There are vaccines. Types of vaccines, their classification and methods of administration

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. Vaccine development became possible when scientists learned to cultivate pathogens of various dangerous diseases in a laboratory. And the variety of ways to create vaccines provides their varieties and allows them to be grouped according to manufacturing methods.

Types of vaccines:

• Living weakened(attenuated) - where the virulence of the pathogen is reduced different ways... Such pathogens are cultivated in unfavorable environmental conditions for their existence and, through multiple mutations, lose their initial degree of virulence. Vaccines on this basis are considered the most effective. Attenuated vaccines give a long-term immune effect. This group includes vaccines against measles, smallpox, rubella, herpes, BCG, poliomyelitis (Sabin vaccine).
• Killed- contain pathogens of microorganisms killed in different ways. Their effectiveness is lower than that of attenuated ones. Vaccines obtained by this method do not cause infectious complications, but can retain the properties of a toxin or allergen. Killed vaccines have a short-term effect and require re-immunization. This includes vaccines against cholera, typhoid, whooping cough, rabies, polio (Salk vaccine). Also, such vaccines are used to prevent salmonellosis, typhoid fever, etc.
• Antitoxic- contain toxoids or toxoids (inactivated toxins) in combination with an adjuvant (a substance that enhances the effect of individual components of the vaccine). A single injection of this vaccine helps protect against multiple pathogens. This type of vaccine is used against diphtheria, tetanus.
• Synthetic- an artificially created epitope (a part of an antigen molecule that is recognized by agents of the immune system), connected to an immunogenic carrier or adjuvant. These include vaccines against salmonellosis, yersiniosis, foot and mouth disease, influenza.
• Recombinant- virulence genes and genes of a protective antigen (a set of epitopes that cause the strongest immune response) are isolated from the pathogen, the virulence genes are removed, and the gene of the protective antigen is injected into a safe virus (most often the vaccinia virus). This is how vaccines are made against influenza, herpes, and vesicular stomatitis.
• DNA vaccines- The plasmid containing the protective antigen gene is injected into the muscle, in the cells of which it is expressed (converted into the final result - protein or RNA). This is how vaccines against hepatitis B were created.
• Idiotypical(experimental vaccines) - Instead of an antigen, anti-idiotypic antibodies (antigen simulators) are used, which reproduce the desired configuration of the epitope (antigen).

Adjuvants- Substances that supplement and enhance the action of other constituents of the vaccine provide not only a general immunostimulating effect, but also activate a type of immune response specific for each adjuvant (humoral or cellular).

• Mineral adjuvants (alum) enhance phagocytosis;
• Lipid adjuvants - cytotoxic Th1-dependent type of immune response (inflammatory form of the T-cell immune response);
• Virus-like adjuvants - cytotoxic Th1-dependent type of immune system response;
• Oil emulsions (liquid paraffin, lanolin, emulsifiers) - Th2- and Th1-dependent type of response (where thymus-dependent humoral immunity is enhanced);
• Nanoparticles in which the antigen is incorporated are Th2- and Th1-dependent response types.

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

Vaccines- it medications that have, like any other medicine, contraindications and side effects. In this connection, there are a number of rules for the use of vaccines:

• Preliminary skin testing;
• The state of human health 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 harmlessness of the components that make up their composition;
• For each vaccine, the administration schedule is observed (frequency of vaccination, season for its administration);
• The dose of the vaccine and the interval between the time of its administration are maintained;
• There are routine vaccinations or vaccinations for epidemiological indications.

Adverse reactions and complications after vaccination:

• Local reactions- hyperemia, tissue edema 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, poliomyelitis associated with the vaccine, and others);
• Nonspecific complications- immediate reactions (edema, cyanosis, urticaria), allergic reactions(including Quincke's edema), proteinuria, hematuria.

requirements for vaccines.

