home Endocrinology Immunity and vaccinations. What vaccines are there and what are they for? Lecture: Vaccines, requirements for vaccines. Types of vaccines, characteristics, preparation methods. New approaches to creating vaccines Types of vaccination

Immunity and vaccinations. What vaccines are there and what are they for? Lecture: Vaccines, requirements for vaccines. Types of vaccines, characteristics, preparation methods. New approaches to creating vaccines Types of vaccination

To certain pathogenic microorganisms) with the help of drugs (vaccines) in order to form immunological memory to the antigens of the causative agent of the disease, bypassing the stage of development of this disease. Vaccines contain biomaterial - pathogen antigens or toxoids. Creation of vaccines It became possible when scientists learned to cultivate pathogens of various dangerous diseases in the laboratory. And the variety of methods for creating vaccines ensures their varieties and allows them to be grouped according to production methods.

Types of vaccines:

Adjuvants– substances that complement and enhance the effect of other components of the vaccine, provide not only a general immunostimulating effect, but also activate a specific type of immune response for each adjuvant (humoral or cellular).

Mineral adjuvants (aluminum alum) enhance phagocytosis;
Lipid adjuvants – cytotoxic Th1-dependent type of immune system response (inflammatory form of T-cell immune response);
Virus-like adjuvants are a cytotoxic Th1-dependent type of immune system response;
Oil emulsions (vaseline oil, lanolin, emulsifiers) – Th2- and Th1-dependent type of response (where thymus-dependent humoral immunity is enhanced);
Nanoparticles containing antigen - Th2- and Th1-dependent type of response.

Some adjuvants due to their reactogenicity (ability to cause side effects) were prohibited for use (Freund's adjuvants).

Vaccines– these are medications that, like any other drug, have contraindications and side effects. In this regard, there are a number of rules for using vaccines:

Preliminary skin testing;
The state of health of the person at the time of vaccination is taken into account;
A number of vaccines are used in early childhood and therefore they must be carefully checked for the safety of the components included in their composition;
For each vaccine, an administration schedule is followed (frequency of vaccination, season for its administration);
The dose of the vaccine and the interval between the times of its administration are maintained;
There are routine vaccinations or vaccinations for epidemiological reasons.

Adverse reactions and complications after vaccination:

Local reactions– hyperemia, swelling of tissue in the area of vaccine administration;
General reactions– fever, diarrhea;
Specific complications– characteristic of a particular vaccine (for example, keloid scar, lymphadenitis, osteomyelitis, generalized infection with BCG; for the oral polio vaccine - convulsions, encephalitis, vaccine-associated poliomyelitis and others);
Nonspecific complications– immediate type reactions (edema, cyanosis, urticaria), allergic reactions (including Quincke’s edema), proteinuria, hematuria.

Immunology and allergology >>>> Vaccination and types of vaccines

Vaccination is a way of creating protective immunity(immunity to certain pathogenic microorganisms) with the help of drugs (vaccines) in order to form immunological memory to the antigens of the causative agent of the disease, bypassing the stage of development of this disease. Vaccines contain biomaterial - pathogen antigens or toxoids. Creation of vaccines It became possible when scientists learned to cultivate pathogens of various dangerous diseases in the laboratory. And the variety of methods for creating vaccines ensures their varieties and allows them to be grouped according to production methods.

Types of vaccines:

Mineral adjuvants (aluminum alum) enhance phagocytosis;
Lipid adjuvants – cytotoxic Th1-dependent type of immune system response (inflammatory form of T-cell immune response);
Virus-like adjuvants are a cytotoxic Th1-dependent type of immune system response;
Oil emulsions (vaseline oil, lanolin, emulsifiers) – Th2- and Th1-dependent type of response (where thymus-dependent humoral immunity is enhanced);
Nanoparticles containing antigen - Th2- and Th1-dependent type of response.

Some adjuvants due to their reactogenicity (ability to cause side effects) were prohibited for use (Freund's adjuvants).

Vaccines– these are medications that, like any other drug, have contraindications and side effects. In this regard, there are a number of rules for using vaccines:

Preliminary skin testing;
The state of health of the person at the time of vaccination is taken into account;
A number of vaccines are used in early childhood and therefore they must be carefully checked for the safety of the components included in their composition;
For each vaccine, an administration schedule is followed (frequency of vaccination, season for its administration);
The dose of the vaccine and the interval between the times of its administration are maintained;
There are routine vaccinations or vaccinations for epidemiological reasons.

Adverse reactions andcomplications after vaccination:

Local reactions– hyperemia, swelling of tissue in the area of vaccine administration;
General reactions– fever, diarrhea;
Specific complications- characteristic of a particular vaccine (for example, keloid scar, lymphadenitis, osteomyelitis, generalized infection with BCG; for oral polio vaccine - convulsions, encephalitis, vaccine-associated poliomyelitis and others);
Nonspecific complications– immediate type reactions (edema, cyanosis, urticaria), allergic reactions (including Quincke’s edema), proteinuria, hematuria.

Vaccines, requirements for vaccines. Types of vaccines, characteristics, preparation methods. New approaches to creating vaccines

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vaccine requirements.

Safety is the most important property of a vaccine; it is carefully studied and monitored in

process of production and use of vaccines. The vaccine is safe if administered to people

does not cause the development of serious complications and diseases;

Protectiveness - the ability to induce specific defense of the body against

a certain infectious disease;

Duration of preservation of protection;

Stimulation of the formation of neutralizing antibodies;

Stimulation of effector T lymphocytes;

Duration of preservation of immunological memory;

Low cost;

Biological stability during transportation and storage;

Low reactogenicity;

Easy to administer.

Types of vaccines:

Live vaccines are made from weakened strains of a microorganism with genetically fixed avirulence.

