Immunization; Definitions and Scope
Definition: A way to improve the immune someone actively against a Ag, so that when he exposed the Ag similar, the disease does not occur.
Specific immune system: Only can destroy foreign substances, known previously
Humoral:
Limfosit role of B or B Tuesday (Bursa Fabricius) where if Tuesday dirangsang B "plasma cells" substances or anti-anti-body "in the Ser Function: Defender of the infection of viruses, bacteria and toxins set.
Antibody:
1. IgG:
- The main components ig serum (75%)
- Can penetrate Placenta
- Formed in response to the secondary
- Anti-bacterial, anti-virus, anti-fungus
2. IgM:
- The largest Imunoglobulin
- The primary immune response
- Prevent the movement of microorganisms secondary
- Enable complement
3. IgA:
- Formation of mucous membrane skin-stimulus
- Immune from infection of breath, digestion, urogenitalis
- Complement fixation, antitoxin, aglutinasi reaction, anti-virus
4. IgD:
- Very low in circulation
- Function is not yet clear
5. IgE:
- Very few in number
- High on the allergy, complement fixation, worm infection, parasitic infection
Cellular
Limfosit the role of T cells or T, where T was formed Tuesday in the bone marrow "proliferation and differentiation occurs in the gland timus
Function: Defender of the bacteria (intraselular), viruses, fungi, parasites, violence
Comprising
1. Helper T cell-B cell help
1. Suppressor T-cell:
- Pursue B cells
- Pursue T cells
3. Cytotoxic T-cell: Menyerang antigens directly
Passive immunization Derived
Acquired immune from outside the body rather than by individuals themselves, for example, babies are immune from the mother after giving ig Resources serum protected short (2 - 3 weeks)
• Example:
- Gamma globulin, pure people - measles
- ATS, ADS, Anti-Rabies, Anti - Snake venom
- Profilaksi & therapeutic (treatment)
Reaction aktopik
There was a few minutes in which to Shock body weight, itching all over the body, where syringes urticaria "widespread, restlessness, pale, cyanosis, dyspnoe, convulsions" dead
Therapi: Adrenalin, Corticosteroid
Ser queenqueer
The shoots Period: 6 - 24 days
Fever, urticaria, exanthema, vomit, feces, the danger urticaria (oedem) glottis "choking.
Therapi: Adrenalin, Corticosteroid, Anti Histamin
Giving to II (replay)
1. Ana phylactic reaction:
The period of shoot: Several minutes - 24 hours
Symptoms: Same reaction atopik -
2. Accelerated Reaction:
The period of the shoot: 1 - 5 days
Symptoms: Same serum queenqueer "Giving serum - first test
Test of serum
1. Skin test: 0.1 ml exclamation 1 / 10 - intra kutan waiting 15 minutes, "infiltrat> 10 mm
2. Eye test: 1 drop of serum, and wait 15 minutes: + "eyes swollen red
When the skin or eye test and positive "the Ser: How Bersedka
- 0,1 ml serum in 1 ml physiological saline water - Subkutan - waiting ½ hour reaction
- 0.5 ml serum in 1 ml physiological saline water - Subkutan - waiting ½ hour reaction
- The remaining serum "Intra Muskular
Immunization Goals
• Preventing the disease in certain someone
• Eliminate certain diseases in the population
Immunization success depends on factors:
1. Penjamu immune status:
• Having a specific Ab penjamu ® on the success of vaccination, eg:
- Measles in infants
- Kolustrum breastfeeding - IgA polio
• Maturasi imunologik: neonatus ® function makrofag else, the rate of complement else, the activation optonin else.
• formation of the Ag Ab specific results of vaccination less ® ¯ ® delayed until the age of 2 months.
• Immunization coverage as possible so that the immune simultaneously children, infants immunized
• Frequency of the disease, its impact on weight neonatus ® immunization can be given in neonatus.
• Status imunologik else (ie immune defisiensi) ® response to the vaccine less.