Safety is the most important property of the vaccine, it is carefully researched and monitored in

the production and use of vaccines. The vaccine is safe if given to humans

does not cause the development of serious complications and diseases;

Protectiveness - the ability to induce specific protection organism against

a certain infectious disease;

The duration of the 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;

Ease of introduction.

Types of vaccines:

Live vaccines are made on the basis of attenuated strains of a microorganism with genetically fixed avirulence. The vaccine strain, after administration, multiplies in the body of the vaccinated and causes the vaccine infectious process. In the majority of those vaccinated, the vaccine infection proceeds without pronounced clinical symptoms and leads to the formation of, as a rule, strong immunity. An example of live vaccines are vaccines for the prevention of poliomyelitis ( live vaccine Sabin), tuberculosis (BCG), mumps, plague, anthrax, tularemia. Live vaccines are available in freeze-dried (powdered)

form (except for polio). Killed vaccines are bacteria or viruses inactivated by chemical (formalin, alcohol, phenol) or physical (heat, ultraviolet radiation) exposure. Examples of inactivated vaccines are: pertussis (as a component of DTP), leptospirosis, influenza whole virion, 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, that is, causing the formation of protective immune reactions, antigens. For example, typhoid fever vaccine, meningococcal vaccine.

Toxoids. These drugs are bacterial toxins, rendered harmless

formalin exposure to elevated temperature(400) for 30 days, followed by purification and concentration. Toxoids are sorbed on various mineral adsorbents, for example, on 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

the action of a sorbent that causes local inflammation, an increase in the plasmacytic reaction in regional lymph nodes Toxoids are used to prevent tetanus, diphtheria, staphylococcal infections.

Synthetic vaccines are artificially created antigenic determinants of microorganisms.

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

Genetically engineered vaccines. The essence of the method: the genes of a virulent microorganism responsible for the synthesis of protective antigens are inserted into the genome of any harmless microorganism, which, upon cultivation, produces and accumulates the corresponding antigen. An example is a recombinant vaccine against viral hepatitis B, rotavirus vaccine.

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 from plasmid (extra-nuclear) DNA encoding antigens of pathogens are being intensively developed infectious diseases... The idea behind such vaccines is to insert the genes of a microorganism responsible for the synthesis of a microbial protein into the human genome. In this case, human cells do not have the production of this protein foreign to them, and the immune system will develop antibodies to it. These antibodies will neutralize the pathogen if it enters the body.

71Poet vaccine immunity. Factors influencing its development Methods of determination

tension of post-vaccination immunity. The value of herd immunity, methods of its assessment.

Post-vaccination immunity - the immunity that develops after the administration of the vaccine. On the development of post-vaccination immunSH "PYARUOT<эдду»ОЩ)Кф|КТОры: Dependent on the vaccine itself

The quality of the drug,

The presence of protective antigens,

Multiplicity of introduction

organism-dependent

the state of the individual immune reagppnost; age,

the presence of immunodeficiency, the state of the body as a whole depends on the external environment nutrition,

working and living conditions, flora and fauna,

physical and chemical factors of the environment

Methods for monitoring the effectiveness of post-vaccination immunity

To assess the state of artificial post-vaccination immunity, the following methods are used

Serological tests with vaccinated sera, immunological skin tests, allergic skin tests

Assessment of the state of immunity in the population is carried out mainly to infections controlled by means of specific prophylaxis - whooping cough, measles, paratitis, diphtheria and tetanus There are effective vaccines against these infections.In addition, the effectiveness of immunization and the state of collective immunity to influenza, poliomyelitis, tuberculosis is selectively monitored. tularemia, brucellosis and other infections

To control the state of immunity, highly specific and, at the same time, harmless methods are used that are available for mass examination. finger, 1.5 ml - 0.75 ml of serum Each serum sample is tested for the presence of antibodies to various pathogens Indicators of immunological protection are titers of antibodies to diphtheria and tetanus 1 20 to measles -1 4

