Vaccine

Vaccine :

Definition of Vaccine:

  • It is a biological preparation that provides active acquired immunity to a particular infectious disease.
  • Typically it 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.
  • The agent stimulates the body’s immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future.

How Vaccine comes in this world?

  • The terms vaccine and vaccination are derived from Variolae vaccinae (smallpox of the cow), the term devised by Edward Jenner (who both developed the concept of vaccines and created the first vaccine) to denote cowpox.
  • Edward Jenner is considered the founder of vaccinology in the West in 1796, after he inoculated a 13 year-old-boy with vaccinia virus (cowpox), and demonstrated immunity to smallpox. In 1798, the first smallpox vaccine was developed.
  • He used the phrase in 1798 for the long title of his Inquiry into the Variolae vaccinae Known as the Cow Pox, in which he described the protective effect of cowpox against smallpox.

How Vaccine works?

  • Vaccines added with weakened or inactive parts of a particular organism (antigen) that triggers an immune response within the body.
  • Now day new vaccines contain the blueprint for producing antigens rather than the antigen itself.
  • As a response body will produce the antigen, this weakened version will not cause the disease in the person receiving the vaccine, but it will prompt their immune system to respond much as it would have on its first reaction to the actual pathogen.
  • Some vaccines require multiple doses. This will allow body for production of long-lived antibodies and development of memory cells.
  • In this way, the body is trained to fight the specific disease-causing organism, building up memory of the pathogen so as to rapidly fight it if and when exposed in the future.

What is the Antibody & Antigen?

  • An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the pathogen, called an antigen

What is T-Cell?

  • T cells are part of the immune system and develop from stem cells in the bone marrow. They help protect the body from infection and may help fight cancer. Also called T lymphocyte and thymocyte.

Type:

  • Conventional adaptive T cells
  • Cytotoxic T cells
  • Memory T cells

What is Herd immunity?

  • If someone is vaccinated, they are very likely to be protected against the targeted disease. Practically not possible that everyone can be vaccinated. People with weaken or compromised their immune systems (such as cancer or HIV) or who have severe allergies to some vaccine components may not be able to get vaccinated with certain vaccines.
  • They can still be protected if they live in and amongst others who are vaccinated or immunized with disease. If large number of people in a community are vaccinated the pathogen has a hard time circulating because most of the people it encounters are immune.
  • So, the more that others are vaccinated, the less likely people who are unable to be protected by vaccines are at risk of even being exposed to the harmful pathogens. This is called “Herd immunity”.
  • Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from person to person unlikely. As a result, the whole community becomes protected not just those who are immune.
  • Vaccinating not only protects yourself, but also protects those in the community who are unable to be vaccinated. If you are able to, get vaccinated.

Some Notable Vaccine Name with Brand Available:

Name of VaccineHistoryYearAvailable in Market
Poliovirus Vaccine (IPV)
Oral poliovirus vaccines (OPV)		Hilary Koprowski19501. Primopol Oral Poliovirus Vaccine (Panacea Biotec Ltd)
Cholera vaccine (OCVs)Louis Pasteur18971. Shanchol (Sanofi India Ltd)
Anthrax vaccineLouis Pasteur19041. Priorix Vaccine (GSK)  
The bacille Calmette-Guérin (BCG) vaccine for TuberculosisAlbert Calmette and Camille Guérin19211. SII-Onco-BCG Injection (Serum Institute of India Ltd)  

2. Onco Bcg (Cipla Ltd)  

3. Oncovac (Zydus Cadila)
Pneumonia vaccine (PCV or PPSV)Sir Almroth Wright19111. Prevnar20 (Pfizer)

2. Vaxneuvance (Merck)

3.PNEUMOSIL® (Serum Institute of India Ltd)

4.Pneumovax 23 Vaccine (MSD)

5.Prevenar 13 Vaccine (Pfizer)

6.Synflorix Vaccine (Glaxo SmithKline Pharmaceuticals Ltd)

7. Pulmovax 23 Injection (Lupin Ltd)    
Rabies virusLouis Pasteur and Émile Roux19851. RabAvert & Rabipur (Glaxo SmithKline Pharmaceuticals Ltd)  

2. Xprab (Sun Pharmaceutical Industries Ltd)  

3. Rabies (Rabivax) (Serum Institute of India Ltd)  

4.  Indirab (Bharat Biotech)  

5. Verorab (Zuventus Healthcare Ltd)

6.Worab (Wockhardt Ltd)
Pertussis (Whooping Cough)Pearl Kendrick, Loney Gordon and Grace Eldering19301. Usually in Combine     (DTP Vaccine)
Hepatitis A (HAV) and Hepatitis B (HBV)Hepatitis A (HAV) :   “Vaqta” developed by Maurice Hilleman and his team at Merck & Co.  