PREPARATIONS: VACCINES AND SERUM

The vaccine strain, after administration, multiplies in the body of the vaccinated person and causes a vaccine infectious process. In the majority of vaccinated people, the vaccine infection occurs without pronounced clinical symptoms and leads, as a rule, to the formation of stable immunity. Examples of live vaccines include vaccines for the prevention of polio (Sabin live vaccine), tuberculosis (BCG), mumps, plague, anthrax, and tularemia. Live vaccines are available in lyophilized (powdered) form.

form (except polio). Killed vaccines are bacteria or viruses that have been inactivated by chemical (formalin, alcohol, phenol) or physical (heat, ultraviolet irradiation) effects. Examples of inactivated vaccines are: pertussis (as a component of DTP), leptospirosis, whole virion influenza, vaccine against tick-borne encephalitis, against inactivated polio vaccine (Salk vaccine).

Chemical vaccines are obtained by mechanical or chemical destruction of microorganisms and the release of protective antigens, i.e., those that cause the formation of protective immune reactions. For example, a vaccine against typhoid fever, a vaccine against meningococcal infection.

Anatoxins. These drugs are bacterial toxins that are rendered harmless

exposure to formaldehyde at elevated temperatures (400) for 30 days, followed by purification and concentration. Toxoids are sorbed on various mineral adsorbents, for example, aluminum hydroxide (adjuvants). Adsorption significantly increases the immunogenic activity of toxoids. This is due both to the creation of a “depot” of the drug at the injection site and to the adjuvant

by the action of the sorbent, which causes local inflammation, enhancing the plasmacytic reaction in the regional lymph nodes. Toxoids are used to prevent tetanus, diphtheria, and staphylococcal infections.

Synthetic vaccines are artificially created antigenic determinants of microorganisms.

Associated vaccines include drugs from previous groups and against several infections. Example: DPT - consists of diphtheria and tetanus toxoids adsorbed on aluminum hydroxide and killed pertussis vaccine.

Vaccines obtained using genetic engineering methods. The essence of the method: the genes of a virulent microorganism responsible for the synthesis of protective antigens are inserted into the genome of a harmless microorganism, which, when cultivated, produces and accumulates the corresponding antigen. An example is the recombinant vaccine against viral hepatitis B and the vaccine against rotavirus infection.

In the future, it is planned to use vectors in which not only genes are embedded,

controlling the synthesis of pathogen antigens, but also genes encoding various mediators (proteins) of the immune response (interferons, interleukins, etc.

Currently, vaccines are being intensively developed from plasmid (extranuclear) DNA encoding antigens of pathogens of infectious diseases. The idea of such vaccines is to integrate the genes of the microorganism responsible for the synthesis of microbial protein into the human genome. In this case, human cells stop producing this foreign protein, and the immune system begins to produce antibodies to it. These antibodies will neutralize the pathogen if it enters the body.

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What types of preventive vaccinations are there?

Vaccination - what kind of injection is it? What does it mean by its name? Why do pediatricians and therapists recommend mandatory preventive vaccinations from the very first days of life, which supposedly help our body fight viruses and infections that can overtake us in the pull of life? All preventive vaccinations contain a purely immunobiological drug. The timing and frequency of vaccinations can always be found out at a clinic or specialized medical institutions.

Vaccination carries weakened viral particles of infectious diseases, which, when entering our body in small doses, help the human immune system produce protective antibodies to a specific virus. Any vaccination will help the body develop negative susceptibility to different types and types of infections, which is the reason to vaccinate at any age.

The body produces special cells - memory cells that live in the human body from one month to ten years, remembering infections previously introduced to us using a subcutaneous injection. Thanks to them, the virus protection function occurs. Vaccination is not carried out against those viruses that the immune system copes with on its own, releasing protective antibodies.

The reaction to vaccination can be different: from mild to severe forms. As a rule, the most common cases of reaction occur in young children, which are accompanied by the following symptoms: one of the more common causes is an increase in body temperature, as well as the child’s restlessness, lethargy, redness or hardening of the site where the vaccine was administered. Allergies manifest themselves as red spots all over the skin, difficulty breathing, and even attacks of suffocation.

Types of vaccinations

Types of vaccines and vaccinations are divided into groups such as:

The most frequently asked questions about vaccinations. Part 1. General questions

2. Killed infection organisms;

3. Weak organisms;

4. Mandatory preventive;

5. Voluntary;

6. Vaccinations during an epidemic.

Mandatory vaccinations are approved by the Ministry of Health, are prescribed in the vaccination calendar and are of a preventive nature. During the first day of a child’s life, they always try to give an injection against hepatitis B.

A weakened hepatitis virus is administered during the first 12 hours of a baby’s life. Further according to the scheme: at thirty days of life, at sixty days, at five months, at one year of age and every subsequent five years. Vaccines against tuberculosis, also called (BCG), the very first injections are given on the 3rd - 4th day of a newborn baby’s life, if there are no pediatric contraindications, which may arise due to the child’s low weight and tumor associated with cancer. Next, the vaccine is given at the age of five or seven years, and by the age of fifteen.

The DTP vaccine protects against (whooping cough, tetanus, polio and diphtheria), the drug is administered for the first time in the period from three months to six months. Afterwards, the procedure is repeated at two years, at five years, and at the age of majority, according to the patient’s wishes. The process of vaccination against polio takes place separately; it is done four times during a lifetime: at five months, eighteen months, two years and seven years.

For rubella, measles and mumps, it is administered to children aged twelve months and seven years; contraindications for such a vaccine are allergic reactions and disorders of the immune system.

Contraindications from doctors for vaccination are: the patient’s unsatisfactory health condition, namely a weak general condition of the body, colds, nervous diseases, oncology, postoperative period, with second and third degree skin burns. It is recommended to vaccinate after achieving complete recovery.

Voluntary vaccination takes place with the voluntary consent of the person if there is a danger of becoming infected with seasonal viruses (influenza, allergies), tick-borne encephalitis, or for visiting other countries where the virus may be spreading.

