IAP Textbook of Vaccines Nitin K Shah, Rohit Agrawal, Vipin M Vashishtha, TU Sukumaran
INDEX
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Page numbers followed by ‘f ’ and ‘t’ indicate figures and tables respectively.
A
ABH histo-blood group antigens 422
Accessory cholera enterotoxin 383
Accredited social health activists 550
Acellular pertussis vaccines 194, 199, 200, 203, 204, 517
Achievement of GVAP goals 549
Acquired immunodeficiency syndrome 3, 64, 242, 454, 549
Active and passive immunization 508
Acute
disseminated encephalomyelitis 367
flaccid paralysis 85t, 119, 578
gastroenteritis with vomiting 422
hypersensitivity reaction 85t
illness 257
neurologic phase 376
respiratory tract infections 586
toxin mediated bacterial infection 174
toxin mediated disease 174
viral infection 284
Adaptive immune systems 507
Adenovirus (AD35) 249, 463
Adequate titer of antibody 38
Adjuvantation
concept 124
human vaccines 133
in licensed vaccines 127t
systems 130
Administration of the vaccine to seroconversion 485
Adolescent
immunization 61, 516
vaccination 168, 518
Adverse drug reaction 582
Adverse events following immunization (AEFI) 19, 79, 548, 589
Advisory Committee on Immunization practices 288, 294, 347, 388, 566
AEFI causality assessment 86
Aerophobia 376
Age of immunization 590
AIDS: a clinical syndrome 455
Alleviation of pain associated with injections 53
Allied vaccine group 603t
Alternative
routes of administration 479
vaccine delivery methods 484
Alum-adjuvanted gpE1 glycoprotein 445
Aluminium salt adjuvants 126
Alzheimer’s disease 406
American Academy of Pediatrics 57, 603t
American Health Organization 576
Analytical testing 545
Anaphylactoid reaction 85t
Angioimmunoblastic lymphadenopathy lesions 435
Animal
bite wounds 376
vaccine production in the USA 14
Antenatal tetanus vaccination 214
Anterior nasal diphtheria 176
Antibiotic resistance 224
Antibody
containing product 60
dependent cell-mediated cytotoxicity 39
responses in different age groups 275, 286, 338
vaccine interactions principles of 59
Antigen
and formulation preparation 541
presenting cells 65, 122, 403, 484
shift and drift 196, 342
specific cancer immunotherapeutics 131
AntigpE1/gpE2 446
Anti-hypertensive vaccine 407
Anti-idiotype vaccines 403
Antimeasles antibodies 268
Antimicrobials and antimicrobial resistance 310
Anti-nicotine antibodies 406
Antirabies vaccines 378
Antiseptics 377
Apical membrane antigen-1 464
Aplastic anemia 291t
Appraisal of national vaccine policy 535
Argentinian hemorrhagic fever 387
Artemisinin combination therapy (ACT) for treatment 461
Arthritis 291t
Aseptic meningitis 284
Associated malpractices 600
Assuring vaccines of quality and safety 105
Astroviruses 249
Asymptomatic
carriers 180
case contacts 180
pleocytosis 284
respiratory tract carriage 175
Atherosclerosis 401, 406
Attenuated live
oral cholera vaccine 425
virus vaccines 32
Autoimmune
disorders and other non-infectious conditions 405
phenomena 291t
Autologous
EBV CTLs 435
hematopoietic stem cell transplants 507
tolerizing dendritic cell vaccine 406
Autonomic changes 186
Auxiliary nurse midwives 84, 99, 596
Avian H5N1 influenza 344
B
B lymphocytes and antibodies 38
Bacillus calmette-Guérin (BCG) 28, 52, 58, 77, 91, 393, 563, 590
Bacterial
components 197
Corynebacterium diphtheriae 174
disease 196
polysaccharide antigens 485
Barriers for adolescent vaccination 520
Basic
map of vaccine locations outside 94
reproductive number 75
Basics of immune system and vaccination 507
BCG
against primary infection 141
laboratory in guindy 14
revaccination strategies 142
vaccine correlate for protection afforded 41
