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Vaccines: Bench to Clinic

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by

Ramil Sapinoro

on 15 October 2015

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Transcript of Vaccines: Bench to Clinic

Vaccines:
From Bench to Clinic

L
i
v
e

Vaccine Development
Timeline
K
I
L
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D
Clinical Trials & Licensing
T
O
X
O
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D
S
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B
U
N
I
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Oxygen and Respiratory
Immunization Strategies
Vaccine Formulations
Clinical Trials

Characteristics of an
Ideal Vaccine
Safe
; minimal risk of adverse reactions
Ease of administration
; given in a single dose
Effective in
protection
from live pathogen and
preventing
transmission
Offer
sustained protection
many years after vaccination
Induction of neutralizing Abs and protective T cells
Low cost
, allowing widespread vaccination in developing countries
Biological stability
: Easy to transport and administer, even in countries with minimal infrastructure
Broadly effective
against different variations of the pathogen
@edwardjenner
C
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N
J
U
G
A
T
E

D
N
A

R
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C
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M
B
I
N
A
N
T
V
E
C
T
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R
A
D
J
V
A
N
T
S

Future Vaccine Strategies
"The 4th Century"
Novel live vaccines
Reassortment
Recombination
Replication-defective VLPs
Reverse vaccinology
Prime-Boost
Adjuvants
Routes of administration
Polysaccharide Vaccines
Decrease pathogenicity
Maintain immunogenicity
Inactivated to block replication; maintain immunogenicity
Pros
Avoids use of whole organism
Multiple antigens
Cons
Not immunogenic in <2 years old
Induces minimal antibody isotype switching
No immunological memory induced
Immunogenicity improved by conjugation to carrier proteins
Vaccine Components
1. Antigen
2. Immune potentiator
3. Delivery system
Substances that enhance the immune response; enhance the immunogenicity of vaccines
Not all antigens are immunogens
Increase duration of immune response
Enhance immune response in weakly responding populations
Decrease amount of antigen
Decrease number of doses
Adjuvants
Which type of vaccine most likely requires an adjuvant?
Live
Inactivated
Toxoid
Subunit
Advisory Committee on Immunization Practice (ACIP)
Vaccine Requirements
-The government of each state decides whether people in that state will be required to get a vaccine
Medical, religious, and often philosophical/personal belief exemptions are available
-All states require that children be vaccinated for certain diseases before school entry (the required immunizations vary by state)
Influenced by economics and politics
Reasons for Refusal
Concern that the vaccine might cause harm
Low safety profile of vaccine
Low susceptibility to disease
Low vaccine efficacy
Severity of disease was low
Children receive too many vaccines

Role of Health Care Providers
Cited by parents of vaccinated and un-vaccinated children as the most frequent source of information about vaccinations

Play a critical role in highlighting the benefits of vaccinations and addressing parental concerns about its risks

Ok for provider to discontinue relationship with families that refuse vaccines?

Pharmacists role -- provide counseling on hazards of refusing vaccines?
Arch Pediatr Adolesc Med 2005; 59: 470-6
http://www.pbs.org/wgbh/nova/body/tiny-tattoo-vaccines.html
18th Century
"Attenuation" using cowpox

19th Century
Biological attenuation of microbe
Physical inactivation of microbe

20th Century
Attenuation via animal passage/cell culture
Physical inactivation of toxins
Purified capsular polysaccharides
Genetic engineering

21st Century (the "4th century")
Induce cellular immunity via Prime-boost regimen
Novel adjuvants
Reverse genetics/Reverse vaccinology, Reassortant technology

http://www.pbs.org/wgbh/nova/body/tiny-tattoo-vaccines.html
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