2. Genetic
in the human genetic immune response against certain Ag ® good, enough, the success of low ® vaccination is not 100%
4. the quality of the vaccine
a. way of giving, for instance, oral polio ® local and systemic immunity
b. Doses of vaccine
- Higher ® hamper the response, cause side effects
- Low ® does not stimulate cell imunokompeten
c. Frequency Giving
Secondary immune response ® on Tuesday efektor faster, higher production, higher afinitas. The frequency of which affect the immune response occurs. When the vaccine is given at a specific rate is still high Ab ® Ag dinetralkan by specific Ab ® does not stimulate cell imunokompeten.
d. Ajuvan: Him that improve the immune response against Ag
• Ag does not maintain a rapid loss
• Enabling cells imunokompeten
e. Type of vaccine
Vaccines cause life better immune response.
Content vaccine
1. ® virus antigens, bacteria
- The attenuated vaccines: polio, measles, BCG
- Dead vaccine: pertussis
- Eksotoksin: Toksoid, dipteri, tetanus
1. Ajuvan: aluminum compound
2. Liquid solvent: water, physiological saline fluid, culture network, eggs.
Things - things that damage the vaccine:
• Hot ® all vaccines
• sun ray ® BCG
• Freezing ® toxoid
• decontamination / antiseptic: soap
Immunization Schedule
• For uniformity
• Getting a good immune response ® Based on the epidemiological situation, the priority of the causes of death, pain
IMUNISASI BCG
BCG vaccine does not prevent someone can be spared from infection M. tuberculosa 100%, but can prevent further spread of the disease, Derived from bacteria that live attenuated (Pasteur Paris 1173 P2), found by Calmette and Guerin
• Assigned before the age of 2 months Disuntikkan intra kutan in the region insertio m. deltoid with a dose of 0.05 ml, the right
• reset Immunizations are not required, the success of doubt
BCG vaccine dry powder form must be reconstituted with 4 cc NaCl 0.9%. After reconstitution should be used within 3 hours, and the rest discarded. Storage temperature 5 ° C shunt from the sun (day-light indoors).
How the injection of BCG
• Clean the arm with a cotton water
• Put the needle almost parallel with the arm children with a hollow needle tip facing upwards.
• 0.05 ml injections intra kutan
- Feel the resistance
- Benjolan with pale skin pores typical diameter of 4-6 mm
Why injection intra kutan?
• BCG vaccine ® layer of the skin as a storehouse chorium ® ® breed reactions indurasi, Natal, pustula
• After growing just enough sub kutan ® capillary, limfe gland, blood circulation
Infant skin, thin ® intra kutan difficult ® injection is too often in the (sub kutan)
Reaction after the immunization of BCG
1. Reaction normal local ®
• 2 weeks indurasi ®, Natal, and then to pustula
• 3-4 weeks ® pustula broken into ulkus (do not need treatment)
• 8-12 weeks ® ulkus a scar diameter of 3-7 mm.
2. Reaction in the regional gland
• It is the response of cellular defense body
• Sometimes there just in kelj axila and servikal (BCG-normal it is)
• Incurred 2-6 months after immunization
• gland berkonsistensi solid, no pain, fever (-)
• Will wane 1-3 months later without treatment.
Complications
1. Abses at the injection site
• Abses a quiet (cold abses) ® does not need therapy
• Because of the sub injection kutan
• Abses cooked ® aspirations
2. Limfadenitis supurativa
• Because of the sub kutan injection or high dose
• There was 2-6 months after immunization
• Special tuberkulostatik ® accelerate diminution.
Reaction in the once high TB:
• Koch phenomenon of engaging the local reaction ® running fast (2-3 days after immunization) ® 4-6 weeks arising scar.
• Immunization of infants 2 months tuberkulin ® test (Mantoux)
• To show what had contact with TB
• inject 0.1 ml of PPD in the region Flexor forearm in the intra kutan
• Reading is done after 48 - 72 hours of injecting
• indurasi diameter measured at the injection site.