To detect immunity to pertussis, RA is put, protective antibody titer 1 100 Data on seronegative individuals who do not have protective antibody titer are transferred to the polyclinic for the development of individual immunization regimens

The state of immunity to influenza viruses RTGA (hemogglutination inhibition reaction) is also constantly monitored. Protective antibody titer 1 20 in PITA. Selective control of immunity to poliomyelitis in children is also carried out using the neutralization reaction (pH) of the virus with antibodies in serum on cell culture. antibodies 1 16 - tense immunity To control immunity to diphtheria in children's groups (for epidemiological indicators or dubious quality of vaccinations), the Shick immunological test is also used - intradermal administration of a minimum dose of diluted diphtheria toxin If there is a sufficient titer of antibodies (antitoxin) in the blood, the injected toxin neutralized and the skin reaction is absent The effectiveness of the vaccine prophylaxis of tularemia is also monitored by setting a skin-allergic test about tularin, with a negative test, there is no immunity. unit to tuberculosis Since 1984, a new allergen-tetanin has also been used to perform a skin-allergic test in order to monitor the state of immunity to tetanus Conducting immunological monitoring of the effectiveness of vaccine prophylaxis allows us to assess the actual protection against this infection and the quality of vaccination work and, if necessary

72. Passive immunoprophylaxis - the creation of immunity through the introduction of serum preparations and

gamma globulin;

Serum preparations - contain ready-made antibodies. Depending on the purpose, they are divided into

therapeutic and prophylactic and diagnostic, from the degree of purification - to serum,

polyglobulin and gamma globulin preparations, by origin - from animals and

human; the latter are subdivided into donor and placental.

For the manufacture of serum preparations, three methods are currently used:

1. Immunization of animals in order to obtain polyvalent sera, i. E. containing antibodies to both specific and group antigens of the immunizing microbe. Such sera are often given so-called. group serological reactions. Therefore, to improve their specificity, antibodies to group antigens are adsorbed from them:

2. Obtaining monoclonal antibodies produced after immunization of an animal with individual plasma cells, "fused" with cells of certain tumor lines. Such a hybridoma has a combined genome: from a plasma cell, it inherits the ability to produce certain antibodies, from a tumor cell - the ability to multiply for a long time. The purpose of hybridomas is long-term production of antibodies of the same specificity.

3. Obtaining serum from people who have previously been ill or vaccinated and therefore have certain titers of antibodies, as a rule, to pathogens of various infectious diseases. Sera are obtained either from donors or from a mixture of placental blood. They, as a rule, contain antibodies to the measles virus, and antibodies to staphylococci, streptococci, Escherichia, Proteus, Pseudomonas, influenza pathogens, whooping cough, poliomyelitis, and infectious hepatitis in varying amounts.

Treatment-and-prophylactic serum preparations are used to create an artificial

passive immunity in emergency prevention and immunotherapy of the following diseases:

staphylococcal infections - antistaphylococcal human plasma or antistaphylococcal

human immunoglobulin;

whooping cough - normal human immunoglobulin;

influenza - donor gammaglobulin;

measles, normal human immunoglobulin;

poliomyelitis - normal human immunoglobulin;

hepatitis A - normal human immunoglobulin;

tetanus - antitoxic horse serum or (in individuals allergic to horse protein) -

pro-tetanus antitoxic human immunoglobulin (from vaccinated donors);

anaerobic wound infections - antigangrenous (antiperfringens A, antiedematieno,

antisepticum) horse serum;

botulism - antibotulinic A, B, C. horse serum;

diphtheria - antitoxic horse serum;

rabies - equine rabies gamma globulin and human serum immunoglobulin,

vaccinated against rabies

73 Herd immunity - population immunity

Determined by:

The number of those who have recovered

The number of people vaccinated against this infection

Immune layer number of persons (%) in the population,

Immune to this disease.

The higher this indicator, the higher

Herd immunity level.

