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© Claudio Stefanini
mucca carnia 2014
edward jenner Berkeley
Albert Bruce Sabincincinnati 1953
Andrew Wakefieldlondon 1998
Jenner damaged the business of his colleagues by offering protection against smallpox
free of charge.
Vaccines became the
victims of their own success
http://autismovaccini.org/2013/11/12/allarme-polio-alcune-considerazioni/
viewing Web sites critical of vaccination for only 5–10
min increased the perception of the risks of being
vaccinated… Betsch C, Renkewitz F, Betsch T, Ulshöfer C. The influence of vaccine-critical websites on perceiving vaccination risks. J Health Psychol. 2010;15:446–55.
…and decreased the perception of the risks of
omitting vaccinations
Betsch C, Renkewitz F, Betsch T, Ulshöfer C. The influence of vaccine-critical websites on perceiving vaccination risks. J Health Psychol. 2010;15:446–55.
Vaccinophobia safety and
effectiveness
Vaccinophobia
complot!!!
Vaccinophobia alternative health
practices
Andrew Wakefieldlondon 1998
Correlation does not prove
causation
Correlation coefficients between 0.9 and 1.0 indicate variables which can be considered very highly correlated.
Imunnizzazione
passiva trasferimento di anticorpi preformati
Prescott−Harley−Klein: Microbiology, Fifth Edition
IX. Nonspecific Resistance and the Immune Response
33. Medical Immunology © The McGraw−Hill Companies, 2002
Types of Vaccines and Their Characteristics
As previously noted, the diseases for which we already havevaccines are ones in which the infection is acute and either re-solves in several weeks or causes death of the infected individ-ual. In the absence of vaccination, many individuals would sur-vive as a result of the immune system defeating the invader. For
766 Chapter 33 Medical Immunology
Age Birth
Bars indicate range of recommended ages for immunization. Ovals indicate vaccine to be given if previousrecommended doses were missed or given earlier than the recommended age.
1mo
2mos
4mos
6mos
12mos
15mos
24mos
18mos
4–6yrs
11–12yrsVaccine
Hepatitis B
Diphtheria,Tetanus,Pertussis
Haemophilus influenzaetype b
Measles, Mumps,Rubella
Chickenpox (Varicella)
Hepatitis A
Polio
14–16yrs
Hep B
Hep B
DTaP DTaP DTaP
Hep B Hep B
MMR
Var
DTaP
Hib Hib Hib Hib
MMR MMR
IPV IPV
TdDTaP
IPV
Var
Hep A in selected areas
IPV
Figure 33.1 RecommendedRegimen and Indications forVaccinations of Children in theUnited States. (Data from TheAmerican Academy of Pediatrics.)
Table 33.2 Immune Globulins and AntitoxinsUsed for Passive Immunizationagainst Specific Organisms andDiseases in the United States
Organism/Disease Agenta
Black widow spider bite Horse antivenomSnakebite Horse antivenomAcute respiratory failure Monoclonal antibodies
(respiratory syncytial virus)Botulism Botulinum antitoxin (equine)Diphtheria Diphtheria antitoxin (equine)Hepatitis A and B Pooled human immune gamma globulinMeasles Pooled human immune gamma globulinRabies Rabies immune globulin administered
around the wound in addition tobeing injected intramuscularly
Tetanus Tetanus immune globulinEczema Vaccinia immune globulinImmunocompromised Varicella-zoster immune globulin
individuals
aImmune globulins and antitoxins are administered intramuscularly unless otherwise noted.
these diseases, the vaccine mimics the pathogen and causes animmune response similar to that raised by the pathogen. Thesevaccines have eradicated smallpox, pushed polio to the brink ofextinction, and spared countless individuals from hepatitis Aand B, measles, rotavirus disease, tetanus, typhus, and otherdangerous diseases.
In contrast, successful vaccines have yet to be developed fortoo many deadly or debilitating diseases (AIDS, herpes, hepatitisC, malaria, tuberculosis) because they are due to chronic infections.In a chronic infection, the pathogen is able to evade the immunesystem or subvert it into making ineffective responses. Successfulvaccines against these chronic diseases must be able to stimulateimmune responses that are similar to those resulting from most nat-ural exposures to the pathogen. To date, this has been an unsolvablechallenge in medical immunology and vaccine development.
In the remainder of this section, various approaches to the de-sign of vaccines, both currently used vaccines and experimentalones, are described and examined in terms of their ability to in-duce humoral and cell-mediated immunity and the production ofmemory cells. Vaccinomics, the application of genomics andbioinformatics to vaccine development, is bringing a fresh ap-proach to the Herculean problem of making vaccines against var-ious microorganisms and parasites.
Whole-Organism Vaccines
Many of the current vaccines in use for humans that are effectiveagainst viral and bacterial diseases consist of whole microorgan-isms that are either inactivated (killed) or attenuated (live butavirulent) (table 33.1). These are termed whole-organism vac-cines. The major characteristics of these vaccines are compared
Imunnizzazione
1. Controllo
riduzione n° casi e complicanze
(vaccinazione antinfluenzale)
2. Eliminazione interruzione trasmissione
endemica (rischio di reintroduzione)
3. Eradicazione
scomparsa dell’agente causale
e della malattia a livello globale
herd immunity
Vaccini 1.SICUREZZA non deve causare la malattia o la morte
Vaccini 2.protezione deve proteggere contro la malattia causata dall’esposizione al patogeno
Vaccini 3.tempo la protezione deve durare nel tempo
Vaccini 4.neutralizzazione indurre la produzione di anticorpi neutralizzanti
Stability
5.pratica
Vaccini
risposta innata presente alla nascita (fagocitosi, lisozima, interferoni, flogosi)
controlla piccole invasioni da parte di microrganismi
risposta adattativa anticorpi e linfociti (in
grado di riconoscere specificamente un solo
antigene.
memoria immunologica
Imunnizzazione
attiva produzione attiva di anticorpi
Vaccini vivi attenuati
Prodotti a partire da agenti infettivi resi non patogeni. L'attenuazione viene effettuata attraverso passaggi multipli in colture cellulari.
Vaccini vivi attenuati
durata costo rapidità risposta simile a quella naturale
Pro
Vaccini vivi attenuati
mutazioni pazienti immunocompromessi
Cons
Vaccini vivi attenuati polio (sabin) BCG Febbre gialla
poliomielite
poliomielite
poliomielite
Vaccini inattivati
no mutazioni buona immunitÀ con richiamo
Pro
Vaccini inattivati minore efficacia costo elevato
Cons
Vaccini inattivati polio (salk) pertosse HAV
Vaccini inattivati Hi B HBV tetano diferite
Dna vaccine
injecting genetically engineered DNA
cells directly produce antigens