In case of an epidemic, vaccination is carried out to all residents of the metropolis in which the outbreak of the epidemic occurred.

Complications from the vaccine

Complications appear not only in a newborn, but also in an already mature human body, which has a different nature of the disease. The first reason for the reaction is a special intolerance to the drug, poor quality of the vaccine (defective, expired), incorrect procedure, large dose of the drug, providing the vaccine to a sick patient.

Post-vaccination complications bring with them such types of diseases as: polyneuritis, encephalitis, an allergic reaction among the people (Quincke's edema), neuritis, anaphylactic shock, meningitis, otitis, poliomyelitis. At the first symptoms of poor health after vaccination, we recommend that you consult a general practitioner in order to promptly warn yourself, your loved ones and children from the above-mentioned diseases that provoke complications. download dle 12.1

What types of vaccines exist1?

There are different types of vaccines, which differ in the way they produce the active component, the antigen, to which immunity is produced. The method of vaccine production determines the method of administration, method of administration and storage requirements. Currently, there are 4 main types of vaccines:

Live attenuated vaccines
Inactivated (killed antigen) vaccines
Subunit (with purified antigen)
Vaccines with toxoid (inactivated toxin).

How are different types of vaccines produced1, 3?

Live weakened (attenuated) vaccines- produced from weakened pathogens. In order to achieve this, the bacteria or virus is multiplied in conditions unfavorable for it, repeating the process up to 50 times.

Example of live attenuated vaccines against diseases:

Tuberculosis
Poliomyelitis
Rotavirus infection
Yellow fever

Positive and negative features of live attenuated vaccines

Inactivated (killed antigen) vaccines- produced by killing the culture of the pathogen. In this case, such a microorganism is not able to reproduce, but causes the development of immunity against the disease.

Adapted from http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

Example of inactivated (killed antigens) vaccines

Whole cell pertussis vaccine
Inactivated polio vaccine

Positive and negative features of inactivated (killed antigens) vaccines

Adapted from WHO e-Training. Basics of vaccine safety.

Subunit vaccines- just like inactivated ones, they do not contain a live pathogen. Such vaccines contain only individual components of the pathogen to which immunity is developed.
Subunit vaccines are in turn divided into:

Subunit vaccines with protein carrier (influenza, acellular pertussis vaccine, hepatitis B)
Polysaccharides (against pneumococcal and meningococcal infections)
Conjugated (against Haemophilus influenzae, pneumococcal and meningococcal infections for children from 9-12 months of life).

Scheme for the production of recombinant vaccine against hepatitis B

Adapted from http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

Positive and negative features of subunit vaccines

Adapted from WHO e-Training. Basics of vaccine safety.

Toxoid-based vaccines- contain a neutralized bacterial toxin or so-called toxoid. In some diseases, such as diphtheria and tetanus, the toxin enters the bloodstream, causing the development of symptoms of the disease. To create a vaccine, enhancers (adjuvants), such as aluminum and calcium salts, are added to the neutralized toxin.

Adapted from http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

Examples of toxoid-based vaccines:

Against diphtheria
Against tetanus

Positive and negative features of toxoid-based vaccines

Adapted from WHO e-Training. Basics of vaccine safety.

How are different types of vaccines administered1?

Depending on the type, vaccines can be introduced into the human body in various ways.

Oral(by mouth) - this method of administration is quite simple, since the use of needles and a syringe is not required. For example, oral polio vaccine (OPV), vaccine against rotavirus infection.

Intradermal injection- with this type of administration, the vaccine is injected into the very top layer of the skin.
For example, the BCG vaccine.
Subcutaneous injection- with this type of administration, the vaccine is injected between the skin and muscle.
For example, the measles, rubella, and mumps vaccine (MMR).
Intramuscular injection- with this type of administration, the vaccine is injected deep into the muscle.
For example, the vaccine against whooping cough, diphtheria and tetanus (DTP), the vaccine against pneumococcal infection.

Adapted from http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

What other components are included in vaccines1,2?

Knowledge about the composition of vaccines can help in understanding the possible causes of post-vaccination reactions, as well as in choosing a vaccine if a person has allergies or is intolerant to certain vaccine components.

Vaccine - what is it? Types and types of vaccines

In addition to foreign substances (antigens) of pathogens, vaccines may contain:

Stabilizers
Preservatives
Antibiotics
Substances to enhance the immune system response (adjuvants)

Stabilizers necessary to help the vaccine maintain its effectiveness during storage. The stability of vaccines is critical because improper transportation and storage of the vaccine may reduce its ability to induce effective protection against infection.
The following can be used as stabilizers in vaccines:

Magnesium chloride (MgCl2) – oral polio vaccine (OPV)
Magnesium sulfate (MgSO4) - measles vaccine
Lactose-sorbitol
Sorbitol-gelatin.

Preservatives are added to vaccines that are packaged in vials designed to be used by several people at the same time (multi-dose) to prevent the growth of bacteria and fungi.
The preservatives most often used in vaccines include:

Thiomersal
Formaldehyde
Phenol
Phenoxyethanol.

Thiomersal (mercury-containing alcohol)

Since 1930, it has been used as a preservative in multi-dose vials of vaccines used in National Vaccination Programs (e.g. DPT, Haemophilus influenzae, Hepatitis B).
Vaccines enter the human body with less than 0.1% of the mercury we receive from other sources.
Concerns about the safety of this preservative have led to numerous studies; Over the course of 10 years, WHO experts conducted safety studies with thiomersal, as a result of which it was proven that there was no toxic effect on the human body.

