Difference between revisions of "Immunization" - New World Encyclopedia

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[[Image:Poliodrops.jpg|right|thumb|A child being immunized against [[Polio]].]]
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:''For financial immunization, see [[Immunization (finance)]].''
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[[Image:Poliodrops.jpg|right|thumb|300px|A child being immunized against [[polio]].]]
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'''Immunization''', or '''immunisation''', is the process by which an individual is exposed to an agent that is designed to fortify his or her immune system against that agent. The material is known as an [[antigen|immunogen]]. Immunization is the same as [[inoculation]] and [[vaccination]] in that inoculation and vaccination use a viable infecting agent like immunization does. Immunization is just the general term for vaccination and such things as what you gain from these proccess. 
 
  
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When the human immune system is exposed to a disease once, it can develop the ability to quickly respond to a subsequent infection. Therefore, by exposing an individual to an immunogen in a controlled way, their body will then be able to protect itself from infection later on in life.
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'''Immunization''' (or '''immunisation''' in British English) is the process of conferring increased resistance to an infectious [[disease]] by a means other than experiencing the natural infection. Typically, this involves exposure to an agent ([[antigen]] or immunogen) that is designed to fortify the person's [[immune system]] against that agent or similar infectious agents (active immunization). Immunization also can include providing the subject with protective [[antibody|antibodies]] developed by someone else or another organism (passive immunization).
  
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{{Vaccines}}
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When the human immune system is exposed to a disease once, it can develop the ability to quickly respond to a subsequent infection. Therefore, by exposing an individual to an immunogen in a controlled way, the person's body will then be able to protect itself from infection later on in life.
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{{immunology-stub}}
 
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'''Vaccination''' is the process of administering weakened or dead pathogens to a healthy person, with the intent of conferring immunity against a targeted form of a related disease agent. 
 
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The term was coined by [[Edward Jenner]] and adapted by [[Louis Pasteur]] for his pioneering work in vaccination. Vaccination ([[Latin]]: ''vacca—[[cow]]'') is so named because the first [[vaccine]] was derived from a [[virus (biology)|virus]] affecting cows: the [[cowpox]] virus, a relatively benign virus that provides a degree of immunity to [[smallpox]], a contagious and deadly disease.  In common speech, 'vaccination' and 'immunization' generally have the same colloquial meaning.  Vaccination efforts were [[anti-vaccinationists|initially met with some resistance]] before early success brought widespread acceptance and mass vaccination campaigns were undertaken.
 
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The eradication of [[smallpox]], which was last seen in a natural case in 1977, is considered the most spectacular success of vaccination. Some people assert that childhood vaccination plays a role in [[autoimmune disease]] and [[autism]], though large-scale scientific studies have not shown any link.
 
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==Triggering immune sensitization==
 
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In the generic sense, the process of [[artificial induction of immunity]], in an effort to protect against [[infectious disease]], works by 'priming' the [[immune system]] with an '[[immunogen]]'.  Stimulating immune response, via use of an infectious agent, is known as ''[[immunization (medicine)|immunization]]''.  Vaccinations involve the administration of one or more immunogens, in the form of live, but weakened ([[attenuated]]) infectious agents, which normally are either weaker, but closely-related species (as with smallpox and cowpox), or strains weakened by some process.  In such cases, an immunogen is called a ''[[vaccine]]''.
 
