk meningkatkan kekebalan seseorang secara aktif
terhadap suatu antigen, sehingga bila kelak ia terpajan
pada antigen yang serupa tidak terjadi penyakit
Tujuan : -
mencegah penyakit tertentu pada seorang anak -
menghilangkan penyakit tertentu pd sekelompok masya-
rakat (populasi) -
menghilangkan penyakit tertentu dari dunia (variola)
Ultimate goal:
- eradication of disease
Immediate goal:
- prevention of disease
Terms
5
Immunization – conferring immunity by artificial
means
1780AD
Edward Jenner discovers small
pox vaccine
Immunization saves lives
Immunization saves
the lives of
approximately 3
million people each
year, all over the
world.
2.3 million still die each year
Vaccine Truths
Vaccines are one of the most important public
health achievements
Public concern about vaccines is pervasive
Fear of vaccines can lead to public harm
Vaccines are not 100% safe
Parents want what is best for their children
The public has little understanding of the vaccine
development process
Vaccine Truths continued
Risk perception is critical
There are anti-vaccine champions
Questions remain
The decision not to vaccinate is an active
decision to accept the risk of the disease.
(Marshall, G. 2003).
8888888888888888
Immunity
Natural Acquired
resistance
Passive Active
Passive immunization
Characteristics of a Vaccine
inactivated (killed) antigen: Flu shot, Hep. A
live attenuated (weakened) antigen: MMR,
Varicella
synthetic (laboratory synthesized) microbial
materials:Toxoids DTaP
conjugate vaccines use outer- coats of the bacteria:
Hib, PCV
recombinant vaccines use the virus genetic
material: Hep B
Active immunization
17
Penetrate cells
Formulations: - intracell. Ag
processing to
1. Live pathogens – attenuated surface of cells -
2. Killed micro-orgs cytotoxic T cell
response
3. Microbial extracts
4. Vaccine conjugates
5. Toxoids
Natural Artificial
Attenuated
organisms
killed organisms
exposure to sub- sub-cellular
clinical infections fragments
toxins
others
Live Attenuated Vaccines
polio* hepatitis A
not used in std. schedule standard 2006
measles, mumps & yellow fever
rubella Military and travelers
Varicella zoster Influenza
children with no history selected age group
of chicken pox (5-49)
tuberculosis
not used in this
country
Killed Whole-Organism Vaccines
polio Q fever
population at risk
influenza typhoid, cholera, plague
elderly and at risk epidemics and travelers
rabies pertussis
post exposure replaced by the
acellular vaccine
Microbial Fragment Vaccines
Bordetella. Pertussis
virulence factor protein
Haemophilus influenzae B
protein conjugated polysaccharide
Streptococcus pneumoniae
Polysaccharide mixture
Neisseria meningitidis
polysaccharide
Microbial Fragment Vaccines
Hepatitis B virus
cloned in yeast
Figure 10-17
Passive Immunization
24Microbiology. 1998.
Mims C et al. Medical
Passive Immunity
Natural Artificia
l
Placental transfer Antibodies or
of IgG immunoglobulins
Advantages Disadvantages
no long term
protection
serum sickness
immediate
protection risk of hepatitis
and Aids
graft vs. host
disease (cell
graft only)
A generic disease model
Susceptibl Diseased
e
Not at
risk
A generic disease model
Susceptibl Diseased
e
Not at
risk
A generic disease model
Vaccination
Susceptibl Diseased
e
Not at
risk
A generic disease model
Therapy producing
temporary cure
Susceptibl Diseased
e
Not at
risk
A generic disease model
Therapy producing
permanent cure
Susceptibl Diseased
e
Not at
risk
A generic disease model
Education
Susceptibl Diseased
e
Not at
risk
Epidemiologic Triad
Freezer:
- varicella
Hand hygiene
Gloves are not required
IM - <1y anterolateral aspect of the thighs
- >1y deltoids
SQ 45 angle
-MMR,Varicella
-IPV, menomune
-Yellow fever
PRETERM AND LOW BIRTH WEIGHT
INFANTS
systemic: Mild/moderate
fever, drowsiness, fretfulness 1 in 2-3 doses
vomiting
anorexia 1 in 5-15 doses
systemic: more serious
persistent crying, fever 1 in 100-300 doses
collapse, convulsions 1 in 1750 doses
acute encephalopathy 1 in 100,000 doses
permanent neurological deficit 1 in 300,000 doses
44
Examples of types & frequency of AEFIs (in some common
vaccines)