Relevant for:

Epidemiological process forecasting

Immunization planning

Assessment of the quality of immunoprophylaxis

74.ALLERGY (from the Greek.allos - another) - a form of the immune response, specific hypersensitivity of the body to an allergen (antigen) as a result of an inadequate response of the immune system to repeated contact with the allergen, resulting in tissue damage.

Currently, mankind knows of such types of vaccines that help prevent the development of dangerous infectious diseases and other pathologies. The injection can help the immune system build up resistance to certain types of diseases.

Vaccine subgroups

There are 2 types of vaccinations:

• alive
• inactivated.

Live - they contain a mixture of strains of various weakened microorganisms. Loss of pathogenic properties is assigned to vaccine strains. Their action begins at the place where the drug was injected. When vaccinated with this method, strong immunity is created, which is able to maintain its properties for a long time. Immunopreparations with live microorganisms are used against the following diseases:

• pigs
• rubella
• tuberculosis
• polio.

There are a number of disadvantages of living complexes:

1. Difficult to dose and combine.
2. In case of immunodeficiency, it cannot be used categorically.
3. Unstable.
4. The effectiveness of the drug is reduced by the naturally circulating virus.
5. During storage and transportation, safety precautions must be observed.

Inactivated - or killed. They are specially grown using inactivation. As a result, damage to structural proteins is minimal. Therefore, treatment with alcohol, phenol or formalin is used. At a temperature of 56 degrees, the inactivation process takes place for 2 hours. Killed types of vaccines have a shorter duration of action than live types.

Advantages:

• lend themselves well to dosage and combination;
• vaccine-associated diseases do not occur;
• it is allowed to use them even with human immunodeficiency.

Flaws:

• a huge number of "ballast" components and others that are not able to participate in the creation of the body's defense;
• allergies or toxic effects may occur.

There is a classification of inactivated drugs. Biosynthetic - the second name is recombinant. They include genetic engineering products. Often used in combination with other drugs to strengthen immunity against several diseases at once. They are considered safe and effective. The most common injection is for hepatitis B.

Chemical - get antigens from a microbe cell. Use only those cells that can affect immunity. Polysaccharide and pertussis injections are chemical injections.

Corpuscular are bacteria or viruses that have been inactivated with formalin, alcohol, or exposure to heat. DTP vaccination and tetracoccus, injection against hepatitis A, influenza belong to this group.

All inactivated drugs can be produced in 2 states: liquid and dry.

The classification of vaccine complexes is carried out according to another principle. Distinguish depending on the number of antigens, that is, mono- and polyvaccines. Depending on the composition of the species, they are subdivided into:

• viral
• bacterial
• rickettsial.

Now they are developing at an accelerated pace:

• synthetic
• anti-idiotypic
• recombinant.

Anatoxins are produced from neutralized exotoxins. Usually, aluminum hydroxide is used to sorb toxoids. As a result, antibodies appear in the body that act against toxoid. As a result, their action does not exclude the penetration of bacteria. Toxoids are used against diphtheria and tetanus. 5 years is the maximum validity period.

DPT - diphtheria, whooping cough, tetanus

The characteristic of this injection is that it acts as a barrier to severe infections. The composition of the drug includes antigens that are able to form bodies that prevent the penetration of infection.

Varieties of DPT vaccine

DPT - adsorbed pertussis vaccination, diphtheria and tetanus. The injection helps to protect a person from the most dangerous diseases. They begin to vaccinate at a very young age. The body of babies cannot cope with the disease on its own, so they need to be protected. The first injection is given at 2 or 3 months. When vaccinating with DPT, the reaction can be different, which is why some parents are wary of doing it. Komarovsky: "The risk of complications after vaccination is much lower than in the event of complications from the emerging disease."