• <5 mm: negative
• 6-9 mm: impeach
• 10 mm ³: positive
Mantoux test (-) immunization ® (+)
Kontraindikasi
• Response imunologik subject: HIV infection, immune def kongenital, leukemia, violence
• Response imunologik Film: kortikosteroid, cancer drugs, radiation
• god
Hepatitis B immunization
• The vaccine contains HBsAg pure
• Provide early as possible after birth
• Intra Muskular injections in the deltoid region, 0.5 ml dose.
• Storage of the vaccine in the temperature of 2-8 ° C
• Babies born from mothers HBsAg (+) imunoglobulin hepatitis B given 12 hours after birth, Hepatitis B immunization
• Dosage next two 1-month
• A third dose the next 5 months (age 6 months)
• Immunization retrial 5 years later
• The prevention of anti-HBsAg> 10mg/ml
• Production of Hepatitis B vaccine in Indonesia, the immunization program began in 1997
Side effects
• mild fever
• The malaise in the digestive
• Rekasi pain in the injection site
No kontraindikasi
IMUNISASI POLIO
• polio vaccine from the virus (type 1.2 and 3) the vaccine, made in Vero-cell culture: amino acids, antibiotics, in calf serum magnesium chloride and Phenol red
• Vaccine-shaped liquid packaging with 1 cc or 2 cc in the flacon, pipette.
• Giving the 2 drops of oral (0.1 ml)
• polio vaccine is given 4 times, intervals of 4 weeks
• Immunization retrial, 1 next year, primary school class I, VI
• Children ® interruption of the absorption of diarrhea vaccine.
• There are 2 kinds of vaccines
- IPV ® salk
- OPV ® ® IgA local sabin
• Storage on the temperature of 2-8 ° C
• Virus vaccine bertendensi mutation in the network culture and the body of the vaccine recipients
• few diekskresi virus mutation to polio virus back into savage neurovirulen that
• Paralisis occur 1 per 4.4 million vaccine recipients and 1 per 15.5 million contact with vaccine recipients
Contra indications: defisiensi imunologik or contact with
IMUNISASI DPT
Comprising
- Diphtheria toxoid vaccine poisons ®
- Bordittela ® pertussis bacteria are attenuated
- Tetanus toxoid vaccine poisons ® (+) and aluminum phosphate mertiolat
• It is a liquid vaccine. If taken a little hazy, white sediment didasarnya
• Assigned to the baby> 2 months because of reaktogenitas pertussis in a small baby.
• Dosage 0.5 ml in the intra muskular on the outside thigh.
• Immunization basic 3x, with intervals of 4 weeks.
• The vaccine contains aluminum phosphate, if given the sub kutan cause local irritation, inflammation and local nekrosis.
Reaction post-immunization:
• fever, pain in place of injections given 1-2 days ® anafilatik + antipiretik
• When there are excessive reactions to post-immunization ® fever> 40 ° C, convulsions, shock ® immunization further replaced with DT or DPaT
Kontraindikasi
• aberration n late neurologic grow flowers
• There is a history of convulsions
• disease degeneratif
• Participated in the previous DPT vaccine shows: anafilaksis, ensefalopati, convulsions, renjatan, hiperpireksia, weeping / cry great.
Measles immunization
From live virus vaccine (CAM 70 - Chick chorioallantonik membrane), which weakened + kanamisin sulphate eritromisin shaped frozen and dried, are dissolved in 5 cc aquades solvent.
• Assigned to the baby by the age of 9 months because there are antibodies obtained from the mother.
• Dosage 0.5 ml given sub kutan in the left arm.
• Kept in temperature of 2-8 ° C, can be up to - 20 degrees Celsius
• Vaccines have only be resistant to 8 hours at the temperature of 2-8 ° C
• If there are outbreaks, immunization can be given at the age of 6 months, 6 months and then repeated
Side effects: fever, diarrhea, konjungtivitis, rash after 7 - 12 days after immunization. Gen. encefalitis more rare
Kontraindikasi:
* Acute infection with fever, defisiensi imunologik, TX imunosupresif, allergic to egg protein, hipersensitifitas dng kanamisin and eritromisin, pregnant women.