Formaldehyde

It is used in the production of killed (inactivated) vaccines (for example, injection polio vaccine) and for the production of toxoids - a neutralized bacterial toxin (for example, ADS).
During the purification stage of the vaccine, almost all formaldehyde is removed.
The amount of formaldehyde in vaccines is hundreds of times lower than the amount that can cause harm to humans (for example, the five-part vaccine for whooping cough, diphtheria, tetanus, polio and Haemophilus influenzae contains less than 0.02% formaldehyde per dose or less than 200 ppm) .

In addition to the above preservatives, two other vaccine preservatives are approved for use: 2-phenoxyethanol(used for inactivated polio vaccine) and phenol(used for typhoid vaccine).

Antibiotics

They are used in the production of some vaccines to prevent bacterial contamination of the environment where pathogens are grown.
Vaccines usually contain only trace amounts of antibiotics. For example, the measles, rubella, and mumps vaccine (MMR) contains less than 25 micrograms neomycin per dose.
Patients allergic to neomycin should be monitored after vaccination; This will allow immediate treatment of any allergic reactions.

Adjuvants

Adjuvants have been used for decades to enhance the immune response for the administration of the vaccine. Most often, adjuvants are included in killed (inactivated) and subunit vaccines (for example, influenza vaccine, human papillomavirus vaccine).
The longest and most frequently used adjuvant is an aluminum salt - aluminum hydrochloride (Al(OH)3). It slows down the release of antigen at the injection site and prolongs the time the vaccine contacts the immune system.
To ensure the safety of vaccination, it is extremely important that aluminum salt vaccines are administered intramuscularly and not subcutaneously. Subcutaneous administration may lead to the development of an abscess.
Today, there are several hundred different types of adjuvants that are used in vaccine production.

Immune response to vaccine with and without adjuvant3

Adapted from http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

Vaccination is one of the greatest medical achievements in human history.

Sources

WHO. Basics of vaccine safety. Electronic learning module.
http://ru.vaccine-safety-training.org/
http://www.who.int/immunization/newsroom/thiomersal_questions_and_answers/en
Thiomersal: questions and answers. October 2011
Date of last visit: 10/15/2015
On-line presentation available on http://www.slideshare.net/addisuga/6-immunization-amha Accessed by May 2016

Calculate your baby's personal vaccination schedule! On our website this can be done easily and quickly, even if some vaccinations were performed “at the wrong time”.

Therapeutic and prophylactic drugs Vaccines

Immunobiological medical therapeutic and prophylactic drugs are used to prevent and treat patients with infectious diseases by creating artificial immunity.

Vaccines- drugs containing antigens and intended to create artificial active immunity in the body. The introduction of a vaccine into the body is called vaccination. Vaccines are used more often for prevention, less often for treatment.

Depending on the nature of the antigen they contain, vaccines are divided into live, killed, chemical, toxoid, and associated.

Vaccines and toxoids with a reduced dosage of antigen (BCG-m, AD-m and others) are used for vaccination and revaccination in the presence of contraindications to vaccination with a full dose of antigen.

Vaccines against one infection are called mono-vaccines; vaccines against two, three, or several are called divaccines, trivaccines, or polyvaccines, respectively.

Polyvalent vaccines are those that contain several serological variants of pathogens of the same type, for example, anti-influenza vaccines of types A and B.

Live vaccines prepared from living microorganisms, the virulence of which is weakened, and the immunogenic properties are preserved. The scientific basis for obtaining vaccine strains was developed by L. Pasteur, who established the possibility of artificially weakening the virulence of pathogenic microbes.

Various methods have been used to obtain vaccine strains.

1) Growing on nutrient media unfavorable for the growth and reproduction of the pathogen. Thus, French microbiologists A. Calmette and G. Guerin obtained a vaccine strain of Mycobacterium tuberculosis (BCG) by cultivating pathogens on a nutrient medium containing bile.

2) Passage of the pathogen through the body of animals. In this way, L. Pasteur received a vaccine against rabies. Repeated passages led to the fact that the virus adapted to the rabbit’s body, its virulence for rabbits increased and its virulence for humans decreased.

3) Selection of natural cultures of microorganisms that are low virulent for humans. This is how vaccines against plague, brucellosis, tularemia, polio, etc. were obtained.

Live vaccines have a number of advantages over killed vaccines. Reproduction of a vaccine strain of microbes in the human body leads to the development of a vaccine infection - a benign process that leads to the formation of specific immunity. Live vaccines are administered in simpler ways (orally, intranasally, cutaneously, intradermally) and, as a rule, once. Thanks to the ability of the vaccine strain to multiply in the body and exert a long-term antigenic effect, intense, persistent immunity is created.

To maintain stability, live vaccines are produced in the form of lyophilized preparations. They should be stored in the refrigerator at a temperature of 4°-8°C during the entire storage period, as well as during transportation of vaccines. Otherwise, the viability of the vaccine strain may be lost, and vaccinations will not have the desired effect.

When vaccinations with live vaccines are carried out, certain rules are observed. One to two days before the vaccine and for a week after vaccination, you should not use antimicrobial drugs, immune serums, or immunoglobulins. Do not use hot instruments to administer the vaccine. Consume the opened ampoule immediately or within 2-3 hours; Protect from sunlight and heat. Treat the skin with volatile substances, for example, alcohol, and administer the vaccine after it evaporates; do not use iodine, carbolic acid and other compounds that remain on the skin for this purpose. The remaining unused or rejected vaccine should not be thrown away, but killed first. A local reaction to the vaccine should not be treated with antibacterial agents.

Live vaccines are used to prevent the following diseases: tuberculosis, plague, tularemia, brucellosis, anthrax, measles, smallpox, mumps, polio, yellow fever.

Killed (inactivated) vaccines contain bacteria and viruses inactivated by heating, UV rays, formaldehyde, phenol, and alcohol. To obtain killed vaccines, strains that are fully immunogenic are used. Inactivation is carried out in such a way as to reliably kill microbes without damaging the antigenic properties.

