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KEY CONCEPTS

KEY CONCEPTS

  • image Live vaccines may confer life-long immunity but cannot be administered to immunosuppressed patients.

  • image Inactivated and subunit vaccines and toxoids often require multiple doses to protect from infection, and generally booster doses are needed following the primary series.

  • image Children less than 2 years of age are unable to mount T-cell–independent immune responses that are elicited by polysaccharide vaccines.

  • image Severely immunocompromised individuals should not receive live vaccines, and their responses to inactivated, polysaccharide, toxoid, and recombinant vaccines may be poor.

  • image The childhood and adult immunization schedules are updated frequently and published annually. These documents can be used to develop an immunization plan.

  • image Immunoglobulin (Ig) provides short-term, rapid postexposure protection from measles, hepatitis A, varicella, and other infections.

  • image Ig adverse effects are often secondary to infusion rate. Slowing the IV infusion rate ameliorate chills, nausea, and fever that may develop during administration.

  • image Rho(D) Ig prevents Rh-negative mothers from mounting an immune response against the Rh(D) antigen on the red blood cells of the fetus that results in hemolytic disease of the newborn.

PRECLASS ACTIVITY

Preclass Engaged Learning Activity

  • Use the current childhood immunization schedule to recommend vaccines for the children in the following cases. The current immunization schedule can be found on the CDC’s website.

  • A healthy 2-month-old infant who received hepatitis B vaccine dose #1 at hospital discharge. What vaccines are needed today?

  • A 4-month-old infant who received no vaccines except hepatitis B vaccine dose #1 at hospital discharge. Devise a vaccine schedule to catch up and to immunize him until age 12 months.

INTRODUCTION

Immunization is defined as rendering a person protected from an infectious agent. Immunity to an infectious agent can be acquired by exposure to the disease, by transfer of antibodies from mother to fetus, through administration of immunoglobulin (Ig), and from vaccination. Immunization is the process of introducing an antigen into the body to induce protection against the infectious agent without causing disease. An antigen is a substance that induces an immune response. An antibody produced by the humoral arm of the immune system usually is the response that is measured as evidence of successful vaccination. However, cellular immune responses, which are more difficult to measure, are also an important aspect of vaccine responses. This chapter introduces the clinical use of vaccines and immunoglobulins. Agents with a limited use, such as agents for bioterrorism or travel, are beyond the scope of this chapter.

PRODUCTS USED TO IMMUNIZE

image image image Vaccines induce active immunity—that is, immunity generated by a natural immunologic response to an antigen. Vaccines can be live-attenuated or inactivated. Inactivated vaccines may consist of whole or a particle of the pathogen that induces a protective immune response. Live-attenuated vaccines induce an immunologic response more consistent with that occurring with natural infection. Because the organisms in live-attenuated vaccines undergo limited replication in the vaccinated individual after ...

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