Vaccines in Immunobiology and Medicine Folder title: Vaccines Updated: December 06, 2011 VaccTtle Immunology in Human and Animal Health and Disease Why do we want to know about Immunology? What does it tells us about ourselves and about biology? What can it do for us? As a tool in biomedical research? As a diagnostic and therapeutic modality in clinical and veterinary medicine? What can it do to us, as a source of pathology? InHealth Immunology in Human and Animal Health and Disease What can we make it do for us? ImmUse KEY FEATURES OF SPECIFIC ADAPTIVE IMMUNITY IN HISTORY Freedom from Plague after Surviving First Exposure Immunity Exists Susceptibility to Other Diseases Even After Surviving Plague Immunity is Specific Deliberately Induce Small-pox to Protect Against Later Exposure Induce Non-pathogenic Cow-pox to Protect Against Virulent Small-pox (Vaccination) Resistance to Chicken Cholera after Surviving Exposure to Weakened Chicken Cholera Bacilli (Attenuated Vaccines) Immunity has Memory Related Antigens are Cross-Reactive Antigens can be separated from pathogenicity ImHistry Vaccines in Human and Veterinary Medicine What have they done for us? What do we have now? How do they work? What don't we have? Why not? How can we get what we need? How can we improve their immunogenicity? Can vaccines for millions of healthy persons cause problems ? Can we make them faster in response to changes in pathogens? VacQuest Oakwood Cemetery 10-Nov-96 Filename: OakSec29.doc Name Robbie Bonta Katherine T. Bonta Frank M. Bonta Helen A. Plumb Laura J. Benner Samuel George L. Bonta H. Benner Blank Frankie L. Curtis Frances B. Curtis Nathan L. Curtis Roger L. Jones Mary C. Jones Fannie Lathrop Rachel Amelia Cody Burials Born 1868 1864 1845 1853 1850 1873 1848 1876 Unk 1864 1844 1836 1872 1875 1871 1840 Died 1875 1945 1939 1886 1876 1874 1922 1888 Unk 1875 1932 1922 1951 19?? 1879 1840 Unk Missing Unk Unknown 1800 George Chapman Lathrop Unknown Unk George Nelson 1847 George Chapman Average Age: Notes: 10 died aged 6 wks to 33 yrs. Age in Years 7 81 94 33 25 1.5 74 12 Unk 11 88 86 79 8 0.1 Unk Unk 1883 1811 Unk 1849 Section 29 Survey by Tom Fondy Remarks March 22, 1875, Age 6 yrs & 8 mos.; Son of Samuel Jan. 20, 1886; Wife of Frank M. Bonta Died Feb. 9, 1876; Wife of Frank M. Bonta Son of F & L Bonta; Aged 1 yr & 7 mos Born Feb. 9, 1876 (See Laura S. Benner) Next to H. Benner; Tombstone is Blank Born Sept. 22, 1864; Died Feb. 14, 1875 Died Dec. 27, 1879; Age 8 yrs, 8 mos, 3 dys d. August 8, 1840; Age 6 wks and 4 dys; Daughter of Narcissa & Niel? Cody Faded (Could be Narcissa or Niel Cody) Unk 83 1898 87 Unk Tombstone Toppled 2 Son of Benjamin & Permela Lathrop 4 Aged 3 yrs, 10 mos, 16 dys 43.1 50% of Identifiable Dates! 8 died aged 74 to 94. See Verses by TPFondy at http://tpfondy.mysite.syr.edu/ Song of the Oakwood Children Verses and Self-running Presentation Song of the Oakwood Children See Verses by TPFondy at http://tpfondy.mysite.syr.edu/ Verses and Self-running Presentation BIO 477 Fall 1999 Filename: Oakwood.xls Oakwood Cemetery Data Updated: December 5, 1999 Young S ection Mean Median S pan Children Adults Prior 1900 0 to 15 16 to 40 Abrams, Marshall 46 Not given Not Given 0 to 103 17% 13% Arace,Jennifer A Not Given 46.7 47.5 1 to 89 25% 15% Arcuri, Phil 