Behavior-related productivity gains 566, 569
Benefits
and harms to community by vaccines 73
of adjuvanted vaccines 130
Bioadhesive delivery system 491
Biodegradable polymers 486
Blood
borne virus infection 80, 105
stage vaccines 463
Bolivian hemorrhagic fever 387
Boolean operators 604
Booster doses 59
Bordetella pertussis 194, 196, 216
Bovine-human reassortants 253
Brachial neuritis 85t
Breast
cancers 404
feeding and vaccine take 259
British Medical Journal 605
Broader framework means for India 568
Burden of disease 195, 215, 216, 557
Burkitt’s lymphoma 402, 435
C
Caliciviruses
using norovirus 421
vaccine available 422
Campylobacter jejuni 423
Canadian Coalition for Immunization Awareness and Promotion 108
Canadian International Development Agency 281
Cancer
testis antigens 402
vaccines
adjuvant 402
antigen 402
in phase 2/3 trials 404t
vaccines therapeutic 401
Capacity building 545
Capsomers 433
Capsular strains 222
Carbohydrate vaccines 403
Carboxyfluorescein succinimidyl ester 40
Carcinoembryonic antigen 402
Case definition of
chikungunya virus 469
malaria 461
neonatal tetanus 111
severe malaria 461
the rotavirus vaccine 103
typhoid fever 308
vaccine-associated paralytic poliomyelitis 587
Catch-up
immunization 60, 520
vaccination of children 167, 168
vaccination schedule for an unimmunized child 62t
Causality assessment of serious AEFI 87f
Causation of diseases 45
Causative agent of cervical carcinoma 402
Causes of
malpractice in vaccine marketing 600
pneumonia 222
respiratory tract infections 472
viral lower respiratory tract infection 473
CD4+ helper T cells 38
CD8 cells 33
Cell culture
infective dose 254
vaccines 378
Cell-mediated
immune responses to vaccines 40
immunity 131, 200, 455, 462
Cells of the innate immune system 122
Cellular
immune response 33, 275
immunity 26, 70
response 269, 286
Centers for Disease Control and Prevention 108, 117, 172t, 292, 602, 603, 588
Central Drugs Standard Control Organization 581
Central nervous system 68, 284, 365, 380, 405, 434
Cephalic tetanus 185
Cerebellar ataxia 284
Cervical intraepithelial neoplasia 335
Cetrimide solution 377
CFSE-labeling assay 40
Characteristics of the
disease 558
two new-generation typhoid fever vaccines 311t
Chemokine receptor 7 29
Chickenpox 323
Chikungunya
vaccine 468
virus 468
Childhood immunization support program 108
Children with asplenia/hyposplenia 54
Children’s hospital of Philadelphia 603t
Chimeric vaccine 369
Chlorhexidine gluconate 377
Chloroxylenol 377
Choice of
influenza vaccine 351t
meningococcal vaccine 525
vaccines for travel 522
Cholera
epidemiology and risk factors 423
Cholera
toxin 67, 383
vaccines in
epidemic situation 385
development 425
Chronic hepatitis C infection 439
Circumsporozoite protein 462
Classification of
adverse event following immunization 80t
HPV affecting anogenital epithelia 335t
Cleavage of opinion 588
Clinical
and epidemiological features of polio virus infection 148
features of malaria 461
manifestations of hepatitis A virus infection 290
picture of typhoid fever 307
studies of vaccine 324
trials registry-India 582
Cocooning strategy 206
Cohort study 49
Coincidental 80
Cold
boxes 96
chain and vaccine logistics 20
Coley’s toxins 401
Collective decision-making 281
Colonization factor antigens 426
Combination of
hepatitis A and B vaccine 170
measles-mumps-rubella-varicella 60
vaccines including multiple life cycle stages 464
blood stage antigens 464
Commercially available vaccines 337t
Common
minor vaccine reactions 80t
technical document 582
Communicable diseases 588
Community health center 90f
Community-based immunization programs 589
Company medical representative educated 598
