Vaccines and related biologic products constitute an important group of agents that bridge the disciplines of microbiology, infectious diseases, immunology, and immunopharmacology. A list of the most important preparations is provided here. The reader who requires more complete information is referred to the sources listed at the end of this appendix.
Active immunization consists of the administration of antigen to the host to induce formation of antibodies and cell-mediated immunity. Immunization is practiced to induce protection against many infectious agents and may utilize either inactivated (killed) materials or live attenuated agents (Table A–1). Desirable features of the ideal immunogen include complete prevention of disease, prevention of the carrier state, production of prolonged immunity with a minimum of immunizations, absence of toxicity, and suitability for mass immunization (eg, cheap and easy to administer). Active immunization is generally preferable to passive immunization—in most cases because higher antibody levels are sustained for longer periods of time, requiring less frequent immunization, and in some cases because of the development of concurrent cell-mediated immunity. However, active immunization requires time to develop and is therefore generally inactive at the time of a specific exposure (eg, for parenteral exposure to hepatitis B, concurrent hepatitis B IgG [passive antibodies] and active immunization are given to prevent illness).
Table A–1 Materials Commonly Used for Active Immunization in the United States.1 |Favorite Table|Download (.pdf)
Table A–1 Materials Commonly Used for Active Immunization in the United States.1
|Vaccine||Type of Agent||Route of Administration||Primary Immunization||Booster2||Indications|
|Diphtheria tetanus acellular pertussis (DTaP)||Toxoids and inactivated bacterial components||Intramuscular||See Table A–2||None||For all children|
|Haemophilus influenzae type b conjugate (Hib)3||Bacterial polysaccharide conjugated to protein||Intramuscular||One dose (see Table A–2 for childhood schedule)||Not recommended|
1. For all children
2. Asplenia and other at-risk conditions
|Hepatitis A||Inactivated virus||Intramuscular||One dose (see Table A–2 for childhood schedule) (administer at least 2–4 weeks before travel to endemic areas)||At 6–12 months for long-term immunity|
1. Travelers to hepatitis A endemic areas
2. Homosexual and bisexual men
3. Injection drug users
4. Chronic liver disease or clotting factor disorders
5. Persons with occupational risk for infection
6. Persons living in, or relocating to, endemic areas
7. Household and sexual contacts of individuals with acute hepatitis A (with additional gamma globulin in select patients)
8. For all children
|Hepatitis B||Inactive viral antigen, recombinant||Intramuscular (subcutaneous injection is acceptable in individuals with bleeding disorders)||Three doses at 0, 1, and 6 months (see Table A–2 for childhood schedule)||Not routinely recommended|
1. For all infants
2. Preadolescents, adolescents, and young adults
3. Persons with occupational, lifestyle, or environmental risk
5. Persons with end-stage renal disease, HIV, or chronic liver disease
6. Postexposure prophylaxis
7. Household and sexual contacts of individuals with acute and chronic hepatitis B
|Human papillomavirus (HPV)4||Virus-like particles of the ...|
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