14 63.15 64.5 25 to 87 0% 20% Azeez,Mohamed C 50* 59.3 78.5 4 to 109 19% 6% Berard, Eric 29 45.1 48 2 to 74 10% 25% Boyer, James 20A Not given Not Given Not Given ? ? Broderick,Lori 48 48.1 59.5 1 to 89 25% 10% Brusgul,Anthony M 10 56.4 71 1 to 94 15% 20% Burpee,Stacey D 9 67.5 75.5 1 to 94 5% 5% Clark,Sharon K 48W* 60.2 56 20 to 102 0% 5% Covington,Ari-Anna M 46* 55.6 71 1 to 96 20% 5% Darling,Jennifer S 35* 47.2 57 1 to 97 28% 17% Di Re,Vicky 47 41 51.5 0 to 85 40% 5% Domville,Shelley L 7 51.9 52.5 0 to 84 10% 10% Douangnouanexay,Ladda 58* 59.9 69.5 6 to 94 5% 11% Fernandez,Jason E 15 60.5 66 9 to 83 5% 10% Fogu,Brian S See Julie Sherman Gengo,Jessica 46* 55.7 61 2 to 96 10% 25% Groysman,Galina 40* 54.1 55 20 to 96 0% 10% Guinan,Justin T 9 53.6 52 0.1 to 89 5% 15% Hale,Lyman L 14 38 41.5 1 to 79 35% 10% Haygood,Shauna M 37* 41 47 0 to 92 25% 20% Hernandez,Melvin O 46* 56.2 58 19 to 85 0% 25% Herzog,T ami 51 56.8 60 17 to 93 0% 30% Hess,Heather E 15* 32 17 0.1 to 78 40% 20% Hetey,Sara E 44 79 81.5 44 - 90 0% 0% Hoang,Ha K 18 47.4 51 1 to 82 20% 10% Hopkins,Anthony B 20 57.3 64 0 to 91* 4% 20% Horsford,Alisa C 5 38.5 43 1 to 78 25% 25% Huynh,Janne 34 37.6 29 1 to 95 30% 30% Kirui, Philemon 5 33.65 43 8 to 78 20% 25% Kotiah,Sandy D 47* 41.2 54 1.5 to 88 27% 5% Lewis,Lisa M 15 - 22 40.4 41.5 1 to 82 30% 20% Lollo,Stephanie 52 53.8 62.5 1 to 85 20% 20% Louis,Dunchy 1855 to 1999 58.7 63 4 to 78 5% 10% Majovski,Robert C 14 54.1 59.5 8 to 75 5% 15% Maragliano,Angela R 9 46.6 50 3 to 82 10% 20% Martin,Nicole M 46 68 72 19 to 97 0% 10% Mathews,Marissa L 15 30.6 20 0.5 to 78 40% 25% Mattiacio,Brian L 4 44.3 47 1 to 85 30% 20% Milow,Clifford A M ultiple Montalbano,Joanne M 5 56.5 55.5 20 to 91 0% 30% Newell,Shanna M Unk* 37.4 37.5 0 to 88 25% 25% Papsidero,Sara A Unk 53 57.5 10 to 90 15% 15% Pearlman,Ryan D 54 58.6 61 8 to 88 5% 10% Penschow,Jonelle L 44* 70 73 41 to 88 0% 0% Quazi,Shaila 48 46.4 49 8 to 81 10% 25% Rienbeck,Melissa A 3 57.8 65 1 to 87 10% 10% Saez, Zugely Not Done Sabado,T homas N Unk 55 68 0 to 91 11% 16% Sajeski,Jaime L 34 44.9 42 0.4 to 87 15% 35% Schultz Jr.,William R 3* 69 67 30 to 89 0% 5% Sherman,Julie J 37 33 35 1 to 78 30% 40% Siket,Matthew S Unk* 60.1 66 2 to 90 10% 0% Sousou,T arek J 46 45.3 52 1 dy to 82 yr 25% 10% Suk,Elena C* 41.4 39.5 0.2 to 88 15% 30% T an,Piek L 48* 35.6 40.5 0 to 76 30% 20% T aszymowicz,Jodi 48 45.7 48 1 to 82 20% 25% T illou,Brett T J* 59.3 65 7 to 95 4% 16% Vespo, Jacqeuline 62* 52.6 66 10 to 74 5% 10% Wagner,Eilis B 42 46.65 44 1 to 96 10% 35% Yates,Gail F Unk 37 23 0 to 85 37% 16% Zimerman,Erik Not Done S tudent Immunobiology Class Experiment Oakwood Cemetery Tombstones prior to 1900 (Left Half of Table) Tombstones after 1940 (Right Half) Summary of Results Next Slide Averages 50.6 54.3 15.2% 48 out of 58 sections have child deaths 55 out of 58 S ections have young adult deaths 16.5% Young S ection Mean Median S pan Children Adults Post 1940 0 to 15 16 to 40 Not Done Not Given 67.4 78 5 to 100 5% 15% 57 68.6 68 43 to 86 0% 0% 60 72.2 72 11 to 98 5% 0% 68 58.3 67 1 to 90 5% 10% 81 Not Given Not Given Not Given ? ? C* 73.5 73.5 52 to 93 0% 0% 15 63 63 44 to 81 0% 0% 81 68.6 71.5 28 to 95 0% 0% 64E** 56.3 59 1 to 89 5% 20% 46 61.3 64.5 21 to 84 0% 5% C 76.9 81 39 to 94 0% 5% T 55 64.5 8 to 91 5% 