Diseases for the prevention of which killed vaccines are used: leptospirosis, whooping cough, influenza, rabies, tick-borne encephalitis.

Vaccinations with killed vaccines are carried out twice or three times; immunity is shorter lasting.

Vaccine therapy. Vaccines made from killed microbes are used to treat patients with chronic sluggish infectious diseases, such as brucellosis, chronic dysentery, chronic gonorrhea, chronic recurrent herpes, chronic staphylococcal infections. The therapeutic effect is associated with the stimulation of phagocytosis and the immune response.

Treatment with vaccines is carried out individually, under medical supervision, since vaccine therapy often causes an exacerbation of the infectious process.

In some cases, autovaccines are used for treatment, which are prepared from bacteria isolated from the patient himself.

Chemical vaccines contain antigens extracted from microbial cells and viruses that have a protective (protective) effect. Thus, unlike live and killed vaccines, which are corpuscular, chemical vaccines do not contain microbial cells or whole virions.

On the shelves: vaccines - what, when, for whom

They can be called molecularly dispersed.

The advantage of chemical vaccines is that they do not contain ballast substances, they are less reactogenic, that is, they cause fewer adverse reactions.

Examples of chemical vaccines: typhoid - contains O-antigen; cholera (O-antigen); meningococcal - contains a polysaccharide antigen; typhus - contains a surface soluble antigen from Provacek's rickettsia. Viral subunit (split) vaccines contain the most immunogenic antigens of viruses. For example, the influenza vaccine (AGV) contains hemagglutinin and neuraminidase.

To increase immunogenicity, chemical vaccines are adsorbed on an adjuvant (aluminum hydroxide). The adjuvant enlarges antigen particles, slows down the resorption of the antigen, prolonging its effect. In addition, the adjuvant is a nonspecific stimulator of the immune response.

Anatoxins- preparations obtained from bacterial exotoxins, devoid of toxic properties, but retaining immunogenic properties. The method for producing toxoids was proposed in 1923 by the French scientist G. Ramon. To prepare the toxoid, 0.3-0.4% formalin is added to the exotoxin and kept at a temperature of 37-40°C for 3-4 weeks until the toxic effects completely disappear.

Toxoids are produced in the form of naive preparations or in the form of purified concentrated preparations adsorbed on adjuvants.

Toxoids are used to create artificial active antitoxic immunity. Toxoids are used, staphylococcal native and purified adsorbed, cholera- toxoid; adsorbed diphtheria (AD, AD-m), diphtheria-tetanus (ADS, ADS-m), trianatoxin (botulinum types A, B, E), tetra-toxoid (botulinum types A, B, E and tetanus).

Associated vaccines contain antigens that are different in nature. Adsorbed pertussis-diphtheria-tetanus vaccine (DTP) contains inactivated pertussis vaccine, diphtheria and tetanus toxoids adsorbed on aluminum hydroxy-dehyde.

New generation vaccines. These are the vaccines of the future, some of them are already in use.

1) Artificial vaccines composed of determinant groups of antigens combined with a carrier protein.

2) Genetically engineered vaccines. Using genetic engineering methods, genes responsible for antigen synthesis are inserted into the genome of bacteria, yeast, and viruses. A vaccine has been created containing hepatitis B virus antigens produced by recombinant yeast cells; a genetically engineered vaccine against HIV infection is being prepared from virus antigens produced by recombinant strains of E. coli; a vaccine made from HIV antigens contained in the vaccinia virus.

3) A method for producing vaccines based on anti-idiotypic antibodies, that is, antibodies specific to immunoglobulin, is being developed. For example, antibodies against an antitoxin can immunize an animal or human like the toxin (or toxoid).

Vaccines are administered cutaneously, intradermally, subcutaneously, intramuscularly, intranasally, orally, and inhalation. For mass vaccinations, needle-free injection using pistol-type machines is used, as well as oral administration of the vaccine and the inhalation method.

The vaccination system for the prevention of infectious diseases among the population is regulated by the vaccination calendar, which defines mandatory vaccinations for each age and vaccinations according to indications.

Local and general reactions may occur when vaccines are administered. General reaction: fever up to 38°-39°C, malaise, headache. These symptoms usually disappear 1-3 days after vaccination. Locally, after 1-2 days, redness and infiltration may appear at the injection site. Some live vaccines - smallpox, tularemia, BCG, when administered intradermally, cause characteristic skin reactions, which indicates a positive result of vaccination.

The main contraindications to the use of vaccines: acute infectious diseases, active form of tuberculosis, impaired cardiac activity, liver function, kidney function, endocrine disorders, allergies, diseases of the central nervous system. For each vaccine there is a detailed list of contraindications given in the instructions. In the event of an epidemic or life-threatening indications (bite by a rabid animal, cases of plague), it is necessary to vaccinate persons with contraindications, but under special medical supervision.

It was thanks to vaccination that humanity began to rapidly survive and reproduce. Opponents of vaccines do not die from plague, measles, smallpox, hepatitis, whooping cough, tetanus and other scourges only because civilized people, with the help of vaccines, have practically destroyed these diseases in the bud. But this does not mean that there is no longer a risk of getting sick and dying. Read about which vaccines you need.

History knows many examples where diseases caused devastating damage. Plague in the 14th century wiped out a third of Europe's population, the Spanish Flu of 1918-1920 killed an estimated 40 million people, and a smallpox epidemic left fewer than 3 million of the 30 million Incan population.

It is obvious that the advent of vaccines has made it possible to save millions of lives in the future - this can be seen simply by the growth rate of the world's population. Edward Jenner is considered a pioneer in the field of vaccination. In 1796, he noticed that people working on farms with cows infected with cowpox did not get smallpox. To confirm, he inoculated the boy with cowpox and proved that he was no longer susceptible to infection. This subsequently became the basis for the eradication of smallpox throughout the world.

What vaccines are there?

