VACCINES FOR NEET MDS - Dr. Raina

hey guys this is dr. Dana Joshi and I would be taking a bit of discussion on vaccines and vaccinations so starting from what the vaccine is it is basically a immuno biological substance designed to produce a specific protection against the given disease whichever disease occurs we are providing an advanced protection against it so it is a kind of what we are prophylactically immune in other selves so it is an type of immuno prophylaxis and this is octet this gives us an artificial acquired active type of an immunity no Tom vaccine was coined by you is first pasture first however later the term vaccination must given by Edward Jenner who developed the first vaccine of smallpox in year 1798 right so this was a first major breakthrough for the discovery of vaccine through by Edward Sir Edward Jenner later on or other vaccines were also discovered so if you have a brief history of vaccines and it's difficult sometimes to remember each and every year so how you can remember is write a briefly kind of an remembering in which our T's is occurs that the first vaccine that was invented in by Sir Edward Jenner in 1798 that is a smallpox right the smallpox vaccine so we can remember in 70s 70s right 1700 this was discovered right then in 1800 so in 1800 switch vaccines can double to two major I'll see you RC in 1800 so rabies and cholera then in 1900 so in 1900 there are there was much much more discovery and invention of new and other kind of and vaccines which occurred so in 1920s so in nineteen months since we had a major breakthrough the most important vaccines right so remember this in 1920s we had a basic vaccine group that was a BCG vaccine that is bachelor's Talmud guru Dean the full for this area but iNSYS and tetanus vaccine right in nineteen thirties we had a yellow fever and influenza vaccine in 1949 a year before the India but Republic was the month vaccine was discovered in 1950s foster ah intravenous polio vaccine was discovered and then oral pal polio vaccine was discovered right in 60s we had Mr sixties the 60s mr right so on measles and rubella next month in 70s also meningococcal Type C vaccine was also discovered in 60s only right in 17th we had type in meningococcal vaccine and another important breakthrough here was HIPPA Titus B vaccine here's how to remember Rafi by not remembering the exact year even if you are remembering this you can have some highlights for remembering the years next we come up to the classification of patterning that is what are the types of vaccination so broadly classified there are major four types we can say like based on the type of preparation that based on the type of conjugation which we know type of immunization and built in a type of fruit they are administered okay so built on the type of preparation that is how basically we are preparing the vaccine so are we taking live organisms okay so my organism step attenuated life what is when my attenuation is we are didn't lie you microorganisms but we are reducing the pathogenicity that is their capacity of producing a disease we are removing that pathogenicity part but however we are maintaining the antigenicity of the microorganism so that the antigen would stimulate the further production of our amuse immune cells that is antibodies okay then we are producing killed vaccines we are killing the microorganisms we are inactivated it and we are producing it next is at oxides or toxins like whatever toxins that are produced by virus and bacterias they have been taken and they have been converted into the form of toxoid that is the removing the pathogenicity and capability of those toxins to Kiryat the disease and they have been used to produce vaccines right the another type is a using subunit that is we are using a protein or a polysaccharide a fragment or a subunit from the bacterial or viral antigens which are responsible for producing a specific type of an pathogen isset e so we are not using an whole organism or something we are just you taking that much fragment and which is responsible for providing us immunity and we are using that and then 50 titles the combination type we care where we can we are combining two types of vaccine that is either lime plus that is d pity for example then we are combining Victoria produces return as vaccines together and we are injecting them as one next is names upon conjugation so the subunits are of two times we are either polysaccharide or they are made up of protein so the polysaccharide part of the subunit they are unconjugated right but however when this bone is like a right is a conjugated that is we are connecting it joining it with the help of a protein carrier then those vessels become conjugated vaccines okay then the Vectrex things are based upon the type of immunization so and we know that there are vaccines which are to be routinely in your nice life so from the birth there is a cycle which is to be given and these are the mandatory vaccines which are being written by the national immunization schedule which is provided by government and they are for free most of them right so the other routinely immunized in vaccines and another type they are immunized for individual so every other message which are costly we are being spent and they are to be taken with by the people of you need to buy them for all you need to provide them for example if there are BR dot dentistry a doctor so we are repeated exposure to hepatitis B vaccine so we must to do the vaccination of that by ourselves right there are other vaccines like Reddy's vaccine so we are providing it only when a person gets a infected by a dog bite or something okay then based upon the route of administration it can be oral which is provided by oral route that is oral polio vaccine and parenteral route it can be either intradermal or intramuscular subcutaneous and we can provide them by both some accents can be given by both the route now here o vaccines which are being designed to give by subcutaneous route of it they can be given I am that is intramuscularly however the vaccines which are to be given intramuscularly we cannot we can never give those vessels in by the subcutaneous or into their mobile because after a reaction and side-effects okay so this is one all about the classification and types of vaccines coming up to the next actor how do vaccines work right so basically the main the main mechanism by which the vaccines worked is by producing antibodies that is the cell mediated immunity right however there