15% M ausoleum 61 68.5 2 to 86 15% 0% E 53.8 63 3 to 91 5% 15% M ausoleum A 73.9 75.5 33 to 89 0% 5% Unclear 102* M ausoleum* 51* 60 58** 54 8 81 H11 38 64 75 64 81 38 71 Not Done 100 68* 2 P 102 60.1 61.3 68.1 56.6 82.3 81.9 69.5 69 67.1 71.7 66 69.6 60.3 75.1 60.6 66.8 65.1 63 61 76 Not given 82 81.5 71.5 67 73 78.5 71 77 56 80.5 62.5 72 63.5 35 to 82 25 to 87 2 to 95 1 to 84 58 to 98 27 to 96 17 to 99 44 to 91 15* to 95 31 to 94 7 to 103 17 to 102 26 to 104 42 to 102 15 to 89 7 to 72 41 to 89 0% 0% 10% 5% 0% 0% 0% 0% 5% 0% 5% 0% 0% 0% 5% 5% 0% 10% 5% 5% 20% 0% 5% 15% 0% 0% 5% 5% 5% 15% 0% 15% 5% 0% 68.7 59.4 63 50.8 65.8 72.5 66.5 68 Not Done 68 11 to 98 3 to 99 0 to 90 17 to 91 9 to 98 5% 15% 9% 0% 5% 5% 5% 4% 20% 10% 64 76** I 81 81 58 62 78.8 70.4 75 61.6 73.1 59.4 68.8 78 76 77 61.5 78 60 73 54 to 91 40 to 100 52 to 98 23 to 89 23 to 90 30 to 81 33 to 94 0% 0% 0% 0% 0% 0% 0% 0% 5% 0% 15% 5% 10% 10% Unk 47 G-2 81 Unk* 76 S 15** P J** 81 81 Unk* Not Done 61 74.8 73 70.6 74.1 72.8 69.9 59.9 76 76 68.5 74.9 59.5 69 77.5 73 76 76 73.5 66.5 71 Not Done 74 70 76 64.5 0 to 85 18 to 95 43 to 96 48 to 95 43 to 97 23 to 107 44 to 91 14 to 90 50 to 95 56 to 99 28 to 89 53 to 90 35a to 88 11% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 10% 0% 0% 0% 5% 0% 20% 0% 0% 5% 0% 20% 67.3 70.8 2.2% 18 out of 58 sections have child deaths 35 out of 58 sections have young adult deaths 6.2% *4 out of 20 blank *4 blanks;**1 blank *4 out 24 blank *3 out 21 blank *3 no birth date *14 unreadable ! *Dates not given *Ages 2 & 12;1917/18 *3 Y. Adults before 1920 *3 Bidwell Children *4 blanks,** Y.Ad 1921 Age 17;5/6/1864 Wilderness *M otor Vehicle Accident *2 Unread;4 No BD;25 count Old:8/20 survived past 40 yrs *2 Unreadable markers M other & 2 Children 1988 Multiple *6 Unread;**2 Unread;Harley *Anomalous ;1873-84 All *2 Unread; 19 done each *3 post 1955 deaths *21 Counted;1 1947 Exclud *6 unreadable *10 Read;**1932 early death *25 Read;1 Unread;**26 Read * 4 Blanks;All 1926-44! *Used 15; Xcld 5 prior 1930 a = WWII KIA Summary of Class Experiment: BIO 447 Immunobiology Oakwood Cemetery Deaths by Age: 19th Century vs Post 1940 Prior to 1900 Median Mean 50.6 54.3 0 to 15 yrs 15.2% 16 to 40 yrs 16.5% After 1940 Median Mean 67.3 70.8 0 to 15 yrs 2.2% 16 to 40 yrs 6.2% 48 out of 58 sections have child deaths 18 out of 58 sections have child deaths 55 out of 58 Sections have young adult deaths 35 out of 58 sections have young adult deaths Approximately 180 deaths prior to age 15 Approximately 25 deaths prior to age 15 What Have Vaccines Done For Us? (See Figure 18-1 Kuby, 3rd Edition) Antiviral Vaccines, From Roitt, 4th Edition, Figure 19.3 Data for U.S. VacSave1 What Have Vaccines Done For Us? (See Figure 18-1 Kuby, 3rd Edition) Antiviral Vaccines, From Roitt, 4th Edition, Figure 19.3 Data for U.S. VacSave2 What Have Vaccines Done For Us? Greatest Single Cause of Death for Humankind Since the Beginning of Civilization: Smallpox Deaths from Smallpox 1977 - 2004: 0 Smallpox Passive and Active Immune Protection Passive: Transfer of Pre-existing Immune Response Naturally from Mother to Child Trans-placental Breast Feeding Artificially in Medical Treatment Adoptive - Donor to Recipient Usually Antibodies; Could be Lymphocytes Anti-toxin Antibodies: Treatments for toxins