The vaccine contains killed or greatly weakened microorganisms in small quantities, or their components. They cannot cause a full-fledged disease, but they allow the body to recognize and remember their characteristics, so that later, when encountering a full-fledged pathogen, it can be quickly identified and destroyed.

Vaccines are divided into several main groups:

Live vaccines. For their production, weakened microorganisms are used that cannot cause disease, but help develop the correct immune response. Used to protect against polio, influenza, measles, rubella, mumps, chickenpox, tuberculosis, rotavirus infection, yellow fever, etc.

Inactivated vaccines . Made from killed microorganisms. In this form, they cannot reproduce, but cause the development of immunity against the disease. An example is inactivated polio vaccine, whole cell pertussis vaccine.

Subunit vaccines . The composition includes only those components of the microorganism that cause the development of immunity. An example is vaccines against meningococcal, Haemophilus influenzae, and pneumococcal infections.

Anatoxins . Neutralized toxins of microorganisms with the addition of special enhancers - adjuvants (aluminum salts, calcium). Example – vaccines against diphtheria, tetanus.

Recombinant vaccines . They are created using genetic engineering methods, which include recombinant proteins synthesized in laboratory strains of bacteria and yeast. An example is the hepatitis B vaccine.

Vaccinal prophylaxis is recommended to be carried out in accordance with the National Vaccination Calendar. It is different in each country, since the epidemiological situation may differ significantly, and in some countries the vaccinations used in others are not always necessary.

Here is the national calendar of preventive vaccinations in Russia:

You can also familiarize yourself with the US vaccination calendar and the vaccination calendar of European countries - they are in many ways very similar to the domestic calendar:

Vaccination calendar in the European Union (you can select any country from the menu and view the recommendations).

Tuberculosis

Vaccines – “BCG”, “BCG-M”. They do not reduce the risk of contracting tuberculosis, but they prevent up to 80% of severe forms of infection in children. Included in the national calendar of more than 100 countries around the world.

Hepatitis B

Vaccines – “Euvax B”, “Recombinant hepatitis B vaccine”, “Regevac B”, “Engerix B”, “Bubo-Kok” vaccine, “Bubo-M”, “Shanvak-V”, “Infanrix Hexa”, “ DPT-GEP B".

With the help of these vaccines, it was possible to reduce the number of children with chronic hepatitis B from 8-15% to<1%. Является важным средством профилактики, защищает от развития первичного рака печени. Предотвращает 85-90% смертей, происходящих вследствие этого заболевания. Входит в календарь 183 стран.

Pneumococcal infection

Vaccines – “Pneumo-23”, 13-valent “Prevenar 13”, 10-valent “Synflorix”.
Reduces the incidence of pneumococcal meningitis by 80%. Included in the calendar of 153 countries.

Diphtheria, whooping cough, tetanus

Vaccines - combined (contain 2-3 vaccines in 1 preparation) - ADS, ADS-M, AD-M, DPT, "Bubo-M", "Bubo-Kok", "Infanrix", "Pentaxim", "Tetraxim", "Infanrix Penta", "Infanrix Hexa"

Diphtheria – the effectiveness of modern vaccines is 95-100%. For example, the risk of getting encephalopathy in unvaccinated people is 1:1200, and in vaccinated people it is less than 1:300,000.

Whooping cough – vaccine effectiveness is more than 90%.

Tetanus – 95-100% effective. Persistent immunity lasts 5 years, after which it gradually fades, which is why revaccination is required every 10 years.
194 countries of the world are included in the calendar.

Polio

Vaccines: Infanrix Hexa, Pentaxim, oral polio vaccine types 1, 3, Imovax Polio, Poliorix, Tetraxim.

Poliomyelitis is incurable, it can only be prevented. After the introduction of vaccination, the number of cases fell from 350,000 cases since 1988 to 406 cases in 2013.

Haemophilus influenzae infection

Vaccines: Act-HIB, Hiberix Pentaxim, Haemophilus influenzae type B conjugate, Infanrix Hexa.

Children under 5 years of age cannot independently adequately form immunity to this infection, which is highly resistant to antibacterial drugs. The effectiveness of vaccination is 95-100%. Included in the calendar of 189 countries.

Measles, rubella, mumps

Vaccines: Priorix, MMP-II.

Measles vaccination prevented 15.6 million deaths between 2000 and 2013. Global mortality fell by 75%.

Rubella is tolerated by children without any problems, but in pregnant women it can cause fetal malformations. Mass vaccination in Russia has reduced the incidence to 0.67 per 100,000 people. (2012).

Mumps - can cause a large number of complications, such as deafness, hydrocephalus, and male infertility. The effectiveness of vaccination is 95%. Incidence cases for 2014 in Russia – 0.18 per 100,000 people.

Flu

Vaccines: "Ultravac", "Ultrix", "Microflu", "Fluvaxin", "Vaxigrip", "Fluarix", "Begrivac", "Influvac", "Agrippal S1", "Grippol plus", "Grippol", "Inflexal" V", "Sovigrip".

The vaccine works in 50-70% of cases. Indicated for people at risk (the elderly, those with concomitant respiratory pathologies, weakened immunity, etc.).

Note: Russian vaccines “Grippol” and “Grippol +” have an insufficient amount of antigens (5 mcg instead of the required 15), justifying this by the presence of polyoxidonium, which should stimulate the immune system and enhance the effect of the vaccine, but there is no data confirming this.

What are the negative consequences of using vaccines?

Negative consequences can be divided into side effects and post-vaccination complications.

Side effects are reactions to drug administration that do not require treatment. Their risk is less than 30%, like most drugs.

The list of “side effects”, if summed up for all vaccines:

An increase in body temperature for several days (can be controlled with Ibuprofen; Paracetamol is not recommended due to a possible decrease in the effect of vaccination).
Pain at the injection site for 1-10 days.
Headache.
Allergic reactions.