There are several certified immunotherapy options available. All of these varieties are approved by the World Health Organization. The DTP classification is as follows:

1. Whole cell vaccine - used for children who do not have serious illnesses. The composition contains a whole cell of a microbe, which is capable of showing a strong reaction to the body.
2. Acellular - weakened form. Used for babies if they are not allowed to use the full form. This category includes children who have already suffered from whooping cough, school-age children. In this case, there is no pertussis antigen in the injection. After vaccination, complications almost never occur.

Also, manufacturers are now offering different forms of the DTP drug. Their characteristics indicate that any one can be used without fear. What drugs do manufacturers offer?

1. Liquid form. Usually produced by a Russian manufacturer. For the first time, a child is vaccinated at 3 months. The subsequent vaccination is done in 1, 5 months.
2. Infanrix. Its advantage is that it can be used in combination with other vaccines.
3. IPV. This is the DPT vaccine with polio.
4. Infanrix hexa. It contains ingredients that help fight diphtheria, whooping cough, tetanus, hepatitis B, polio and Haemophilus influenzae.
5. Pentaxim. Vaccination with polio and hemophilus influenza. French vaccine.
6. Tetracoccus. Also a French suspension. It is used for the prevention of DPT and poliomyelitis.

Dr. Komarovsky: "I consider Pentaxim the safest and most effective vaccine, it is able to give a good answer to the disease."

.

Vaccination

Several types of vaccinations may be offered by different clinics. In this case, there are several ways of administration. You can choose any. Methods:

• intradermal
• subcutaneous
• intranasal
• enteral
• dermal
• combined
• inhalation.

Subcutaneous, intradermal and dermal are considered the most painful. When vaccinated in such ways, the integrity of the skin is destroyed. These methods are often painful. To reduce pain, a needleless method is used. Under pressure, the jet is injected into the skin or deep into the cells. Using this method, sterility is observed several times higher than with other methods.

Methods that involve not touching the skin are very fond of children. For example, the polio vaccine comes in the form of pills. When vaccinating against influenza, the intranasal route is used. But in this case, it is important to prevent leakage of the drug.

Inhalation is the most effective method. Helps to vaccinate a large number of people in a short time. This method of vaccination is not yet so widespread, but it may be used everywhere in the near future.

Vaccination is considered the only effective way to avoid infectious diseases and their complications. The vaccine can protect us from influenza, tuberculosis, measles, rubella, whooping cough. Vaccination saved all people from smallpox. What is so special about vaccination, and what kind of vaccines are there?

Vaccine is called a medicine that is able to create immunity to infectious diseases. In order for a vaccine to cause a reaction of the immune system, it is created from weakened or killed microorganisms, their metabolic products, or from their antigens obtained by genetic engineering or chemical means.

A bit of history

The history of vaccination dates back to the 18th century. In the midst of the smallpox epidemic, Edward Jenner concluded that people who had vaccinated with vaccinia were immune to smallpox. 100 years later, based on Jenner's work, Louis Pasteur made one of the most important discoveries in immunology: attenuated strains of diseases induce immunity to diseases themselves. Vaccines can be of different types, depending on the principle of their creation.

Live vaccines

Live vaccines are made using weakened strains of pathogenic microorganisms. In order to prevent the strain from infecting the body, it is weakened, made more harmless. When a weakened strain enters the bloodstream, it multiplies and triggers a response from the immune system. Thus, the person does not get sick, and the immunity to the disease is developed. But if the vaccine is administered to an immunocompromised person, serious problems can arise.

Corpuscular vaccines

To create them, either killed or strongly weakened viral particles (virions) are used.

Chemical vaccines

They are created from antigenic particles that are taken out of the microbe cell. An antigen is also called the manufacturer of antibodies, this is exactly the particle against which the body produces antibodies.

Recombinant (vector) vaccines

The creation of these vaccines was made possible by genetic engineering. The genetic material of the microorganism is inserted into the yeast. Yeast produces an antigen that is purified and used for a vaccine.