  
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Some modern vaccines are administered after the patient already has contracted a disease, as in the cases of experimental [[AIDS]], [[cancer]] and [[Alzheimer's disease]] vaccines. Vaccinia given after exposure to smallpox, within the first four days, is reported to attenuate the disease considerably, and vaccination within the first week is known to be beneficial to a degree. The first Rabies immunisation was given by Pasteur to a child bitten by a rabid dog, and then and subsequently post-exposure immunisation to Rabies has generally been followed by survival. The essential empiricism behind such immunizations is that the vaccine triggers an immune response more rapidly than the natural infection itself.
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The term immunization often is used interchangeably with [[vaccination]] and [[inoculation]], all of which use a viable infecting agent. Like active immunization, vaccination involves administration of [[antigen]]ic material to produce immunity to a disease, which will prevent or ameliorate the effects of [[infection]] by a [[pathogen]]. This material can either be live, but weakened forms of pathogens (such as [[bacteria]] or [[virus]]es); killed or inactivated forms of these pathogens; or purified material such as [[protein]]s. While vaccination is used today in the same sense as immunization, in a strict sense the term refers to its original meaning, which is protection conferred against [[smallpox]] by material taken from cow infected with Cowpox virus, which is related to the ''vaccinia'' virus (Blakemore and Jennett 2001). While in common use, the term inoculation can be used synonymously for immunization, it is often limited to a process involving unweakened, live pathogens. The term inoculation is used less frequently nowadays (Blakemore and Jennett 2001).
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{{toc}}
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Medical researchers have developed diverse immunization processes for a vast number of diseases, beginning on a large scale about a century ago. Immunization has proved to be one of the most cost-effective public health measures available (Breslow 2002), with vaccines providing the means for eradicating [[smallpox]] and bringing into sight the goal of making the world free from [[polio]], [[measles]], and other serious diseases. However, mastery of the agents causing human disease can be a two-edged sword as that mastery can also be applied toward developing biological weapons that cause diseases. Even now there remains the fear that smallpox could be used as such a weapon, now that it has been eradicated and people are no longer being immunized.
  
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Most vaccines are given by hypodermic injection as they are not absorbed reliably through the gut.  Live attenuated Polio, some Typhoid and Cholera Vaccines are given orally in order to produce immunity based in the bowel.
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== History of immunization ==
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Recognizing that an infectious disease, once overcome, did not normally reappear, people have tried to prevent getting a disease by purposely inoculating themselves with infected material. This is first known with [[smallpox]] before 200 B.C.E. (NMAH).  
  
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==History of vaccinations==
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In 1718, [[Lady Mary Wortley Montague]] reported that the [[Turkey|Turks]] have a habit of deliberately inoculating themselves with fluid taken from mild cases of smallpox and she inoculated her own children (Behbehani 1983).
  
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Vaccination campaigns have spread throughout the globe since Jenner's smallpox vaccine of 1796, sometimes prescribed by law or regulations (See [[Vaccination/Vaccination acts|vaccination Acts]]). Vaccines are now used to fight a wide variety of disease threats besides [[smallpox]]. [[Louis Pasteur]] further developed the technique during the 19th century, extending its use to protecting against bacterial [[anthrax disease|anthrax]] and viral [[rabies]]. The method Pasteur used entailed  treating the infectious agents for those diseases so they lost the ability to cause serious disease. Pasteur adopted the name ''vaccine'' as a generic term in honor of Jenner's discovery, which Pasteur's work built upon.
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In 1796, [[Edward Jenner]] (1749-1823) inoculated against smallpox using [[cowpox]] (a mild relative of the deadly smallpox virus). While Edward Jenner has been recognized as the first doctor to give sophisticated immunization, it was British dairy farmer Benjamin Jestey who noticed that "milkmaids" did not become infected with [[smallpox]], or displayed a milder form. Jestey took the pus from an infected [[cow]]'s udder and inoculated his wife and children with cowpox, in order to artificially induce immunity to smallpox during the [[epidemic]] of 1774, thereby making them immune to smallpox. Twenty-two years later, by injecting a human with the cowpox virus (which was harmless to humans), Jenner swiftly found that the immunized human was then also immune to smallpox. The process spread quickly, and the use of cowpox immunization and later the vaccinia virus (of the same family as the cowpox virus and the smallpox virus or ''Variola'') led to the almost total eradication of smallpox in modern human society. After successful vaccination campaigns throughout the nineteenth and twentieth centuries, the World Health Organization (WHO) certified the eradication of smallpox in 1979.
  