Comparison of
hepatitis A virus infection 291
India’s vaccination coverage 565f
inoculation and vaccination 11t
vaccination coverage within india 565f
Components of national vaccine policy 534
Composition of the vaccine 336
Comprehensive multi-year plans 574
Compulsory immunization 589
Concurrent administration with other vaccines 337
Conditioning of ice packs 96
Conflict of interest 579
Congenital
heart disease 274
rubella syndrome 273, 274, 276, 279
Conjugate vaccines 476
Consensus recommendations on immunization 597
Contact immunity 75
Contingency plans 98
Continuous medical education 598
Contraindications for
BCG vaccination 142
varicella vaccination 328
Control of muscle rigidity and spasms 188
Correlates of
protection
mechanisitc 38
nonmechanistic 38
vaccine-induced protection 38
Corresponding polysaccharide vaccine 360
Corynebacterium
diphtheriae 214
species 175
Cost
and affordability 586
and sustainability 560
benefit of varicella vaccine 326
effectiveness analysis 567
imulatory molecules 404
Council of Medical Research 576
Coverage estimate series 101t
Coxsackie A virus serotypes 412, 414
Crimean Congo hemorrhagic fever 387
Crohn’s disease 287, 401
Culex
tritaeniorhynchus 365
vishnui 365
Current
promising candidate vaccines 473
status of immunization 532
Cutaneous diphtheria 176
Cytokine release assays 40
Cytomegalovirus 121, 455
Cytotoxic
assay 40
T cells responses 40, 486
T lymphocyte 455
D
Dangerous diseases 521
Deaths and disability-adjusted life years 262
Defensins 261
Defining search terms 604
Delayed type hypersensitivity 39
Democratic Republic of the Congo 282
Dendritic cell 26, 64, 70f, 122, 487, 403
Dengue
immunity 417
no vaccine to protect against 417
vaccine development 418
vaccines first and second generation 420
virions 418
virus 386
DENV 1
to DENV-4 417
genome 419
serotypes 418
Deoxyribonucleic acid
based vaccines 444
human immunodeficiency virus 458t
vaccines 478
Department of Biotechnology 539
Department of Health Research 579
Dermatitis 291t
Detective ovine at adenovirus expressing NS3 445
Development of
effective vaccines 541
mucosal vaccines 491
Diabetes, type 1 406
Diagnosis of
hepatitis A virus infection 291
malaria 461
Diarrheal disease vaccines 421
Different inactivated hepatitis A virus 296t
Dioxygenase 402
Diphtheria
and tetanus toxoid 218, 597
morbidity 175
pertussis-tetanus vaccine 53, 271, 366, 563, 548
toxoid containing vaccines 174, 178, 179, 180
Direct negative impact 78
Disclosure statements 547
Disease burden 292
Disease Control and Prevention 276, 347
Diseases of
elimination and eradication 110
epidemiology 58, 207
management 516
pattern 293
the most impoverished program 304f
the neighborhood 317
transmission
basic reproductive rate 45
epidemic threshold 45
index case 45
infection rate 45
net reproductive rate 45
primary case 45
secondary attack rate 45
Disposal of auto-disable syringes 106
Disseminated BCG infection 85t
District Immunization Officer 85
District Level Household and Facility Survey-3 271
DNA
based vaccine 405
vaccines 403, 456, 546
Documentation 591
Domestic refrigerator 92
Dosage of routine vaccination 167
DPT vaccines 214
Dracunculiasis 115
Dracunculus medinensis 115
Droplet precautions 358
Drug Controller General of India 581
DTaP vaccines 220
DTP
diphtheria and tetanus toxoids and acellular pertussis 54
vaccine 214, 217
DTwP 394
Duration of
immunity 275, 286, 325, 338
E
Early history of
inactivated polio vaccine 149
OPV 158
Easles vaccine 5
Echovirus serotypes 412
Economic
benefits of vaccination. 563
considerations 114
impact and vaccine importance 520
Edible vaccines 493