Hepatitis B (HBV) Maurice Hilleman and his team		1995 (HAV)  
1981 (HBV) 		For HAV :  
A. Vaqta

B. Havrix for HAV (GSK) (1995)

C.  Avaxim: made by Sanofi Pasteur.     

For HBV:  
1. Recombivax HB (Merck),

2. Engerix-B (GSK),

3. Elovac B (Human Biologicals Institute, a division of Indian Immunologicals Limited),

4. Genevac B (Serum Institute)

5. Shanvac B (Sanofi India Ltd)

6. Heplisav-B, and

7. PreHevbrio

8. Heparel (Reliance Life Sciences)

9.Revac-B (Bharat Biotech)

10. Hepaglob (Sun Pharmaceutical Industries Ltd)

11. HB Vac (Zydus Cadila)

12.Biovac B (Wockhardt Ltd)

Combine Dose:
1. Infanrix Hexa Vaccine for

Prevention of Diphtheria
Prevention of Tetanus
Prevention of Pertussis
Prevention of Polio
Prevention of Haemophilus influenzae Type b disease
Prevention of Hepatitis B infection
Hepatitis C (HCV)No VaccineNANA
Hepatitis A and B vaccineGlaxoSmithKline20011. Twinrix (GlaxoSmithKline)
Hepatitis A and typhoid vaccineGlaxoSmithKlineNA1. Hepatyrix  (GlaxoSmithKline)  

2. ViVaxim and ViATIMfrom by Sanofi Pasteur
MeaslesJohn Franklin Enders, and his Team  

Maurice Hilleman at Merck & Co. (Improved Version of Vaccine)		1963        
1968		1. Measles vaccine       2. Attenuvax
RotavirusRotaShield, (Wyeth Pharmaceuticals)1998   1. Rotarix (GlaxoSmithKline)

2. RotaTeq (Merck)

3. Rotavac (Bharat Biotech International Limited.)

4. Rotasiil (Serum Institute of India)

5. Rotasure Oral Vaccine (Abbott)  
MumpsUnited States government targeted mumps for scientific research  

Maurice Hilleman of Merck & Co. (First Effective Vaccine)		1948    

1967		Now a day MMR, MMRV or other combined vaccine are user instead of single target.  

1.  Mumpsvax (Merck & Co.)
Rubella (German Measles) Parkman, Meyer, and the team from the NIH19691. Meruvax II Rubella (Serum Institute of India Ltd)

2. R-VAC Vaccine (Serum Institute of India Ltd)
MMR vaccine (a combination with the rubella vaccine and mumps vaccine)Maurice Hilleman and his team.19711. Merck (first)
MMRV vaccine (a combination of MMR with the chickenpox vaccine)Merck (Commercialization)Around 19711. Tresivac (Serum Institute of India Ltd)

2. Priorix Vaccine (GSK)

3. M-M-R II (MSD)
Typhoid feverRichard Pfeiffer and Wilhelm Kolle18961. Typbar TCV Vaccine (Bharat Biotech)

2. Typhibev Vaccine (Biological E Ltd)

3. Shantyph 25mcg Vaccine (Shantha Biotech)
Influenza viruses
(A and B)		Thomas Francis Jr., MD, and Jonas Salk, MD1945 (US Militry)1.  Influenza Injection (Serum Institute)

2. Agrippal S1 (Panacea Biotec Ltd)

3. Influvac (Abbott)

4. Vaxigrip (Sanofi India Ltd)
Varicella (Chickenpox) vaccineMaurice Hilleman’s team at Merck (Work on it) 

Michiaki Takahashi was a Japanese virologist, best known for inventing the first chickenpox vaccine and having attenuated the varicella zoster virus to produce the Oka vaccine.
Japan was first to use vaccine		19841.  Varilrix Vaccine (GSK)

2. Biovac V Vaccine (Wockhardt Ltd)

3. Variped (MSD Pharmaceuticals Pvt Ltd)

4. Zuvicella (Zuventus Healthcare Ltd)

5. Varivaxo (Panacea Biotec Ltd)

6.Okavax (Sanofi India Ltd)
Meningococcal polysaccharide vaccineThe first vaccine — meningococcal polysaccharide vaccine or MPSV41978NA
Meningococcal serogroup B vaccineWyeth Pharmaceuticals1970  