Toxoid

For the drug, an inactivated toxin (poison) is used, which is produced by the bacteria of the disease. The poison loses its toxicity, but the immune system notices it and produces antibodies. The vaccine should stimulate the production of antibodies in the body, which will prevent the development of disease when it penetrates.

Synthetic vaccines

With the help of modern technologies, antibodies to the disease are artificially created and introduced into the human body.

Associated vaccines (combination)

For their manufacture, several components are used at once. An example of an associated vaccine is DPT, tetanus, pertussis and diphtheria vaccine. But the vaccine may not always work as it should. The effectiveness of vaccination is influenced by:

• vaccine quality (dosage, shelf life);
• the patient's body (age, immunodeficiency, genetic predisposition);
• external factors (food, climate).

In Ukraine, a list of diseases was compiled against which mandatory vaccination is carried out. This list includes 9 infections: rubella, mumps, whooping cough, tuberculosis, diphtheria, poliomyelitis, tetanus, viral hepatitis B, measles.

Vaccines- immunobiological preparations intended for active immunoprophylaxis, that is, to create active specific immunity of the organism to a specific pathogen. Vaccination recognized by WHO as an ideal method for the prevention of human infectious diseases. High efficiency, simplicity, the possibility of wide coverage of vaccinated persons with the aim of mass prevention of the disease have brought active immunoprophylaxis in most countries of the world into the category of state priorities. The complex of measures for vaccination includes the selection of persons to be vaccinated, the choice of a vaccine preparation and the determination of the scheme of its use, as well as (if necessary) control of the effectiveness, relief of possible pathological reactions and complications. The following are used as Ag in vaccine preparations:

Whole microbial bodies (live or killed);
individual Ags of microorganisms (most often protective Ags);
microorganism toxins;
artificially created AG of microorganisms;
Ags obtained by genetic engineering.

Most vaccines divided into living, inactivated (killed, inanimate), molecular (toxoid), genetic engineering and chemical; according to the presence of a complete or incomplete set of Ar - into corpuscular and component ones, and according to the ability to develop immunity to one or several pathogens - into mono- and associated ones.

Live vaccines

Live vaccines- preparations from attenuated (weakened) or genetically modified pathogenic microorganisms, as well as closely related microbes capable of inducing immunity to a pathogenic species (in the latter case, we are talking about the so-called divergent vaccines). Since all live vaccines contain microbial bodies, then they are referred to the group of corpuscular vaccine preparations.

Immunization with live vaccine leads to the development of the vaccination process, which occurs in the majority of vaccinated without visible clinical manifestations. The main advantage of live vaccines is a completely preserved set of Ag of the pathogen, which ensures the development of long-term immunity even after a single immunization. Live vaccines also have a number of disadvantages. The most characteristic is the risk of developing an overt infection as a result of a decrease in the attenuation of the vaccine strain. Similar phenomena are more typical for antiviral vaccines (for example, a live polio vaccine in rare cases can cause poliomyelitis up to the development of spinal cord injury and paralysis).

Attenuated (attenuated) vaccines

Weakened ( attenuated) vaccines made from microorganisms with reduced pathogenicity, but pronounced immunogenicity. The introduction of a vaccine strain into the body mimics the infectious process: the microorganism multiplies, causing the development of immune reactions. The best known vaccines are for the prevention of anthrax, brucellosis, Q fever, and typhoid fever. However, most live vaccines- antiviral. The best known are the vaccine against the causative agent of yellow fever, Sabin's polio-myelitis vaccine, vaccines against influenza, measles, rubella, mumps and adenovirus infections.

Divergent vaccines

As vaccine strains are used by microorganisms that are closely related to the causative agents of infectious diseases. Ag of these microorganisms induce an immune response cross-directed to the Ag of the pathogen. The most famous and long-term used vaccine against smallpox (from the vaccinia virus) and BCG for the prevention of tuberculosis (from mycobacterium bovine tuberculosis).