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Prior to vaccination with cowpox, the only known protection against smallpox was ''[[inoculation]]'' or ''variolation'' (Variola - the Smallpox viruses) where a small amount of live smallpox virus was administered to the patient;  this carried the serious risk that the patient would be killed or seriously ill.  The death rate from variolation was reported to be around a tenth of that from natural infection with Variola, and the immunity provided was considered quite reliable. Factors contributing to the efficacy of variolation probably include the choices of Variola Minor strains used, the relatively low number of cells infected in the first phase of multiplication following initial exposure, and the exposure route used, via the skin or nasal lining rather than inhalation of droplets into the lungs.
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Vaccination to prevent smallpox was soon practiced all over the world. During the nineteenth century, the cowpox virus used for smallpox vaccination was replaced by vaccinia virus. Vaccinia is in the same family as cowpox and variola but is genetically distinct from both.
  
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Consistency would suggest the activity should have predated Jenner's description of an effective vaccination system, and there is some history relating to opposition to the older and more hazardous procedure of variolation.
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[[Louis Pasteur]] developed a fowl cholera vaccine in 1880, was involved in the introduction of [[anthrax]] vaccine in 1881, and developed a [[rabies]] vaccine in 1885. In 1898, Almoth Wright developed typhoid vaccine, and in 1954 Salk (killed) [[polio]] vaccine was introduced, while in 1957 Sabin (live) polio vaccine was introduced. In 1960, [[measles]] vaccine was introduced, and later vaccines were developed for [[rubella]], [[mumps]], and [[hepatitis B]].
  
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In modern times, the first vaccine-preventible disease targeted for eradication was smallpox. The World Health Organization coordinated the global effort to eradicate this disease. The last naturally occurring case of smallpox occurred in Somalia in 1977.  
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==Passive and active immunization==
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===Passive immunization===
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Passive immunization is where pre-made [[antibody|antibodies]] developed by one organism are given to another organism. This may involve administration of antibodies from one individual organism to another, such as the transfer of human [[immunoglobulin]] from one human to another or transfer of antisera prepared in animals. Passive immunity also includes the natural transfer of antibodies developed by a mother to her child across the [[placenta]] during pregnancy, helping to protect the child before and shortly after birth (Breslow 2002).  
  
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In 1988, the governing body of W.H.O. targeted polio for eradication by the year 2000. Although the target was missed, eradication is very close. The next eradication target would most likely be measles, which has declined since the introduction of measles vaccination in 1963.
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This passive method of immunization begins to work very quickly, but it is temporary and generally short-lasting, because the antibodies are naturally broken down, and not stored for later use. It can also result in [[serum sickness]] and [[anaphylaxis]].  
  
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In 2000, the [[Global Alliance for Vaccines and Immunization]] was established to strengthen routine vaccinations and introduce new and under-used vaccines in countries with a per capita GDP of under US$1000. GAVI is now entering its second phase of funding, which extends through 2014.
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Artificial passive immunization is normally given by injection and is used if there has been a recent outbreak of a particular disease or as an emergency treatment to poisons from insects, and so forth. For example, special risk groups likely to suffer from complications of infection, such as with [[HIV]], [[asthma]], or [[congenital heart disease]], may received passive immunization, as can individuals traveling to a country with high incidences of the disease.
  
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==Compulsory vaccination and opposition to vaccination==
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===Active immunization===
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In an attempt to eliminate the risk of outbreaks of some diseases, several governments and other institutions have instituted policies requiring vaccination for all people. For example, an 1853 law required universal vaccination against smallpox in [[England]] and [[Wales]], with fines levied on people who did not comply. In the United States, the [[United States Supreme Court|Supreme Court]] ruled in the 1905 case ''Jacobson v. Commonwealth of Massachusetts'' that the state could require individuals to be vaccinated for the common good. Common contemporary vaccination policies require that children receive common vaccinations before entering school. Compulsory vaccination is believed to have greatly reduced the rates of some infectious diseases.<ref name="Salmon2006">Salmon, Daniel A ''et al''. (2006) Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future. ''The Lancet'' 367(9508):436-442.</ref>
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Active immunization involves stimulating the individual's own [[immune system]] by the administration of an [[antigen]]ic substance into a person then the recipient will develop [[antibody|antibodies]]. This may involve introduction of an inactivated (killed) agent or an attenuated (live, but enfeebled) agent (Blakemore and Jennett 2001). The ''inactivated'' agents may involve killed whole organisms, sub-units of the killed organisms, or the inactivated toxins released by the organisms (Blakemore and Jennett 2001). Toxoids are made by using the toxins excreted by [[microorganism]]s and inactivating them chemically or physically (Breslow 2002). ''Attenuated'' agents may involve modified strains of the causal organisms (such as ones containing the genetic markers to stimulate antibody production but not the genetic components to produce the infection) or may involve related organisms (Blakemore and Jennett 2001).
  