2015 (Approved)		1. Trumenba (Wyeth Pharmaceuticals Inc., a subsidiary of Pfizer Inc.)  
2.Bexsero (Novartis)
Meningococcal conjugate (MCV)   (Quadrivalent) Sanofi Pasteur20051. Menactra® (Sanofi India Ltd),
2. Menveo® (GSK), and
3. MenQuadfi (Sanofi)
HPV vaccine (Human papillomavirus vaccines)Ian Frazer and Jian Zhou of University of Queensland in Australia
Harald zur Hausen (who suspected HPV for Cervical Cancer)   Merck & Co. (MSD)		 2006 (MSD)1. Gardasil (MSD Pharmaceuticals Pvt Ltd)

2. Cervarix (GlaxoSmithKline)

3. Gardasil 9 (MSD)

4. Silgard (MSD)
Tetanus vaccine (Tetanus Toxoid (TT))Emil von Behring & his German group (passive immunology)18901. Tetglob 500IU Injection (Bharat Biotech)
Diphtheria, tetanus, and whooping cough
(DPT vaccine or DTP vaccine)-

Triguni Vaccine		NA19491. Infanrix Vaccine (GSK)
2.Triple Antigen Vaccine (Serum Institute of India Ltd)
3. Boostrix Vaccine
Tetanus Toxoid + Diphtheria Toxoid + Pertussis Toxoid + Hepatitis B Vaccine (rDNA) NANA1. SII Q-VAC Vaccine (Serum Institute of India Ltd)
2. Quadrovax SD Vaccine (Serum Institute of India Ltd)
Hexavalent vaccine   (diphtheria, tetanus, pertussis, poliomyelitis, haemophilus B, and hepatitis B)Hexavacand for Infanrix hexa by EU.20001. Hexaxim Vaccine (Sanofi India Ltd)
2. Easy Six (Panacea Biotec Ltd)
3.Infanrix hexa (GSK)  
Penta Valent Vaccine   (Known as Panchgunu Vaccine ) diphtheria, tetanus, pertussis, hepatitis B, and poliomyelitis. GlaxoSmithKline20021.Pediarix (GSK)
2. Pentaxim Vaccine (Sanofi India)
Vaccination in Child

*Vaccine List table are reference only. Vaccine effectiveness is depended on Government clinical criteria. Please consult your doctor for further information.

What are the Types of Vaccine and it mode of action?

Type of VaccineMode of ActionIssuesExamples
Inactivated vaccinesIt uses the killed version of the germ that causes a diseaseIt doesn’t provide immunity (protection) that’s as strong as live vaccines, as a result need over a time booster dose.Hepatitis A
Flu (shot only)
Polio (shot only)
Rabies
Covaxin (Covid 19)
Live-attenuated vaccinesLive vaccines use a weakened (or attenuated) form of the germ that causes a disease.

It works similar to the natural infection that help prevent, they create a strong and long-lasting immune response.

Just 1 or 2 doses of most live vaccines can give you a lifetime of protection against a germ and the disease it causes.		Not suitable for      weaken immunity.Storage conditionMeasles, mumps, rubella (MMR combined vaccine)

Rotavirus

Smallpox

Chickenpox

Yellow fever
Messenger RNA (mRNA) vaccinesmRNA vaccines make proteins in order to trigger an immune response.First Used in Covid-19Pfizer-BioNTech or Moderna
(COVID-19 mRNA vaccines)
Subunit, recombinant, polysaccharide, and conjugate vaccinesSubunit, recombinant, polysaccharide, and conjugate vaccines use specific pieces of the germ—like its protein, sugar, or capsid (a casing around the germ).  

Because these vaccines use only specific pieces of the germ, they give a very strong immune response that’s targeted to key parts of the germ.		Drawback is Patient need to take booster dose for on going protection.Hib (Haemophilus influenzae type b) disease

Hepatitis B

HPV (Human papillomavirus)

Whooping cough (part of the DTaP combined vaccine)

Pneumococcal disease

Meningococcal disease
Shingles


Novavax (Covid 19)
Toxoid vaccinesA toxin (harmful product) made by the germ that causes a disease. They create immunity to the parts of the germ that cause a disease instead of the germ itself.Patient need to take booster dose for on going protection.Diphtheria
Tetanus
Viral vector vaccinesViral vector vaccines use a modified version of a different virus as a vector to deliver protection.

Several different viruses have been used as vectors, including influenza, vesicular stomatitis virus (VSV), measles virus, and adenovirus, which causes the common cold.		Adenovirus is one of the viral vectors used in some COVID-19 vaccines being studied in clinical trials.Replicating viral vector vaccines infect cells
Examples:
Recombinant vesicular stomatitis virus (rVSV)-
Zaire Ebola virus vaccine and

The live attenuated tetravalent dengue vaccine.