Edmonston-zagreb strain 265
Edward Jenner’s observations 12
Effect of varicella vaccine 326
Effectiveness of varicella vaccine 325
Efficacy of
DTP 220
effectiveness of Hib conjugate vaccines 232f
HAV vaccines 298
modern IPV 150
tOPV 159
Electrical cold chain equipment 91
Electroencephalogram 366
Elimination of
disease 113
infections 113
measles, rubella, and maternal and neonatal tetanus 23
neonatal tetanus 118
ELIspot 36
Emergence of
developing markets 546
management of anaphylaxis 84t
Emerging
body of literature 563
Salmonella paratyphi infection 316
Encephalitis virus 386
Encephalopathy 85t
Encodes six structural viral proteins 250
Endemic cholera 385
Endemic meningococcal disease 361
Endemicity 293
End-stage kidney disease 130
Enteric encephalopathy 366
Enterovirus (EV)
classification of 411
infections
clinical spectrum of 412
epidemiology 412
laboratory diagnosis 413
management 414
vaccines 411
Enveloped ribonucleic acid 386
Enzyme-linked immunosorbent assay 38, 285, 291, 414, 469
Epidemic
cerebrospinal fever 357
prone diseases 308
response vaccines 518
Epidemiological
effects of vaccination 270, 287, 338, 470
triad 45f
Epidemiology of
chikungunya virus 469
hepatitis A virus infection 291
human papillomavirus 335
malaria 461
relation to vaccinology 43
respiratory syncytial virus infections 472
typhoid fever 304
varicella 326
Epidermal powder immunization 492
Epithelial-mesenchymal transition 405
Epstein-Barr virus 433, 434, 455
complication of 434
disease burden due to 435
nuclear antigen 1 (EBNA 1) 402
Equine rabies immunoglobulin 377
Eradicability of a disease 112
Eradication and comprehensive health programs 114
Eradication of
malaria 460
polio in India 71
poliomyelitis 550
small pox 214
source of toxin 187
vaccine 549
Escherichia coli 372, 384
Estimated global disease burden of typhoid fever 304f
ETEC vaccine approaches 427
Ethical
dilemmas 595
issues in immunization 593, 595
Etiological diagnosis 366
Evolution of vaccination programs 564t
Examples of different vaccine types 122t
Exanthems and enanthems 412
Exosomes 490
Expanded program on immunization 54, 100, 516, 532, 556, 563, 572, 586
Expansion beyond Africa 281
Expiry date of vaccines 591
Expression in
insect cells 449
prokaryote cells 449
Extracellular
bacteria 28
protein 402
Eyes of conjunctivitis patients 222
F
Failure of acellular pertussis vaccines 205
Family flaviviridae 386
Fatal rotavirus diarrhea 250
Fear of
epidemics (Kumbh mela) 593
vaccine market failure 554
Febrile seizures 85t
Financial resources for immunization 548
First dose of BCG 141
First vaccine was administered in India 10
Flaviviral infection 417
Flexibility 586
Follicular dendritic cells 485
Food
and Drug Administration 105
grade bacteria 490
Fourth-generation IPV 152
Framingham heart study 49
Freer 579
Freeze-tolerant vaccines 94
Fulminant
hepatic failure 290
liver failure 291t
septicemia 358
Funding and remunerations 581
Fusion protein 437
G
Gamma glutamyl transferase 291
Gastric carcinoma 435
Gene-based vectors 473
General mode of action (MoA) of adjuvants 126f
Generalized
exanthematous disease 323
tetanus 185
Genetic
changes 196
modification of T cell receptors (TCRs) 435
reassortment 342
susceptibility 405
vaccination 546
Genomes of certain viruses 404
Genus lymphocryptovirus 433
Germinal center 29, 58, 485
Glatiramer acetate 405
Global Advisory Committee on Vaccine Safety 108, 574
Global Alliance for Vaccines and Immunization 260, 281, 312, 339, 541, 603t
Global Measles and Rubella Strategic Plan 2012–2020 279, 282
Global Polio Eradication Initiative 117
Global Vaccine Action Plan 548, 602
Global vaccine market 533