are two types of antigens that are there right one is a T cell dependent antigen and another one is the diesel independent antigen okay so one those are the T cell dependent antigens they are better the vaccines are better with a T cell dependent and they work either by antibody production right producing you wanna cell mediated immunity and it is not antibody production then they walk by cytotoxic cd8 T lymphocytes production right there are the specific empty viral cytokines okay now when in T cell dependent antigens so these are dependent antigens are mysteriously the protein antigen which are the pure proteins against the vaccines of hepatitis B a and toxoid right ah for this what happens is they activate the antigen T cells right then T sin T cells o triggers they migrate to the germinal centers the germinal centers are the one which are the Sentinel which dot immune cells have been produced and then produce the specific antibodies against the disease for providing the protection however this is a form of definitely the plasma cells this canvas as well short half-life identify four to eight weeks after vaccination however the few plasma cells which are remaining from here right they exit the nodes and split and migrate to the a bone marrow site and they survive there in the supporting stromal cells and then later on get converted into the memory B cells generated in response to the T dependent antigens right so this memory is then preserved when the infection occurs and member er infection occurs immediately this memory B cells would work and start producing antibodies against the antigen or the pathogenic organism clear now next is t-cell independent mechanism or antigens to each other t-cell polysaccharides polysaccharides antigens are the basically t-cell independent and agents right so these are offers tough to caucus new money Nigeria meningitidis Haemophilus influenzae Salmonella typhi right this aller the desiccant is the main example the polysaccharide and pigeons and this at the but whenever from the injected site they don't go to the germinal centers right they go to the marginal zone this is the reference we go to the marginal tones of splints and nodes lymph nodes and they bind to the envelope and receptor at bedside and stimulate measles and estimate and produce the proliferation which is further converted into plasma cells now here already they have reduced from the Miller center so they never get exit and plasma cells nice after two to four weeks in the response and they will know and so the immunogenicity or the antibodies are short lived and died rapidly although what happened better as the P antigens do not induce the germinal centers memory B cells are not elicited from here so consequently when we re exposure of course the vaccine is to be given same type and in the same time there is hyper responsiveness to the vaccine then the previous time okay so in such cases we do not have to give booster doses and if we give there is only a single booster dose that is to be given for polysaccharide vaccines to acquire a lifelong protection clear about t-cell independent and T cell dependent now coming after this step after what happens we injected the back fin so it is the false step following the injection so it is referred by live action and the tilde vaccine so what will live actions basically do the live action antigens attract all of the local and system is in itself or in it this is related to innate immunity that area then dry pixels monocytes and neutrophils okay and in response to that further those activate the lymphatic vessels the draining lymph node and further take place the activation of T and B lymphocytes so they are activating the generalized whole system to work against it for producing the immunity however for the T listen kill vaccines what do they do they go only to local all you need at 12 lymph node sites that is very limited area so then immunogenicity is really very low and the preferred site for with the vaccine is or intramuscular right now coming up the top polysaccharide vaccines and the polysaccharide vaccine oh the point satellite antigen specifically is unable to evolve the immune response in children because they have immature marginal zone they really develop around 18 months that is around nearly 2 years of age so polysaccharide vaccines are not to be given in children below 2 years so what to do in such cases in such cases what we do because you get the polysaccharide mix-ins and we inject the conjugated form of the vaccine because as we saw before the polysaccharide antigens give us a step to cook us new Mali Nigeria meningitidis right all this bacteria they are most prone to cause infection in the owners and children lesson to you ok so it is important that we can you get them and give the vaccines so this was all about how the virus oh sorry vaccines whoa now coming up to the general instructions rules Ponta indications and side effects produced by the vaccines ok so whenever the term is given that vaccines that are to be given at birth cut off an massive BCG vaccine okay so weapons that are given to be ad board should be given as early as possible after the birth right or if this is not possible then it should be given within 24 to 72 hours if still not possible then it should be given at least not making delay later than 1v after the birth right so whenever a question comes to you that when the BCG vaccine or the vaccines at the birth are to be administered right the very first option you should go is with as early or as soon as possible clear now when we are injecting to inactivated X vaccines right the time interval between two doses of another activated vaccine should be at least four weeks now regarding the administration of multiple vaccines right whenever my are the administrating multiple vaccines together so to live vaccines can be given together line plus King vaccine can be given together however in the case of cholera and yellow fever we cannot give those two vaccines together because it may cause adverse reaction clear now coming up with a contraindication of vaccines so logically speaking eliminating O in inhibit or contraindicated live vaccines what do live absence fronting microorganisms yeah then then we have reduced the pathogenicity however they are live organisms then I miss chances that infection may occur as a response okay so we would be it split pregnancy is the part where we don't want that infection to occur ed it may cause damage to fetus right we don't want