already present: Rabies, Diphtheria, Tetanus, Botulinus Poisoning Provides Limited Duration Prophylaxis Active: Induce Immune Response Directly in Protected Individual Pass&Act Active Immunization Prophylactic Immunity based on Immunological Memory Controlled Artificial Infection • Active Disease-causing organism: Smallpox Pustule • • • • • • • • • • • Exudates - Variolation Cross-reactive related live organism: Vaccinia (cowpox virus) Vaccination Attenuated Live Organisms Inactivated Killed Organisms Inactivated Exotoxins - Diphtheria, Tetanus Purified Macromolecular Antigens Bacterial Capsular Polysaccharides Membrane Antigens: Plasma Membrane or Virus Envelope Cloned Antigenic Gene Products Synthetic Antigens Anti-idiotypic Antibodies (antigen mimics) DNA vaccines ActImmun Vaccines based on active immunization have one big advantage over vaccines based on passive transfer of immunity. What is that big advantage? 0 of 5 Vaccines based on passive transfer of immunity have one big advantage over vaccines based on active immunization. What is that big advantage? 0 of 5 Live Attenuated Vaccines Against Viral Diseases • Polio (Sabin Vaccine) - Also Use Killed Vaccine (Salk) • Measles • Mumps • Rubella • Yellow Fever • Hepatitis A (Live and killed versions) Against Bacterial Disease • Tuberculosis LiveVacc Killed Whole Organism Vaccines Against Viral Diseases • Polio (Salk Vaccine) - Also Use Attenuated Live Vaccine (Sabin) • Rabies • Influenza (strain-specific only) • Hepatitis A (Live and killed versions) Against Bacterial Disease • • • • • Pertussis (Whooping Cough) Typhoid Cholera (combined with toxin subunit vaccine) Plague (short-term protection only) Pneumococcal Pneumonia KillVacc Anti-Toxin Vaccines Clostridium tetani Formalin-inactivated exotoxin Corynebacterium diphtheriae Formalin-inactivated exotoxin Vibrio cholerae Exotoxin subunit (beta subunit) AntiTox Anti-Diphtheria Toxin Vaccine (Figure 19-5 Roitt, 4th Edition) DiphSave Diphtheria, tetanus, and cholera vaccines are directed toward a _ _ _ _ _ produced by the infectious organism 0 of 94 Purified Macromolecular Antigen Vaccines Capsular Polysaccharides – Must Be Conjugated to Protein Carriers to Get Memory Responses • Hemophilus influenza B (Bacterial meningitis) • Neisseria meningitidis • Streptococcus pneumoniae Recombinant Cell-Surface Antigen • Hepatitis B PureAg Vaccines Generally Given to All Tetanus (Toxoid) Diphtheria (Toxoid) Pertussis (Killed virus) • Given Together as DPT; Periodic Boosters for Tetanus & Diphtheria Required • Polio (Killed or Attnenuated Live Virus) Measles (Attenuated live virus) Mumps (Attenuated live virus) Rubella (Attenuated live virus) Chicken Pox (Attenuated live Varicella Zoster) Hemophilus Influenzae (Polysaccharide capsular component); For bacterial meningitis (not related to flu vaccine) GenVacc Vaccines for Groups at Special Risk Tuberculosis (BCG) Depending on Locale and Travel Hepatitis B (Recombinant Surface Ag) • Medical personnel; drug addicts; contacts Rabies - Animal workers or post exposure Influenza (Killed virus strains) - At risk and Elderly Pneumococcal pneumonia (Killed bacteria) - Elderly Meningitis (Capsular Polysaccharide) Yellow fever (Killed pathogen) Typhoid (Killed pathogen) Cholera (Mutant pathogen; Toxoid Subunit) Hepatitis