* Children who have been given a transfusion of blood or imunoglobulin suspended at least 3 months.
* Tuberkulin test suspended for at least 2 months after measles immunization
IMUNISASI HIB
• To prevent infection by ssp because Haemofilus influenza type B
• Provide Original age 2-4 months, the children> 1 year given 1 times
• Vaccines in the form of freeze dried and 0.5 ml in the solvent semprit.
• Dosage 0.5 ml given IM
• Kept in temperature of 2-8 ° C
• In Asia has not given routinely
• routine immunization are given in the countries of Europe, the United States, Australia.
IMUNISASI MMR
The vaccine is a live vaccine consists of:
- Measles strain moraten (measles)
- Jeryl Lynn strain of mumps (parotitis)
- Rubela strain of RA (german measles)
• Assigned to the age of 15 months. Deuteronomy 12 years of age
• Dosage 0.5 ml in the sub kutan, provided at least 1 month after injection of immunization other.
Contra indications: pregnant women, imuno kompromise, less than the previous 2-3 months to get the blood transfusion or imunoglobulin TX, anafilaksis reaction to eggs
IMUNISASI TYPHUS
There are 2 types of vaccines:
- Injection (typhim) ®> 2 years
- Oral (vivotif) ®> 6 years, 3 doses
• Typhim (Capsular Vi polysaccharide-Typherix) with a given dose of 0.5 ml in the IM. Deuteronomy done every 3 years.
• Kept in temperature of 2-8 ° C
• No prevent Salmonella paratyphi A or B
• Immune occur within 15 days to 3 weeks after immunization
Reaction post-immunization: fever, mild pain, skin rash and sometimes Natal, where indurasi injection, daire, vomiting.
IMUNISASI varicella
Varicella vaccine (vaRiLrix) contains a live virus vaccine strain of the Oka. Can be given at age 1, age 12 years retrial. Vaccines are given in sub kutan storage in the temperature of 2-8 ° C
Kontraindikasi: fever or acute infection, hipersensitifitas against neomisin, pregnancy, TX imunosupresan, violence, HIV, TB is not TX, blood aberration.
Reaction immunization is very minimal, there is sometimes fever papulo and erupsi-vesikuler.
IMUNISASI Hepatitis A
Immunization is given in less exposed areas, children in the age of 2 years. 3x basic immunization in the month to 0, 1, and 6 months later. Doses of vaccine (Harvix-inactivated virus strain HM 175) 0.5 ml in the IM in the deltoid region. Yag reactions occur at least sometimes fever, lethargic, fatigue, nausea, vomiting, and appetite hialng
COMBO VACCINE
Combined single multiple antigens into one product type antigens to prevent the disease vary, for instance, DPT + hepatitis B + Hib or combined some of the flute multiple antigens derived from the same disease organisms, eg: OPV
Goal of
• The number of injections less
• The number of visits less
• More practical, compliance and increased coverage
• Addition of new immunization programs easy
• Immunization late easily be pursued
• Cost cheaper
Power protection
Titer antibody one of the antigens is lower but still above the threshold protektif. The same effectiveness in different immunization schedules. Can occur ability to create antibodies for binding antigen is reduced. Immune response can occur both antigens changed. Reaktogenitas determined mainly by ajuvan not much different. Severe pain occurred more often in the combo vaccine (Bogaerts, Belgium). Immunization coverage is higher. KIPI on extra doses of the vaccine does not increase
Cold Chain (chain)
• Vaccines should be stored in a cold start from the factory to the target.
• Save the vaccine in the refrigerator at the proper temperature
• Door refrigerator should always be closed and terkkunsi
• Save thermometer to monitor refrigerator.
• Place Polio Vaccine, Measles, on the shelves near I freezers.
• To bring the vaccine to India must use the vaccine carrier / thermos containing ice.
