VACCINES

A vaccine is a biological preparation that improves

immunity to a particular disease. (WHO)

A vaccine typically contains an agent that resembles a

disease-causing microorganism, and is often made from
weakened or killed forms of the microbe, its toxins or one
of its surface proteins. (WHO)

Vaccines stimulate the bodys own immune system to

protect the person against subsequent infection or disease.
Types of Vaccine
Live attenuated:
Weakened due to
repeated growing of
virus in lab

Toxoid: Inactivated/
suppressed
bacterial toxins
through means of
heat/chemical
treatment

Conjugated: With
carrier protein to
enhance immune
system response
 Vaccines available in Malaysia
(In the National Immunization Schedule)

1. Bacille Calmette-Guerin (BCG)

2. Hepatitis B
3. Diphtheria, Tetanus, Pertussis
4. Hemophillus influenzae type B
5. Poliovirus
6. Measles, Mumps, Rubella
7. Japanese Encephalitis
8. Human Papilloma Virus
Bacille Calmette-Guerin(BCG)
Tuberculosis
Incidence Rate: 64.7 per 100,000 population (2000)
Highest incidence in Sabah.

Bacille Calmette Guerin vaccine is a live attenuated Mycobacteruim bovis

The diluent is either saline solution or distilled water.
Stored and transported at 2C to 8C not be frozen but kept cool.
The vaccine must be kept refrigerated once the diluent has been added, used within
4 hours and kept away from light.

Administration: intradermal injection with a 25 or 26 gauge needle at the deltoid

region of left upper arm
Dosage 0.05ml

High protective efficacy against meningeal and miliary TB in children

Indication:
Given at birth, repeated if no scar
Contraindication:
Symptomatic HIV

Side effects:
BCG adenitis
Systemic infection BCG in immunodeficiency
Hepatitis B
conjugated vaccine
2 types: plasma derived & recombinant vaccine
Stored 2-8 C.
Dose 0.5ml
IM anterolateral thigh (neonates and infant) . Deltoid for children
Indications:
All infants,included those born to HBsAg positive mother
Health care personnel

Contraindication
Hypersensitivity to aluminium
HBV carrier

Side effects
Local reactions
Fever and flu-like symptoms 1st 48 hours
Diphtheria, Tetanus,
acellular Pertussis (DTaP)
Vaccine
Combination vaccines of diphtheria and tetanus (toxoids) and pertusiss (inactivated bac.)
2 types:
whole cell (DTP)
acellular vaccine (DTaP) (Currently used)

Diphtheria Vaccine
2C to 8C
0.5ml IM

Tetanus toxoid
Stable and able to withstand room temperature for months
In DPT, should be 2C to 8C and kept away from light
0.5ml IM

Pertussis vaccine
2C to 8C
0.5ml IM
Recommended sites is anterolateral thigh (infants) or deltoid (toddler)
Indication:
All infants

Contraindication:
Hypersensitivity to aluminium
Anaphylaxis to previous dose
Encephalopathy within 7 days of vaccination
 Side Effect
Local
Erythema
Induration +/- tenderness
Nodule may be present at injection site for several weeks
Sterile abscess
Systemic
Mild: fever (less than 24h), drowsiness, anorexia
Moderate to severe (infrequent and without sequelae)
High fever
Shock-like episodes
Short-lived convulsions
Anaphylaxis reaction
Contraindication for further dose
Inactivated polio Vaccine
4 types of poliovirus vaccines are currently available:

- Inactivated polio vaccine (IPV) of Salk

- Oral polio vaccine (OPV) of Sabin
- Enhanced-potency inactivated vaccine of
Van Wezel (elPV)
- Combinations with other vaccine like DTP- IPV

Stored at 4-10
OPV by oral drops
IPV by IM
Indication:
All infants

Contraindication:
Allergies to neomycin , polymyxin, streptomycin
Previous anaphylactic reaction
 Adverse Effects
OPV
1.3/1000000 cases reported Vaccine Associated Paralytic Poliomyelitis (VAPP)
IPV does not cause VAPP but
Local reaction at injection site (43%)
Neurological disorders (12%)
Hypertension (10%)
Allergic reactions (10%)
Haemophilus influenza type B (Hib)
4 types
PRP- outer membrane protein conjugate vaccine (PRP-OMP)
PRP-tetanus toxoid conjugate vaccine (PRP-T)
PRP-Hib oligosaccharide conjugate vaccine (PRP-HbOC)
PRP-diphtheria toxoid conjugate vaccine (PRP-D)

Stored at 2-8, must not be frozen, dose is 0.5ml given IM

Indications:
All infants
splenic dysfunction and post splenectomy

Contraindication:
Previous anaphylaxis Hib
Allergies to neomycin,streptomycin
 Adverse Effects
Pain, redness, swelling at injection site (<24h)
Systemic: fever (infrequent)
Measles, Mumps, and Rubella (MMR)
Vaccine
Freeze dried preparation containing Live attenuated measles,mumps, and rubella viruses
Stored 2-8 C away UV
Dose 0.5 ml IM/SC

Indications:
All children

Contraindications:
Allergy to Neomycin
Pregnancy

Adverse effect:
Local reactions, fever,rash,malaise,febrile seizure, allergic reaction
Human Papilloma virus (HPV)
Two types:
Bivalent vaccines, against HPV 16 & 18
Quadrivalent vaccine, against HPV 6,11,16 & 18
Stored 2C to 8C away UV light
Dosage 0.5ml

Indications:
Female aged 9-45

Contraindications
Immunodeficiency
Malignancy
Hepatic and renal problems

Adverse effects
Headache ,myalgia,local reactions , fatigues Nause or vomiting urticaria
Route administration
Immunization Schedule In Malaysia