any toxic reaction occurring due to live microorganisms so B are contraindicated live vaccine during pregnancy secondly in the cases of immunosuppression right even the corticosteroid therapy causes immuno suppression right ah a bit it will do this inflammatory response and all so in both cases as only this immunity is suppressed the counts are low the WBC are low in such cases the effective antibody production would be not so good right so and if this predominates the immune system of our body there are chances the disease or the adverse response in the might occur in such cases also in symptomatic a child what happens in symptomatic HIV the cd4 counts we'll know sometimes say so if there are less number of cd4 counts and normal so in that case obviously the vaccine the live bacterias or the life strains myth predominant and sometimes made there are chances the disease might occur right now all polysaccharides vaccines as I said are contraindicated less than two years so basically as I said the stic pneumococcal and meningococcal there are polysaccharide antigens so the polysaccharide vaccines this three are in contraindicated days and us water is which is meant more than two years it's greater than two years purchases vaccines are contraindicated because they can produce some noodle logical complications however in adults participant uses vaccines I am NOT contraindicated in the cases where epilepsy is properly controlled by medication and in the cases of cerebral palsy right now coming up to the side-effects of vaccines number one is shock which is produced by diphtheria produces tetanus and pertussis vaccines then next is the boolean value lead on this syndrome is usually produced by a bacterium it is Campylobacter jejuni and some of the viruses okay so in this what happens there are multiple syndromic or symptoms which are produced as a result of infection that is you have vomiting followed by diarrhea followed by lower limbs inability to walk coming up - from ascending way from down to upward your system and it affects the central nervous system by producing antibodies right so this syndrome may be a side effect that is produced you to get influenza next is the toxic shock syndrome right it is produced by MMR vaccine and the hypersensitivity that is fun is why you protected me meningococcal and the Tedder produces tightness waxing so this is all about the basic about the vaccine that is classification how the walk and the contraindications and side-effects here is the latest immunization timetable Pro given by Indian Academy of Pediatrics in 2016 so ah NPC around the eight side the first set is given at birth then we have at six week ten weeks 14 weeks the gap is of four so that is 6 plus 4 10 10 plus 4 14 then that thing come in mul status having the gap of 3 right that is six months nine months 12 months and 16 month followed by a gap of 2 that is 16 to 80 months 18 months two years to four to six years and ten to twelve years clear so first four there is a gap of four then there is a gap of three then there is a gap of two so how do you remember the schedule if you want so remember the three main lessons which are to be given and both then see the first node of vaccine which is being started and the last dose so for example if it is B vaccine was first started at the board right then it was given at six weeks and then later on it was given s the third one was at six months or you remember it would take 6 that is 6 weeks and 6 months now dat WP 1 max in was given started at 6 weeks 10 B 14 weeks three times okay three doses then the IP vaccine similarly satedan six ten ten so remember the first one first noise and then go along according to the gap you can remember it well this is about the injection site there is to be given and at what is and which person okay that is freedom and unit you give it the middle third on lower the junction of interval lateral thigh and influence also in toddlers and alders you give it an deltoid region enter lateral ty in adolescents and adults and deltoid in infants at ty in children greater than to Elias or subcutaneous route you give it an outer triceps and all intradermal injections are given is left to Delta so okay now coming up to the storage of vaccine so where do we store vaccines it is enough cold chain right so here usually the routing or time routine temperature for the storage of vaccine is plus two degree to plus eight degree Celsius so if you want to store for the longer period of time then the temperature should be minus twenty degree to minus 40 degree Celsius clear and similarly here the iso picture is shown the most important component of cold chain in india is i L are right what is this IL r it is eyes lined refrigerator right in which our vaccines can be maintained at plus two degrees plus eight degree Celsius here the temperature monitoring is done with the help of a dial thermometer and we must check the temperature twice daily and it is the medium of storage for all kinds of vaccines clear now how can cool the chain oh there is a vaccine vial monitor that is vlm vvm that is a marker of potency of vaccine however it can be used or not right so in this case how it works is the DVM has a heat sensitive material placed within the Val vaccine which registers that you will let you hit exposure over the time right so in that what does the mark and you stop it sends it up an outer circle and it consists of an inner square right so based upon the degree yes then our stand with a blue color okay so next what happens in sir if my wh o grating if the color changes the color changes is only in inner square so in the color change in inner square is white than it is grade one this light blue that is in red - then in this two cases grade 1 grade 2 well color is white and blue light blue respectively the Bison can be used right if it is too diffident blue after the conversion the square is also blue then and then if the square is purple or black then it is termed as great 3 and great for respectively in which case the vaccines cannot be used and it should be discarded so grass three is the mass point where the vaccine should be discarded this is given with an example of an oral polio vaccine mostly the or italia polio vaccines are monitored with the help of vaccine vial monitor clear that is all about the bad basics of vaccines and thank you for watching this video with patience hope that covers you are all doubts regarding the vaccines and make you clear with the basics of vaccines thank you