However, there are also more dangerous, although extremely rare, manifestations that should be treated by the attending physician:

Vaccine-associated polio. There was 1 case per 1-2 million vaccinations. At the moment, thanks to the new inactivated vaccine, it does not occur at all.
Generalized BCG infection is the same probability. Occurs in newborns with immunodeficiency.
Cold abscess - from BCG, about 150 cases per year. Occurs due to improper administration of the vaccine.
Lymphadenitis - BCG, about 150 cases per year. Inflammation of regional lymph nodes.
Osteitis - Damage to the BCG bone, mainly the ribs. Less than 70 cases per year.
Infiltrates - compactions at the injection site, from 20 to 50 cases per year.
Encephalitis - from live vaccines such as measles, rubella, mumps, is extremely rare.

Like any working drug, vaccines can have a negative effect on the body. However, these effects are incredibly small compared to the benefits.

Do not self-medicate and take care of your health.

Vaccines (the definition, the classification of which are discussed in this article) are immunological agents used as active immunoprophylaxis (in other words, to form an active, persistent immunity of the body to a given specific pathogen). According to WHO, vaccination is the optimal method for preventing infectious pathologies. Due to the high efficiency, simplicity of the method, and the possibility of wide coverage of the vaccinated population for mass prevention of pathologies, immunoprophylaxis in many countries is classified as a government priority.

Vaccination

Vaccination is special preventive measures aimed at protecting a child or adult from certain pathologies completely or significantly reducing their occurrence when they occur.

A similar effect is achieved by “training” the immune system. When the drug is administered, the body (more precisely, its immune system) fights the artificially introduced infection and “remembers” it. With repeated infection, the immune system is activated much faster and completely destroys foreign agents.

The list of ongoing vaccination activities includes:

selection of persons to be vaccinated;
choice of drug;
formation of a vaccine application regimen;
performance monitoring;
therapy (if necessary) of possible complications and pathological reactions.

Vaccination methods

Intradermal. An example is BCG. The injection is made into the shoulder (its outer third). A similar method is also used to prevent tularemia, plague, brucellosis, anthrax, and Q fever.
Oral. Used to prevent polio and rabies. At the stages of development, oral drugs for influenza, measles, typhoid fever, and meningococcal infection.
Subcutaneous. With this method, the unsorbed drug is injected into the subscapular or humeral (outer surface at the border of the middle and upper thirds of the shoulder) area. Advantages: low allergenicity, ease of administration, resistance of immunity (both local and general).
Aerosol. Used as emergency immunization. Aerosol agents are highly effective against brucellosis, influenza, tularemia, diphtheria, anthrax, whooping cough, plague, rubella, gas gangrene, tuberculosis, tetanus, typhoid, botulism, dysentery, mumps B.
Intramuscular. Produced in the thigh muscles (in the upper anterior outer part of the quadriceps femoris muscle). For example, DPT.

Modern classification of vaccines

There are several divisions of vaccine preparations.

1. Classification of funds according to generation:

1st generation (particular vaccines). In turn, they are divided into attenuated (weakened living) and inactivated (killed) agents;
2nd generation: subunit (chemical) and neutralized exotoxins (anatoxins);
3rd generation is represented by recombinant and recombinant rabies vaccines;
4th generation (not yet included in practice), represented by plasmid DNA, synthetic peptides, plant vaccines, vaccines containing MHC products and anti-idiotypic drugs.

2. Classification of vaccines (microbiology also divides them into several classes) by origin. Based on their origin, vaccines are divided into:

live, which are made from living but weakened microorganisms;
killed, created on the basis of microorganisms inactivated by various methods;
vaccines of chemical origin (based on highly purified antigens);
vaccines that are created using biotechnological techniques are, in turn, divided into:

Synthetic vaccines based on oligosaccharides and oligopeptides;

DNA vaccines;

Genetic engineering vaccines created on the basis of products resulting from the synthesis of recombinant systems.

3. In accordance with the Ags included in the preparations, there is the following classification of vaccines (that is, Ags may be present in vaccines):

whole microbial cells (inactivated or live);
individual components of microbial bodies (usually protective Ags);
microbial toxins;
synthetically created microbial Ags;
Yeah, that are obtained using genetic engineering techniques.

Depending on the ability to develop insensitivity to several or one agent:

monovaccines;
polyvaccines.

Classification of vaccines according to the Ag set:

component;
corpuscular.

Live vaccines

To produce such vaccines, weakened strains of infectious agents are used. Such vaccines have immunogenic properties, but, as a rule, they do not cause symptoms of the disease during immunization.

As a result of the penetration of a live vaccine into the body, stable cellular, secretory, and humoral immunity is formed.

Advantages and disadvantages

Advantages (classification, application discussed in this article):

minimum dosage required;
the possibility of various methods of vaccination;
rapid development of immunity;
high efficiency;
low price;
immunogenicity is as natural as possible;
there are no preservatives in the composition;
under the influence of such vaccines, all types of immunity are activated.

Negative sides:

if the patient has a weakened immune system when a live vaccine is administered, the disease may develop;
vaccines of this type are extremely sensitive to temperature changes, and therefore, when a “spoiled” live vaccine is administered, negative reactions develop or the vaccine completely loses its properties;
the impossibility of combining such vaccines with other vaccine preparations, due to the development of adverse reactions or loss of therapeutic effectiveness.

Classification of live vaccines

The following types of live vaccines are distinguished:

Attenuated (weakened) vaccine preparations. They are produced from strains that have reduced pathogenicity, but pronounced immunogenicity. When a vaccine strain is introduced, a semblance of an infectious process develops in the body: infectious agents multiply, thereby causing the formation of immune reactions. Among such vaccines, the best known are drugs for the prevention of typhoid fever, anthrax, Q fever and brucellosis. But still, the main part of live vaccines are antiviral drugs against adenoviral infections, yellow fever, Sabin (against polio), rubella, measles, and influenza;
Vaccines are divergent. They are made on the basis of strains related to pathogens of infectious pathologies. Their antigens provoke the occurrence of an immune response that is cross-directed to the antigens of the pathogen. An example of such vaccines is the prophylactic vaccine against smallpox, which is made on the basis of the cowpox virus and BCG, based on the mycobacteria that cause bovine tuberculosis.

