Immune system, Vaccination and herd

immunity
The Immune system

1- Innate Immune System :

First-line defense: physical and chemical barrier
The first-line defense includes barriers to infection, such as skin
and mucus coating of the gut and airways.

Second-line defense:
Phagocytic cells
phagocytic cells (Myeloid cells) (macrophages and neutrophil
granulocytes) can destroy (phagocytose) foreign substances.
Phagocytosis involves digestion of the bacterium by using
enzymes.

2- The Adaptive Immune system:

A- Humoral immune system: -> acts against bacteria and viruses
using immunoglobulins (also known as antibodies) -> produced by
B cells.
B- Cellular immune system: -> destroys intracellular pathogens
(such as virus-infected cells and mycobacteria causing
tuberculosis) using T cells (also called "T lymphocytes"; "T" means
they develop in the thymus).

Active Immunity
A- Protection produced by the person's own immune system
B-Usually permanent.

Passive Immunity
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A- Protection transferred from another person or animal

B-Temporary protection that wanes with time

Antigen
A live or inactivated substance (e.g., protein,
polysaccharide) capable of producing an immune
response

Antibody

Protein molecules (immuno-globulin) produced by B

lymphocytes to help eliminate an antigen

Passive Immunity

Transfer of antibody produced by one human or

other animal to another

Temporary protection
Transplacental most important source in infancy

Vaccination
Vaccination is a method of giving antigen to stimulate the
immune response through active immunization.
A vaccine is an immuno-biological substance designed to
produce specific protection against a given disease.
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 A vaccine is antigenic but not pathogenic.

Immunity and immunologic memory similar to natural
infection but without risk of disease

Types of vaccines
Live vaccines
Attenuated live vaccines
Inactivated (killed vaccines)
Toxoids
Polysaccharide and polypeptide (cellular fraction) vaccines
Surface antigen (recombinant) vaccines.

Live vaccines
Live vaccines are made from live infectious agents without
any amendment.
The only live vaccine is Variola small pox vaccine, which is
not pathogenic but antigenic, giving cross immunity for
variola.
Polysaccharide and polypeptide (cellular fraction) vaccines
They are prepared from extracted cellular fractions e.g.
meningococcal vaccine from the polysaccharide antigen of
the cell wall, the pneumococcal vaccine from the
polysaccharide contained in the capsule of the organism,
and hepatitis B polypeptide vaccine.
Their efficacy and safety appear to be high.
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Surface antigen (recombinant) vaccines.

It is prepared by cloning HBsAg gene in yeast cells where it
is expressed. HBsAg produced is then used for vaccine
preparations.
Their efficacy and safety also appear to be high.
Barriers to Immunizations Coverage:
Improving immunization coverage requires examination of
reasons that children are not immunized. Many barriers
exist. They include religious, financial, social, and cultural
factors; philosophical objections; and provider limitations.

Global Trends:
During ht last several decades, substantial progress has
been made in controlling some major infectious diseases
around the world, although other diseases have not been
managed as well. The following are some of the major
accomplishments:
The WHO's Expanded Program on Immunization (EPI) was
launched in 1974. as a result, by 1995, more than 80% of
the world's children had been immunized against diphtheria,
tetanus, whooping cough, poliomyelitis, measles, and TB,
compared with fewer than 5% in 1974 (WHO, 1998)
Global eradication of smallpox was achieved in 1980.
In 1988, a campaign for global eradication of poliomyelitis by
the year 2000 was launched. Reported cases worldwide have
declined by 99% since the campaign began.

 The global threat of plague has declined in the last 40 years,

largely as a result of the use for antibiotics and insecticides.
Some major problem communicable diseases and areas
remain, including the following:
Malaria remains a major threat, even though the mortality
rate has improved in the last 25 years.
Cholera was mainly confined to Asia in the early 20th
century through improvements in sanitation elsewhere.
However, a series of pandemics have affected much of the
world since 1960 and have become more widespread and
more frequent in Africa since 1970s.
TB has made a powerful resurgence in the last 3 decades as
many countries let their control programs become
complacent. WHO declared TB a global emergency in 1993.

Disease Control :
The term disease control describes ongoing operations aimed
at reducing:
The incidence of disease
The duration of disease and consequently the risk of
transmission
The effects of infection, including both the physical and
psychosocial complications
The financial burden to the community.
Control activities focus on primary prevention or secondary
prevention, but most programs combine both.

Disease Elimination
Between control and eradication, an intermediate goal has
been described, called "regional elimination"
The term "elimination" is used to describe interruption of
transmission of disease, as for example, elimination of
measles, polio and diphtheria from large geographic regions
or areas
Regional elimination is now seen as an important precursor
of eradication

Disease Eradication
It is the process of Termination of all transmission of
infection by extermination of the infectious agent through
surveillance and containment.
Eradication is an absolute process, an "all or none"
phenomenon, restricted to termination of an infection from
the whole world. It implies that disease will no longer occur
in a population.
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 To-date, only one disease has been eradicated, that is smallpox.

Herd Immunisation

immunisation against various deadly diseases is an

important preventive measure which the doctors recommend
right from the birth. Behind the program schedule of
vaccination there is a definite science and policy and such
preventive measures help in the long run to protect the
whole human community from diseases and infections.
When non immunized people live with community of people
who are immunized they are indirectly protected from
getting inflicted from any disease.
This is called as herd immunity or community immunity.
According to herd immunity theory when sufficient amount
of people in a particular group or community is immune to a
certain type of disease, it acts as a barrier for other non

immunized people as well. Due to this people who are not

vaccinated too are protected.
High herd immunity reduces the probability that the few
unimmunized parsons will come in contact with one another,
making spread of the disease less likely. Outbreaks may
occur if the immunization rate falls to less than 85%
(scutchfield & Keck, 2001) or if unimmunized susceptible
persons are grouped together rather than dispersed
throughout the immunized community. An example of lack of
herd immunity is presented in the Global Community.