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Beginning with early vaccination in the nineteenth century, these policies led to resistance from a variety of groups, collectively called [[anti-vaccinationist]]s, who objected on ethical, political, medical safety, [[vaccination and religion|religious]], and other grounds. Common objections are that compulsory vaccination represents excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe. Many modern vaccination policies allow exemptions for people who have compromised immune systems, allergies to the components used in vaccinations or strongly-held objections.<ref name="Salmon2006"/>
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Examples of attenuated (live) vaccines include those for [[yellow fever]], [[poliomyelitis]] (Sabin), [[measles]], [[rubella]], [[mumps]], and [[rabies]] (Blakemore and Jennett 2001). Examples of inactivated (killed) toxoids include [[influenza]], poliomyelitis (Salk), [[hepatitis A]], and [[hepatitis B]] (Blakemore and Jennett 2001). The most commonly used toxoids are [[diphtheria]] and [[tetanus]] (Breslow 2002).  
  
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==Herd immunity and medical risk management issues==
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Normally, protection from active immunization lasts for years or even confers lifetime immunity (Breslow 2002). Some vaccines, such as for diphtheria and tetanus, require periodic booster doses to maintain immunity (Breslow 2002).
  
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Vaccination campaigns are generally accepted as having contributed to the worldwide elimination of [[smallpox]], through [[herd immunity]], and to the restriction of [[polio]] to isolated pockets in countries where healthcare access is difficult.  The [[risk management]] practices of government health agencies' promoting widespread vaccination campaigns has prompted increasing controversy in recent years, despite the fact that many once-common childhood diseases, such as [[mumps]], [[measles]] and [[rubella]], are now relatively rare in developed countries.
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== Use of vaccines ==
  
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Nevertheless, vaccination campaigns may have unfortunate [[Co-evolution|co-evolutionary]] side-effects, particularly if they produce a selective pressure in favor of certain strains against which there are no vaccines or [[pharmacology|treatment]].  Another problem related to co-evolution is that vaccines that may eliminate one infectious diseases or another may, in turn, allow others to thrive in the [[ecological niche]] that has been vacated.  For example, it has been postulated that (the less-often-fatal) serogroup-B [[meningitis]] strains may expand into the niche provided if serogroup-C is largely eradicated through vaccination.  However, while there has been a rise in serogroup-B meningitis, there is as yet no evidence to link this to the meningitis-C vaccination.
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For a vaccine to be suitable for general use, the following are broad principles applicable for its use (Blakemore and Jennett 2001):
 +
#Vaccine should prevent an illness regarded as serious
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#There should be a major risk of contracting the infection for which the vaccine is designed
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#The efficacy of the vaccine (ability to produce the desired effect) should be high
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#The risk from the vaccine should be low
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#The procedures (such as number of doses) necessary should be acceptable to the public
  
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An incompletely-successful attempt at eradication of a disease through vaccination might increase the [[mathematical modelling in epidemiology#The mathematics of mass vaccination|average age of contraction of the disease]].  In diseases such as [[measles]], where there is a higher rate of complication in older people, the overall effect might, in theory, be to cause more deaths than before the vaccination was introduced.  Potentially, this could be a '[[perverse effects of vaccination|perverse effect]]' of vaccination campaigns.  Observation of immunity levels in a population over many years has been followed by booster immunization programs, for instance, in the [[United Kingdom]], with measles and mumps.
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Ideally, vaccines should yield long-lasting protection, be inexpensive, have no adverse effect on the recipient, and be stable for transportation and storage (Blakemore and Jennett 2001).
  