Flu vaccines

Vaccines are the most effective way to prevent influenza. They are biological preparations that provide short-term resistance to influenza viruses.

Indications for such vaccination are:

age 60 years and older;
bronchopulmonary chronic or cardiovascular pathologies;
pregnancy (2-3 trimesters);
staff of outpatient clinics and hospitals;
persons permanently residing in closed groups (prisons, hostels, nursing homes, etc.);
patients undergoing inpatient or outpatient treatment who have hemoglabinopathies, immunosuppression, pathologies of the liver, kidneys and metabolic disorders.

Varieties

The classification of influenza vaccines includes the following groups:

Live vaccines;
Inactivated vaccines:

whole virion vaccines. Includes undegraded, highly purified inactivated virions;
split (split vaccines). For example: "Fluarix", "Begrivac", "Vaxigrip". Created on the basis of destroyed influenza virions (all proteins of the virus);

Subunit vaccines (Agrippal, Grippol, Influvac) contain two viral surface proteins, neuraminidase and hemagglutinin, which ensure the induction of an immune response in influenza. Other proteins of the virion, as well as the chicken embryo, are absent, as they are eliminated during purification.

All kinds of viruses and infections invariably take first place among the causes of illness. The consequences of viral and infectious diseases can be quite severe. That is why developed countries of the world pay great attention to the prevention of infectious diseases. Unfortunately, in the arsenal of modern medicine there are few methods that can effectively protect the body from infections. The main weapon in the arsenal of modern medicine is preventive vaccination, or vaccination.

What is included in vaccines and how do they protect people from diseases?

The truth was born in a dispute

The word vaccine comes from the Latin word vacca, meaning cow. In 1798, the English doctor Edward Jenner performed the first medical vaccination: he injected the contents of cow pock into an incision on the skin of an eight-year-old boy. Thanks to this, the child did not get smallpox.

At the beginning of the twentieth century, Russian scientist Ilya Mechnikov described his scientific experiment: he stuck a rose thorn into a starfish, and after a while the thorn disappeared. This is how phagocytes were discovered - special cells that destroy biological particles foreign to the body.

The German scientist Paul Ehrlich argued with Mechnikov. He argued that the main role in protecting the body does not belong to cells, but to antibodies - specific molecules that are formed in response to the introduction of an aggressor.

This scientific debate is directly related to the study of the mechanism immunity (from lat. immunitas - liberation, getting rid of something). In short, immunity is the body's immunity to infectious agents and foreign substances. Irreconcilable scientific rivals Metchnikoff and Ehrlich shared the 1908 Nobel Prize in Physiology or Medicine. Both turned out to be right: phagocytes are a component of innate immunity, and antibodies are acquired, which arises as a result of a previous disease or the introduction of a vaccine into the body.

Immunity vaccination

The effect of vaccination is based on the fact that the human body, when antigenic “strangers” penetrate, produces antibodies to them - that is, it forms acquired immunity, thanks to which the body prevents the proliferation of “enemy” cells in the body. The main active component of the vaccine - the substance used for vaccination - is an immunogen, that is, structures similar to the components of the pathogen responsible for the production of immunity.

The discovery of the vaccination method has allowed humanity to achieve incredible results in the fight against infections. Polio, smallpox, scarlet fever, and measles have practically disappeared from the world; the incidence of diphtheria, rubella, whooping cough and other dangerous infectious diseases has been reduced thousands of times. Vaccinations against some diseases provide lifelong immunity, which is why they are given in the first years of a child’s life.

When choosing a vaccine - for example, for vaccination against the influenza virus - you should not focus solely on imported goods as being of higher quality and “environmentally friendly”. All vaccines, regardless of the country of their production, contain preservatives. An indication of the need for their presence is contained in WHO recommendations. The purpose of preservatives is to ensure the sterility of the drug in the event of microcracks on the packaging during transportation and storage of the opened primary multi-dose package.

Experts believe that vaccinations are useful for the child’s immune system as a kind of “additional information”.

From the fourth day of life until four or five years, the child’s body is in a physiological state of “immunological learning,” that is, it collects maximum information about the microbial and antigenic (that is, genetically alien) world around it. The entire immune system is tuned to this learning process, and vaccinations as an option for “giving information” are much easier to tolerate and turn out to be more effective than at a later time. Some vaccinations (for example, against whooping cough) can only be given before the age of 3 years, since then the body will react too violently to the vaccine.

Long-term observations have shown that vaccination is not always effective. Vaccines lose their quality if stored improperly. But even if the storage conditions are met, there is always a possibility that immunity will not be stimulated. There is no “response” to the vaccine in 5-15% of cases. Be careful! Opponents of vaccinations should remember that the consequences of viral infections can be much more serious than just “childhood” diseases.

For example, after measles, the likelihood of developing type 1 diabetes mellitus (insulin-dependent) is quite high, and a complication of rubella can be severe forms of encephalitis (inflammation of the brain).

What are we vaccinated with?

The effectiveness of vaccination depends on two components: the quality of the vaccine and the health of the person being vaccinated. The question of the necessity and usefulness of vaccinations is considered controversial today. Article 11 of the Russian Federation Law on Infectious Diseases states that vaccination is completely voluntary, based on awareness of the quality and origin of the vaccine, all the advantages and possible risks of vaccination. Children under 15 years of age can only be vaccinated with parental permission. A doctor has no right to order, a doctor can only recommend.