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Vaccines

See Childhood vaccinations

See Vaccination in adults

Before 2020, the average time from conception of a vaccine to licensure was 10 to 15 years; the shortest time was four years for mumps.
The development of a vaccine for coronavirus disease,Covid-19, was done in 11 months.
The process of immunization immunization can be active or passive.
Active immunization follows the administration of vaccines or toxoid that stimulate the body’s immune system to produce antibodies or cell mediated immunity, or both.
Use a vaccination is a powerful method for disease prevention, relevant to people of all ages and in all countries.

Vaccines provide protection in a far safer way than natural infections: they generally do not cause the diseases they protect against and severe adverse effects are significantly less common than complications from natural infections.

Four vaccine preventable illnesses have been eliminated from the Americas: smallpox in 1971, polio in 1994, and rubella and congenital rubella syndrome in 2015.
Vaccination has eliminated smallpox in 1980.
Viral or bacterial vaccines can be attenuated live or inactivated micro organisms or parts of an organism, plain polysaccharide or polysaccharide conjugated to a protein, modified toxins produced by bacteria, or genetically engineered.
Passive immunization allows temporary protection with exogenously  produced antibody administered for protection against a specific disease or by transplacental transfer of maternal antibodies of a fetus.
Categories of immunizing agents include vaccines, toxoid, antibodies containing standard or hyperimmune preparations, and monoclonal antibodies.
Standard immune globulins can be derived from human or animal donors and provide broader protection than do  disease specific monoclonal antibody preparations.
Adjuvants enhance the immune response and consists of various aluminum salts.
Other adjuvants include licensed vaccines for hepatitis B, human papillomavirus, zoster virus and some influenza vaccines.

Have led to the eradication of smallpox, the reduction of worldwide polio incidence by 99%, the control of measles, with a 74% decline in global measles deaths since 2000.

In the US between 50,000 and 90,000 adults day each year from pneumococcal disease, influenza, and hepatitis B infection, highlighting the need for adult vaccinations.

Vaccines may have nonspecific effects that affect morbidity and mortality from non-targeted diseases.

Vaccine coverage estimates the number of people who have received vaccines.

Vaccine refusal has been associated with outbreaks of invasive Heamophilus influenza type B disease, varicella, pneumococcal disease, measles, and pertussis.

In 2013 national vaccine coverage was 91.9% for one dose or more of measles, mumps, and rubella vaccine, and 83.1% for four doses of more of diphtheria, tetanus, and acellular pertussis vaccine.

There are four main categories vaccines: live attenuated, inactivated, vaccine based on an organism component such as a subunit, recombinant, polysaccharide, congugate and toxoid.
Newer vaccine types are DNA/RNA vaccines.

Attenuated vaccines are created by weakening of virus with bacterium, such that it still replicated induces immune responses but there’s not cause disease in an immuno competent person.

Live vaccines such as measles, and BCG vaccination have non specific beneficial effects, reducing nontargeted morbidity and mortality.

Live-attenuated vaccines should not be administered to pregnant women or most immunocompromise people due to the fact that live vaccines could cause harm by causing disease attributable to the vaccine.

Inactivated vaccines, such as diphtheria-tetanus-pertussis, and activated poliovirus vaccine and hepatitis B vaccine have been associated with increased morbidity and mortality in girls.Pertussis immunity at least in children and adolescents, is significantly shorter than the standard 10 year interval.

The disease specific protection of different vaccines are additive and they are not affected by the sequence in which the vaccines have been administered.

The nonspecific effects of vaccines are largely determined by the most recent administered vaccine.

The administration of measles vaccine as the most recent vaccine after receipt of DPT vaccine is associated with decreased mortality.

Receiving and inactivated vaccine as the most recent vaccination after measles vaccine is associated with increased mortality among girls.

Live virus vaccines are generally contraindicated in immunolocompromised patients: That includes patients with HIV, those with active malignancies receiving chemotherapy, and those receiving immunosuppressive drugs or corticosteroids.