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==Adjuvants and preservatives==
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In the United States, each state provides school districts with an obligation to regulate those eligible to enter public schooling. Since schools are congregate settings, and thus communication of diseases is a consideration, school districts may exclude children who seek to attend ''without'' the protection of certain immunizations.
  
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Vaccines typically contain one or more [[adjuvants]], used to boost the immune response.  
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For example, in the state of [[Ohio]], each student is required to provide proof of specific immunizations or have an authorized waiver from the requirement upon entry to school at age six. If a student does ''not'' have the necessary immunizations or a waiver acceptable to the state, the school principal may refuse entry and require compliance with a set deadline. This procedure is for the safety of all students and the public health and follows Ohio State law.  
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Tetanus toxoid for instance is usually adsorbed onto Alum.  This presents the antigen in such a way as to produce a greater action than the simple aqueous tetanus toxoid.  People who get an excessive reaction to adsorbed tetanus toxoid may be given the simple vaccine when time for a booster occurs.
 
  
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In the preparation for the 1990 Gulf campaign, Pertussis vaccine (not acellular) was used as an adjuvant for Anthrax vaccine.  This produces a more rapid immune response than giving only the Anthrax, which is of some benefit if exposure might be imminent.
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Unless given a waiver, students must meet the following requirements:
  
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They may also contain preservatives, which are used to prevent contamination with [[bacteria]] or [[fungi]]. Until recent years, the preservative [[thimerosal]] was used in many vaccines that did not contain live virus. [[As of 2005]], the only childhood vaccine in the U.S.A. that contains thiomerosal is the influenza vaccine [http://www.vaccinesafety.edu/thi-table.htm], which is currently recommended only for children with certain risk factors.<ref>Melinda Wharton. National Vaccine Advisory committee [http://www.hhs.gov/nvpo/vacc_plan/ U.S.A. national vaccine plan]</ref> The UK is considering Influenza immunisation in children perhaps as soon as in 2006-7. Single-dose Influenza vaccines supplied in the UK do not list Thiomersal (its UK name) in the ingredients. Preservatives may be used at various stages of production of vaccines, and the most sophisticated methods of measurement might detect traces of them in the finished product, as they may in the environment and population as a whole[http://www.npl.co.uk/environment/vam/nongaseouspollutants/ngp_metals.html].
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#'''DPT ([[Diphtheria]], [[pertussis]], [[tetanus]])'''—Five doses if the fourth one was before the fourth birthday.
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#'''[[Measles]]'''—Two doses, the first one after 12 months of age, and the second at least 28 days after the first birthday.
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#'''[[Rubella]]'''—Same as measles.
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#'''[[Mumps]]'''—Same as measles.
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#'''[[Poliomyelitis|Polio]]'''—Four doses if the third was before the fourth birthday.
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#'''[[Hepatitis B]]'''—For students starting kindergarten.  
  
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== Vaccine research ==
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Additionally, for schools offering a pre-school program, add the requirements for two doses of [[haemophilus influenzae]].
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Some major contemporary research in vaccination focuses on development of vaccinations for diseases including [[HIV vaccine|HIV]] and [[malaria]].
 
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''Vaccine'' is an international [[peer-reviewed]] journal for vaccination researchers, indexed in [[Medline]] pISSN: 0264-410X.
 
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==See also==
 
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*[[Vaccine controversy]]
 
  
 
==References==
 
==References==
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<references/>
 
  
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==External links==
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* Behbehani, A.M. 1983. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC281588/ The smallpox story: Life and death of an old disease] ''Microbiol Rev'' 47(4): 455-509. Retrieved Marh 13, 2021.
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* [http://vaccines.org/ aggregation site] links to resources in many countries. Growing.
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* Blakemore, C., and S. Jennett. 2001. ''The Oxford Companion to the Body''. New York: Oxford University Press. ISBN 019852403X.
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* Breslow, L. 2002. ''Encyclopedia of Public Health''. New York: Macmillan Reference USA/Gale Group Thomson Learning. ISBN 0028658884.
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* National Museum of American History (NMAH). [https://amhistory.si.edu/polio/virusvaccine/history.htm History of vaccines]. ''Smithsonian National Museum of American History''. Retrieved March 13, 2021.
  
