VACCINE PREVENTABLE

DISEASES (VPDs)

Ida Safitri Laksono

Dept of Child Health

Infectious Disease Sub division

Outline

 Background
 Vaccine/ Immunization program
 VPDs
 Impact of immunization program on
spectrum of VPDs
Background
 Definition :
Immunization is the development of a
protective immune response against a
disease
- Active Immunization
- Passive Immunization ( antibody
administration)
Active Passive
 Vaccine  Immunoglobulin (
 Stimulate a host specific or non
specific immune specific)
response similar to  Neutralization of
that induce by natural
infection microorganism/
 Require single or pathogen by antibody
multiple preparation
 Time delay for onzet of  Require single dose
protection  Immediate onzet
 Lasting complete or  Short/ temporary ( 3-6
partial protection for mo) protection against
some years or life specific disease
 immunization
 Develop immune response similar to response
toward natural infection, without evidence of
apparent disease ( high immunogenicity, low
reactogenicity)
 EPI program
: PPI :Hep B, BCG, Polio, DPT, Campak
Non PPI: Hib, Hepatis A, MMR, Varicella
 Component ofAntigent:
 Life attenuated vaccine ( BCG, OAP, Campak, MMR,
Varicela, Tipus oral)
 Death materials: Toxoid, recombinant, konjugasi, whole
cell, sebagian sel ( Hepatitis A, B, DPT, DPaT, Tipus inj,
IPV HiB,
Active immunization
 Provides protection at 2 levels

- Individual immunity
- Herd Immunity ( resistance of
groups of people to the spread of
infection  depend on proportion of
individuals in the population who are
immune)
How vaccine can protect the
disease
 Vaccines contain the same antigens or parts of
antigens that cause diseases, but the antigens in
vaccines are either killed or greatly weakened. When
they are injected into fatty tissue or muscle, vaccine
antigens are not strong enough to produce the
symptoms and signs of the disease but are strong
enough for the immune system to produce antibodies
against them (Tortora and Anagnostakos, 1981). The
memory cells that remain prevent re-infection when
they encounter that disease in the future. Thus,
through vaccination, children develop immunity
without suffering from the actual diseases that
vaccines prevent.
IMMUNIZATION PROGRAMS
Eradication is defined as reduction of the
worldwide incidence of a disease to zero
as a result of deliberate efforts, obviating
the necessity for further control measures.
Success story
Smallpox eradication

 It had no natural reservoir in species other

than humans
 The infection was obvious and usually
easily diagnosed
 The duration and intensity of infectiousness
were limited, persons who recovered were
immune for life and often permanently
scarred
 Its transmission was highly seasonal in
many areas
Characteristic of smallpox vaccine
 The vaccine was safe, effective even in
newborns, inexpensive, easily administered
 stable in tropical climates; its effects were
long-lasting; and vaccinated persons had a
recognizable scar
 A lot of countries use vaccines to prevent
some diseases because of its safety,
effectivity, cheap price, easily
administrated process and stable condition
in tropical countires.
“

elimination” can be
defined as control of the
manifestations of a disease so that
the disease is no longer considered
“a public health problem,” as an
arbitrarily defined qualitative or
quantitative
level of disease control
•IMMUNIZATION PROGRAMS

•Routine schedule vaccinations (KEEP UP)

Example : Indonesia vaccine schedule
 JADWAL IMUNISASI REKOMENDASI PP IDAI
EDISI AGUSTUS 2000
WAKTU PEMBERIAN
IMUNISASI
UMUR (bulan) UMUR (tahun)

Lahi 1 2 3 4 5 6 9 12 15 18 2 5 6 7 10 12
r
Program Pengembangan Imunisasi (PPI, diwajibkan)

BCG BCG

Hepatitis B Hep. B 4 Hep

B4
Hep. B 2 Hep. B 3

DPT1
DPT
DPT 2

DPT 3 DPT 4 DPT DPT

5 6
Polio Polio 2
POLIO 1
Polio 3

Polio 4 Polio 5 Polio 6

Campak Campak 1 Campak 2

Program Imunisasi Non-PPI (dianjurkan)

MMR MMR 1 MMR 2

Hib PRP-T Hib Hib Hib Hib

1 2 3 4
PRP- Hib Hib Hib
OMP 1 2 3

Dem Oral Vivotif (3 dosis)

am
Tifo Suntika Typhim Vi (diulang tiap 3 tahun)
id n
Hepatitis A Hepatitis A (2 atau 3 dosis)

Varisela Varisela

Ket : Hepatitis B, pada umur 5 tahun periksa antiHBsAg, bila negatif berikan ulangan Hib 4, tetap diberikan walaupun telah mendapat imunisasi Hib sebelum umur 1 tahun
DPT5, dapat diberikan pada saat BIAS di sekolah Campak 2, diperlukan apabila MMR-1 tidak diberikan
Polio 1, diberikan di tempat lahir pada saat pulang untuk mengurangi penularan BIAS, Bulan Imunisasi Anak Sekolah (anak usia SD kelas I s/d VI, pada bulan November
Kepada bayi lain. Setiap tahun).
CATCH UP

 Age 1-14 yo, interrupted of transmission

 National immunization days
Example : In Indonesia ( PIN)  aiming to
rapidly boost immunization coverage levels
 Targeted
Example : natural disaster ( Tsunami in
Aceh, earthquake Jogja  measles booster
dose catch up)
Vaccine Preventable Diseases
 Example of VPDs
List of vaccines for use in humans
Pre World War II
 1798 Smallpox
 1885 Rabies
 1897 Plague
 1923 Diphteria
 1926 Pertusis (whole cell)
 1927 BCG
 1927 Tetanus
 1935 Yellow Fever
List of vaccines for use in humans
Post World War II
 1955 Inactive Polio Vaccine (IPV)
 1962 Oral Polio Vaccine (OPV)
 1964 Measles
 1967 Mumps
 1970 Rubella
 1981 hepatitis B
 Others: Hepatitis A, DTPa, Hib,
Meningococcal, Pneumococcal, Varicella,
Rotavirus, HPV etc
List of diseases
 Anthrax
Cervical Cancer
Diphtheria
Hepatitis A
Hepatitis B
Haemophilus influenzae type b (Hib)
Human Papillomavirus (HPV)
Influenza (Flu)
Japanese Encephalitis (JE)
Lyme Disease
 Measles
Meningococcal
Monkeypox
Mumps
Pertussis (Whooping Cough)
Pneumococcal
Poliomyelitis (Polio)
Rabies
Rotavirus
 Rubella (German Measles)
Shingles (Herpes Zoster)
Smallpox
Tetanus (Lockjaw)
Tuberculosis
Typhoid Fever
Varicella (Chickenpox)
Yellow Fever
Impact of immunization program
on spectrum of VPDs
No control

Control (acceptable level)

Regional Elimination

Eradication (global elimination)

 Global distribution of cause-specific mortality among children under five (2004)
Source: World Health Organization, World Health Report 2005: Make Every Mother and Child Count, 2005