COVID-19 Vaccine

Nonreplicating viral vector vaccines

Example:
Johnson & Johnson/Janssen, Oxford-AstraZeneca and Gam-COVID-Vac (Sputnik V) vaccines
DNA vaccinesThe proposed mechanism is the insertion and expression of viral or bacterial DNA in human or animal cells (enhanced by the use of electroporation), triggering immune system recognition.Under Trails (By Zydus Cadila)COVID-19
Types of Vaccine

What is the Vaccination Schedule in Child Immunization in India?

National Immunization Schedule *

https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/report/National_%20Immunization_Schedule.pdf

For Infants
BCG At birth or as early as possible till one year of age 0.1ml  (0.05ml until 1 month of age) Intra -dermalLeft Upper Arm
Hepatitis B Birth dose At birth or as early as possible within 24 hours 0.5 ml IntramuscularAnterolateral side of mid thigh-LEFT
OPV Birth dose At birth or as early as possible within the first 15 days 2 drops Oral–
OPV 1,2 & 3 At 6 weeks, 10 weeks & 14 weeks 2 drops Oral–
IPV (inactivated Polio Vaccine) 14 weeks 0.5 ml IntramuscularAnterolateral side of mid thigh-RIGHT
Pentavelant 1,2 & 3 At 6 weeks, 10 weeks & 14 weeks 0.5 ml IntramuscularAnterolateral side of mid thigh-LEFT
Rota Virus Vaccine At 6 weeks, 10 weeks & 14 weeks 5 drops Oral–
Measles 1st Dose 9 completed months-12 months. (give up to 5 years if not received at 9-12 months age) 0.5 ml SubcutaneousRight Upper Arm
Vitamin A, 1st Dose At 9 months with measles 1 ml  (1 lakh IU) Oral–
For children
DPT 1st booster 16-24 months 0.5 ml IntramuscularAnterolateral side of mid thigh-LEFT
OPV Booster 16-24 months 2 drops Oral
Measles 2nd dose 16-24 Months 0.5 ml SubcutaneousRight Upper Arm
Vitamin A  (2nd to 9th dose) 16 months with DPT/OPV booster, then, one dose every 6 month up to the age of 5 years) 2 ml  (2 lakh IU) Oral–
DPT 2nd Booster 5-6 years 0.5 ml. IntramuscularLeft Upper Arm
TT 10 years & 16 years 0.5 ml IntramuscularUpper Arm

*Source: National Health Mission in the State a separate Mission Directorate (NHM)

Some Vaccine under pipeline :

Sr. No.Name of VaccineUseCompanyCurrent Stage (till 2022)
1Personalized cancer vaccine (PCV)For CancerMerckDevelopment
2KRAS vaccineFor CancerMerckDevelopment
3Respiratory syncytial virus (RSV) vaccineFor Respiratory syncytial virusJanssen Pharmaceutical Companies of Johnson & Johnson   PfizerPhase 2/3       Development
4Cytomegalo Virus VaccineTo prevent cytomegalo virus (CMV) infection or curb virus re-activationModerna Phase 2
5HIV Vaccine To prevent HIVModerna Clinical Trials
6Zika vaccineTo prevent Zika virusModerna Phase 2
7Nipah vaccineTo prevent Nipah virusModerna Development
8Myocardial ischemia (EPICCURE)To demonstrate safety and tolerability in patients with heart failureAstrazenecaPhase 2
Vaccine under pipeline

For Blood Pressure read :https://pharmasciences.in/explore/blood-pressure/

https://www.hhs.gov/immunization/basics/types/index.html

https://www.immune.org.nz/vaccines/vaccine-development/brief-history-vaccination#:~:text=Edward%20Jenner%20is%20considered%20the,first%20smallpox%20vaccine%20was%20developed.
https://main.mohfw.gov.in/sites/default/files/PCV_Operational%20Guidelines_Jan%20%202021.pdf
https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Operational_Guidelines_for_PCV_introduction.pdf
https://www.webmd.com/children/vaccines/meningococcal-vaccine#:~:text=The%20first%20vaccine%20%2D%2D%20meningococcal,MCV4%20was%20approved%20in%202005.
https://en.wikipedia.org/
https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work#:~:text=Vaccines%20contain%20weakened%20or%20inactive,rather%20than%20the%20antigen%20itself.
https://www.cancer.gov

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