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===Sites promoting vaccination policies===
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==External Links==
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All links retrieved March 13, 2021.
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* [http://briandeer.com/mmr-lancet.htm Brian Deer.com] - 'mmr &  autism investigation: part 1: the ''Lancet'' scandal', [[Brian Deer]]
 
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* [http://www.cdc.gov/nip CDC.gov] - 'National Immunization Program: leading the way to healthy lives', [[Centers for Disease Control|US Centers for Disease Control]] (CDC information on vaccinations)
 
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* [http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/default.htm CDC.gov]  - 'Mercury and Vaccines (Thimerosal)', US Centers for Disease Control
 
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* [http://www.immunize.org/ Immunize.org] - Immunization Action Coalition' (nonprofit working to increase immunization rates)
 
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* [http://nytimes.com/2005/06/25/science/25autism.html NYTimes.com] - 'On Autism's Cause, It's Parents vs. Research', Gardiner Harris, Anahad O'Connor, ''New York Times'' (front page; June 25, 2005)
 
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* [http://www.opinionjournal.com/editorial/feature.html?id=110004700 OpinionJournal.com] - 'Autism and vaccines: Activists wage a nasty campaign to silence scientists' (unsigned editorial opinion), ''[[Wall Street Journal]]'' (February 16, 2004)
 
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* [http://www.shns.com/shns/g_index2.cfm?action=detail&pk=FUMENTO-03-11-04 SNHS.com] - 'Anti-vaccine activists get jabbed', Michael Fumento (March 11, 2004)
 
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* [http://www.who.int/vaccines/ WHO.int] - 'Immunizations, vaccines and biologicals: Towards a World free of Vaccine Preventable Diseases', [[World Health Organization]] (WHO's global vaccination campaign website)
 
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===Sites critical of vaccination policies===
 
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* [http://www.909shot.com/ 909Shot.com] - 'National Vaccine Information Center: the oldest and largest national organization advocating reformation of the mass vaccination system'
 
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* [http://autism.about.com/cs/autisminprint/a/wakefieldfired.htm About.com] - "Killing the Messenger: Dr. Andrew Wakefield Fired", Floyd Tilton (December 5, 2001)
 
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* [http://www.vaccinationdebate.com/ VaccinationDebate.com] - 'Vaccination Debate', Ian Sinclair - despite the site's name, the author is unequivocally opposed to the science of vaccination.
 
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* [https://www.cdc.gov/vaccines/ Vaccines & Immunizations] ''Centers for Disease Control'' (CDC).
  
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{{Vaccines}}
  
  
 
[[Category:Life sciences]]
 
[[Category:Life sciences]]
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{{credit|Immunization|148506497|Vaccination|155831558}}

Latest revision as of 16:11, 27 July 2021

A child being immunized against polio.

Immunization (or immunisation in British English) is the process of conferring increased resistance to an infectious disease by a means other than experiencing the natural infection. Typically, this involves exposure to an agent (antigen or immunogen) that is designed to fortify the person's immune system against that agent or similar infectious agents (active immunization). Immunization also can include providing the subject with protective antibodies developed by someone else or another organism (passive immunization).

When the human immune system is exposed to a disease once, it can develop the ability to quickly respond to a subsequent infection. Therefore, by exposing an individual to an immunogen in a controlled way, the person's body will then be able to protect itself from infection later on in life.

The term immunization often is used interchangeably with vaccination and inoculation, all of which use a viable infecting agent. Like active immunization, vaccination involves administration of antigenic material to produce immunity to a disease, which will prevent or ameliorate the effects of infection by a pathogen. This material can either be live, but weakened forms of pathogens (such as bacteria or viruses); killed or inactivated forms of these pathogens; or purified material such as proteins. While vaccination is used today in the same sense as immunization, in a strict sense the term refers to its original meaning, which is protection conferred against smallpox by material taken from cow infected with Cowpox virus, which is related to the vaccinia virus (Blakemore and Jennett 2001). While in common use, the term inoculation can be used synonymously for immunization, it is often limited to a process involving unweakened, live pathogens. The term inoculation is used less frequently nowadays (Blakemore and Jennett 2001).