Vaccination during pregnancy is an important strategy to protect infants from life-threatening infections during the first months of life.

Influenza vaccine is administered to protect mothers during pregnancy and infants after birth, while vaccines protecting against pertussis, Group B streptococcus, and respiratory syncytial virus mainly target infants.

The period in pregnancy or infancy associated with the highest window of susceptibility to infection targeted by vaccination depends on the targeted pathogen.

Influenza disease is most severe in the third trimester of pregnancy, while pertussis is most severe in infancy during the first few weeks of life.

Trivalent formulation of the influenza vaccine protects against H1N1 and H3N2 influenza A strains and one influenza B strain.

Quadrivalent vaccines protect against a second influenza B strain.

Fluzone at high dose for persons age 65 years or older and the Fluad trivalent formulation are more effective than standard dose trivalent formulations.

Vaccination during pregnancy increases the transplacental transfer of maternal vaccine specific antibodies to newborns with the potential to protect infants from vaccine preventable diseases until they are no longer at increased risk for infection or are protected by their own active immunization.

Shingrix, a herpes zosrer vaccine contains a specific protein subunit of the virus (recombinant glycoprotein E) with a novel adjuvant.

Heplisav-B , A single antigen combination hepatitis B vaccine with the novel adjuvant.

Routine annual influenza vaccine is recommended for all persons age 6 months or older without contraindication.

Antibacterial drugs should not be given within three days of a dose of live oral typhoid or 14 days prior to oral cholera vaccine.

Typhoid vaccine is indicated all travelers to the Indian subcontinent.

Anaphylactic egg allergy precludes the administration of MMR and yellow fever.

Varicella is highly contagious and primarily a disease of adolescents and young adults in non-industrial countries.
Two doses of varicella vaccine administered four weeks apart are considered for travelers.
Adults born before 1980 in the US or considered immune to varicella.
Zoster vaccine, recombinant tape, should be given to all adults age 50 years and older.
Pneumococcal vaccine should be administered to those age 65 years or older where sequential doses of PCV 13 and PPSV 23.

 

The PCV13 vaccine is no longer recommended for routine vaccination in immunocompetent adults.

 

The PCV13 vaccine is recommended for: 

 

Immunocompromised adults aged 19 years or older

 

Adults with immunocompromising conditions, cerebrospinal fluid leak, or cochlear implant.

 

Immunocompetent adults aged 65 years or older

Hepatitis A vaccine is indicated for every nonimmune traveler to countries in areas with moderate to high risk of infection, and includes essentially every destination other than the United States, Canada, Japan, Australia, New Zealand, Scandinavia, and developed countries in Europe.

 

A single dose of hepatitis A vaccine is given before travel.

 

Halloween the initial vaccination two additional appropriate doses should be administered.

 

Hepatitis A and hepatitis B vaccine should be administered separately.

 

Hepatitis B vaccine has reduce the rates of infection in many countries but also is the first vaccine to reduce cancer risk.

 

Haemophilus influenza type B disease incidence has fallen dramatically with the use ofHaemophilus influenza type B vaccine.

 

Side Effects From the COVID-19 Vaccine most commonly reported symptoms were headache (22.4%), fatigue (16.5%), and dizziness (16.5%).

 

More women than men report side effects from Covid-19  vaccine.

In a large population based study, vaccination of pregnant individuals with mRNA Covid-19 vaccine was not associated with increased risks of neonatal adverse events in their infants (Norman M).

 

More women report side effects from the vaccine, may be due to their immune system being more reactive.

 

More women report side effects from the  flu vaccine.

 

In a 2019 study published in the Journal of Allergy and Clinical Immunology that analyzed cases of anaphylaxis after vaccination from 1990 and 2016 found that women made up 80% of all anaphylactic reactions to vaccines in adults.

 

 

 

 

 

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