A (Killed or attenuated virus) Varicella-zoster (Attenuated virus) SpecVacc What Vaccines Don't We Have? Viral Diseases • HIV - Presence of variants and Immunosuppression Ignorance of immunogenic antigens to use • Herpes Viruses (Papilloma virus vaccine announced Fall, 2002) • Adenoviruses, Rhinoviruses - Multiple types Bacterial Diseases • • • • • Staphylococci Group A Streptococci Mycobacterium leprae (Some benefit from BCG) Treponema pallidum (syphilis) Non-Hemophilus and Non-Neisseria Bacterial Menigitis Fungal Pathogens • Candida • Pneumocystis VacNeed1 More Vaccines That We Don't Have Protozoa • Malaria • Trypanosomiasis Sleeping Sickness Chagas Disease - Autoimmunity and Immunosupression • Leishmaniasis Multicellular Parasites - Worms • Schistosomiasis Prophylactic and Therapeutic Cancer Vaccines VacNeed2 How Can We Get What We Don't Have? Combination Epitope Vaccines (Multivalent Subunit Vaccines ) Delivery Vehicles and Adjuvants Anti-Idiotype Vaccines Naked DNA Vaccines Engineered Vector and Antigen-presenting Cell Vaccines Mucosal-Active (IgA Isotype) Vaccines VaccsGet Non-Scientific Problems with Vaccines Medical Risks to Individuals vs "Herd Immunity" Immediate Risks to the Individual Long-term Benefits the the Group and the Individual Very low percentage risks multiplied over huge populations Side-Reactions, Limited Efficacy, Limited Duration Costs and Ability to Pay Geographical Distribution "Orphan" and "Third World" Diseases Limitations in Vaccine Production for Diseases with High Rate of Strain Variation Autonomy, Parental rights, Religious Freedom Public Acceptance and Ignorance of History Problems Risks from Whooping Cough Disease (Pertussis) vs. Risks from Pertussis Vaccine Pertussis Vaccine Seizures: 1 in 1,750 Encephalytis: 1 in 110,000 Brain Damage: 1 in 310,000 Death: 1 in 1,000,000 Whooping Cough Disease Seizures: 1 in 25 to 1 in 50 Encephalytis: 1 in 1, to 4,000 Brain Damage: 1 in 2, to 8,000 Death: 1 in 200 to 1 in 1,000 Difference in Death Rate: Natural Exposure to Whooping Cough vs Exposure to Pertussis Vaccine: 1,000-fold to 5,000-fold increased Risk Whooping View Animation on Textbook Web-site: (Linked to Course Home Page) - Vaccines Survey of Oakwood Cemetery done by BIO 447 Class, 1999: Section with Burials Prior to 1900 vs Sections with Burials after 1940 Song of the Oakwood Children: Rachel Amelia Cody, June 1840 (Your response is anonymous. No name will be recorded) With respect the use of Turning Point XR Transmitter system in BIO 447 and its contribution to the standards of the course: The next slide will ask what you think of how well the system works 0 of 94 or cc ep ta b 0% Po 0% le d 0% A O ut sta n di ng 0% Response Grid 0% Te rr ib le Outstanding Good Acceptable Poor Terrible G oo 1. 2. 3. 4. 5. (Your response is anonymous. No name will be recorded) With respect to how well the Turning Point XR Transmitter system works in the classroom: 1. 2. 3. 4. 5. It works outstandingly well It works well It is OK It is pretty unreliable and hard to make work It doesn’t work well at all It wo rk s ou ts ta n di ng ly we It ll wo rk sw It el is l pr et It ty is un O K re It lia do bl es ea n’ nd tw ... or k we ll at al l 0% 0% 0% 0% 0% 0 of 94 Anti-Idiotypic Antibodies (Figure 19.9, Roitt, 4th Edition) IdioVacc