Government medical store dipots 90f
Gram-negative coccobacillus 196
Gram-positive enhancer matrix 490
Granulocyte-macrophage colonystimulating factor 403
Granzyme 38
Graphical depiction of heat and freeze sensitivities 92f
Guidelines for manufacture of vaccines 102
Guidelines for typhoid threshold responses 310t
Guillain-Barré syndrome 270, 360, 361, 376
Guinea pigs 588
Gut-associated lymphoid tissue 65, 69
GW diseases 115
H
H1N1 virus 344
H5N1 viruses 345
Haemophilus influenza type B
clinical features 222, 223f, 224
disease 224
vaccines 222, 393
Health and child care personnels 327
Health protection agency 108, 602
Healthcare professionals 599
Healthcare providers 352
Heat and light sensitive vaccines 91t
Heat shock protein (HSP)-based vaccines 403
Hemagglutination assay 388
Hematopoietic stem cell transplant 508
Hemolysin 383
Hemorrhagic viral fever 387
Hep A or typhoid combined vaccine 395
Hep B and hep A combined vaccine 395
Hepatitis A
vaccines 290
virus 290
Hepatitis B
immunoglobulin 53, 163
vaccine 59
virus 296, 401, 485
Hepatitis C virus (HCV)
infections 296
epidemiology 441
immune invasive response 441
natural history of 440
pathogenesis 440
rationale for a therapeutic 442
strategies for 442
vaccine approach 441
Hepatitis E virus (HEV) 448
Hepatitis E virus like particles 450
Hepatocellular carcinoma 439
Hepatovirus genus 290
Herd
effect 150
immunity 74, 75, 198, 589
immunity conferred 385
protection provided by vaccines 75
Herpangina 413
Herpes
simplex virus 455, 485
zoster after immunization 327
zoster vaccine 331
Heteroclitic modifications 403
HEV
ORF2 contains epitopes 449
vaccine researches 449
Hib
attributable proportion 226
conjugate vaccines 228, 234t, 235
meningitis 224
pneumonia 224
polysaccharide antigen 224
polysaccharide vaccine 227
vaccine 48
High
cost of production 152
dose chemotherapy 508
endemicity 293
incidence of adverse effects 106
High-grade squamous intraepithelial lesion 335
H-influenzae B 78
Historical background of malaria 462
History of
disease eradication 112
HPV vaccine development 336
modern vaccinology 475
vaccine development 285, 469
varicella 323
HIV 142
Hodgkin’s lymphoma 433, 435
Hold over time 95
Horizontal transmission 164, 165
Host cell ribonucleic acid 546
HPV
vaccination in adolescent 519
vaccine 553
Human
animal reassortant vaccines 252
bovine chimeric viruses 474
caliciviruses 422
carcinogens 164
diploid cell vaccine 375, 378
embryonic lung cells 324
enterovirus 71
vaccine 414
herpes virus 3 323
immune
system 507
virus 105
immunodeficiency virus 1
genome 455f
infection 549
vaccine 454
leukocyte antigen 33, 275, 433, 507
mucous membrane 175
papillomavirus (HPV) vaccines 334, 517
parainfluenza virus vaccines 473
rabies immunoglobulin 377
respiratory syncytial virus 473
rotavirus strain vaccines 253
to-human transmission 379
Humoral
immune response to vaccines 29
responses to vaccine antigens, determinants of 39
Hydrophobia 376
Hyperimmune immunoglobulin 462
Hypersensitivity reactions 388
Hypertension 407
Hypocalcemia 187
Hypotonic hyporesponsive episode 85t, 245
I
Ice lined refrigerators 91, 97
Ideal storage method 94
IgG antibodies against measles 269
IgM antibodies 29, 30f
Immune
correlates of protection 200
evasion strategies by Epstein-Barr virus (EBV) 436
individuals 77
memory 70
reconstitution 508
response to
pathogen 124f
primary 29
secondary 31
T-independent vaccine antigens 29, 31
suppression in the tumor microenvironment 402
system 106
Immunity duration of 270
Immunization
action coalition 108, 603t
active 268, 274
advisory centre 108
certificate 593
coverage in India 564f
cross-pathy 592
during travel 592
for travelers 505