Medical researchers have developed diverse immunization processes for a vast number of diseases, beginning on a large scale about a century ago. Immunization has proved to be one of the most cost-effective public health measures available (Breslow 2002), with vaccines providing the means for eradicating smallpox and bringing into sight the goal of making the world free from polio, measles, and other serious diseases. However, mastery of the agents causing human disease can be a two-edged sword as that mastery can also be applied toward developing biological weapons that cause diseases. Even now there remains the fear that smallpox could be used as such a weapon, now that it has been eradicated and people are no longer being immunized.

History of immunization

Recognizing that an infectious disease, once overcome, did not normally reappear, people have tried to prevent getting a disease by purposely inoculating themselves with infected material. This is first known with smallpox before 200 B.C.E. (NMAH).

In 1718, Lady Mary Wortley Montague reported that the Turks have a habit of deliberately inoculating themselves with fluid taken from mild cases of smallpox and she inoculated her own children (Behbehani 1983).

In 1796, Edward Jenner (1749-1823) inoculated against smallpox using cowpox (a mild relative of the deadly smallpox virus). While Edward Jenner has been recognized as the first doctor to give sophisticated immunization, it was British dairy farmer Benjamin Jestey who noticed that "milkmaids" did not become infected with smallpox, or displayed a milder form. Jestey took the pus from an infected cow's udder and inoculated his wife and children with cowpox, in order to artificially induce immunity to smallpox during the epidemic of 1774, thereby making them immune to smallpox. Twenty-two years later, by injecting a human with the cowpox virus (which was harmless to humans), Jenner swiftly found that the immunized human was then also immune to smallpox. The process spread quickly, and the use of cowpox immunization and later the vaccinia virus (of the same family as the cowpox virus and the smallpox virus or Variola) led to the almost total eradication of smallpox in modern human society. After successful vaccination campaigns throughout the nineteenth and twentieth centuries, the World Health Organization (WHO) certified the eradication of smallpox in 1979.

Vaccination to prevent smallpox was soon practiced all over the world. During the nineteenth century, the cowpox virus used for smallpox vaccination was replaced by vaccinia virus. Vaccinia is in the same family as cowpox and variola but is genetically distinct from both.

Louis Pasteur developed a fowl cholera vaccine in 1880, was involved in the introduction of anthrax vaccine in 1881, and developed a rabies vaccine in 1885. In 1898, Almoth Wright developed typhoid vaccine, and in 1954 Salk (killed) polio vaccine was introduced, while in 1957 Sabin (live) polio vaccine was introduced. In 1960, measles vaccine was introduced, and later vaccines were developed for rubella, mumps, and hepatitis B.

Passive and active immunization

Passive immunization

Passive immunization is where pre-made antibodies developed by one organism are given to another organism. This may involve administration of antibodies from one individual organism to another, such as the transfer of human immunoglobulin from one human to another or transfer of antisera prepared in animals. Passive immunity also includes the natural transfer of antibodies developed by a mother to her child across the placenta during pregnancy, helping to protect the child before and shortly after birth (Breslow 2002).

This passive method of immunization begins to work very quickly, but it is temporary and generally short-lasting, because the antibodies are naturally broken down, and not stored for later use. It can also result in serum sickness and anaphylaxis.

Artificial passive immunization is normally given by injection and is used if there has been a recent outbreak of a particular disease or as an emergency treatment to poisons from insects, and so forth. For example, special risk groups likely to suffer from complications of infection, such as with HIV, asthma, or congenital heart disease, may received passive immunization, as can individuals traveling to a country with high incidences of the disease.

Active immunization

Active immunization involves stimulating the individual's own immune system by the administration of an antigenic substance into a person then the recipient will develop antibodies. This may involve introduction of an inactivated (killed) agent or an attenuated (live, but enfeebled) agent (Blakemore and Jennett 2001). The inactivated agents may involve killed whole organisms, sub-units of the killed organisms, or the inactivated toxins released by the organisms (Blakemore and Jennett 2001). Toxoids are made by using the toxins excreted by microorganisms and inactivating them chemically or physically (Breslow 2002). Attenuated agents may involve modified strains of the causal organisms (such as ones containing the genetic markers to stimulate antibody production but not the genetic components to produce the infection) or may involve related organisms (Blakemore and Jennett 2001).

Examples of attenuated (live) vaccines include those for yellow fever, poliomyelitis (Sabin), measles, rubella, mumps, and rabies (Blakemore and Jennett 2001). Examples of inactivated (killed) toxoids include influenza, poliomyelitis (Salk), hepatitis A, and hepatitis B (Blakemore and Jennett 2001). The most commonly used toxoids are diphtheria and tetanus (Breslow 2002).

Normally, protection from active immunization lasts for years or even confers lifetime immunity (Breslow 2002). Some vaccines, such as for diphtheria and tetanus, require periodic booster doses to maintain immunity (Breslow 2002).

Use of vaccines

For a vaccine to be suitable for general use, the following are broad principles applicable for its use (Blakemore and Jennett 2001):

  1. Vaccine should prevent an illness regarded as serious
  2. There should be a major risk of contracting the infection for which the vaccine is designed
  3. The efficacy of the vaccine (ability to produce the desired effect) should be high
  4. The risk from the vaccine should be low
  5. The procedures (such as number of doses) necessary should be acceptable to the public

Ideally, vaccines should yield long-lasting protection, be inexpensive, have no adverse effect on the recipient, and be stable for transportation and storage (Blakemore and Jennett 2001).

In the United States, each state provides school districts with an obligation to regulate those eligible to enter public schooling. Since schools are congregate settings, and thus communication of diseases is a consideration, school districts may exclude children who seek to attend without the protection of certain immunizations.

For example, in the state of Ohio, each student is required to provide proof of specific immunizations or have an authorized waiver from the requirement upon entry to school at age six. If a student does not have the necessary immunizations or a waiver acceptable to the state, the school principal may refuse entry and require compliance with a set deadline. This procedure is for the safety of all students and the public health and follows Ohio State law.

Unless given a waiver, students must meet the following requirements:

  1. DPT (Diphtheria, pertussis, tetanus)—Five doses if the fourth one was before the fourth birthday.
  2. Measles—Two doses, the first one after 12 months of age, and the second at least 28 days after the first birthday.
  3. Rubella—Same as measles.
  4. Mumps—Same as measles.
  5. Polio—Four doses if the third was before the fourth birthday.
  6. Hepatitis B—For students starting kindergarten.

Additionally, for schools offering a pre-school program, add the requirements for two doses of haemophilus influenzae.

References
ISBN links support NWE through referral fees

  • Behbehani, A.M. 1983. The smallpox story: Life and death of an old disease Microbiol Rev 47(4): 455-509. Retrieved Marh 13, 2021.
  • Blakemore, C., and S. Jennett. 2001. The Oxford Companion to the Body. New York: Oxford University Press. ISBN 019852403X.
  • Breslow, L. 2002. Encyclopedia of Public Health. New York: Macmillan Reference USA/Gale Group Thomson Learning. ISBN 0028658884.
  • National Museum of American History (NMAH). History of vaccines. Smithsonian National Museum of American History. Retrieved March 13, 2021.

External Links

All links retrieved March 13, 2021.

Vaccination/Vaccine (and Immunization, Inoculation. See also List of vaccine topics and Epidemiology)
Development: Models - Timeline - Toxoid - Trial

Administration: ACIP - GAVI - VAERS - Vaccination schedule - VSD

Specific vaccines: Anthrax - BCG - Cancer - DPT - Flu - HIV - HPV - MMR - Pneumonia - Polio - Smallpox

Controversy: A-CHAMP - Anti-vaccinationists - NCVIA - Pox party - Safe Minds - Simpsonwood - Thimerosal controversy - Vaccine injury

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