general recommendations on 52
in the context of global interdependence 554
of HIV infected children 504t
of immunocompromized people 603
passive 268, 274
practices advisory committee 574
practices in childhood 590
program 520
purpose of 57
safety 105
schedule 57
successes 551
technical support unit 579
timetable recommended by Indian Academy of Pediatrics 61t
Immunocompromised
children 323, 169, 508, 514
host 338
Immunoenhancing molecules 128
Immunogenic determinants of LMP1 437
Immunogenicity
and efficacy 166
and vaccine efficacy 179
measurement of 268
of the birth dose 54
Immunoglobulin
A 68, 268
G 68
guidelines 603
isotype and subclass 38
M 59
Immunological
correlates of protection induced by vaccines 37
hyporesponsiveness 361
issues in patients 512
memory 269, 275, 286, 337
principle 59
responsiveness 58
Immunoprophylaxis 64
Immunostimulatory 484
Immunosuppressive
disorders 592
medicines 593
Impact and incidence of vaccine preventable disease 522f
Implications for manufacturing 545
Importance of maintaining the cold chain 90
Improvements in the
live oral vaccines 314
Vi polysaccharide vaccine 315
Inactivated
HAV vaccines 297, 298, 300
influenza vaccine 347
mouse brain vaccine 366
polio vaccine 587
poliovirus vaccine 59, 68, 78, 146, 149, 150, 152, 154, 587
whole-cell vaccines 311
Incidence of communicable diseases 78
Increase cool mass 93
Incubation period 376
India’s national guinea worm eradication program 116
Indian Academy of Pediatrics 57, 60, 288, 557, 577, 601
Indian Academy of Pediatrics Committee on Immunization 277, 290, 517f
Indian national technical advisory group on immunization 271
Indian neonatal strain vaccine 253
Indian technical advisory group on measles mortality reduction 578
Indian vaccine industry 531, 533, 539
Indirect negative impact 78
Indirect or herd protection 262
Infection
and disease 147
in neonates 413
Infectious agent
antigenic stability and survival 46
immunogenicity 46
infectivity 46
pathogenicity 46
virulence 46
Infectious mononucleosis 434
Infective polyneuritis 291t
Inflammatory diseases 511
Influence of radiation therapy 511
Influenza
A viruses 341
clinical management and treatment 346
clinical signs and symptoms 346
complications 343t
diagnosis 346
epidemics and pandemics 342
H9N2 viruses 345
immunization of pregnant women 352
outbreaks 342
pandemics 342
prevention 347
seasonality 345
vaccine 60, 62, 63, 517
choice of 350
licensed in india 352t
viruses
characteristics of 342t
from different species 341
infection 352
Information, education, and communication 20
Informed consent 590
Inhibiting CD4 34
Inhibitors of influenza 346
Injectable poliovirus vaccine 53
Injection
procedure
site and needle length 53
sterile technique 52
reaction 82
safety and waste disposal 19
site
abscess 85t
type of needle and technique 54t
Injiang uighur autonomous region 448
Innate
and adaptive immunity 65
immunity 26, 68, 70, 75
Innovative route of vaccination 67
Inoperable cancers 401
Institute for vaccine safety 108
Integrated disease surveillance program 51
Intellectual property rights and vaccines 553
Intensification of routine immunization 22
Intensity of primary humoral response 31
Intensive care unit 592
Interagency Coordination Committee 281, 574
Interchangeability of
brands 506
vaccines and number of doses 257
Interferon alpha 405
Intermediate endemicity 293
International Pediatric Association 282
International Task Force for Disease Eradication 111
Interval between doses 59
Intestinal
epithelial cells 69, 70f
immunoglobulin A 423
microbiota 261
Intracellular cytokine detection 40
Intradermal rabies vaccination 380
Intramuscular injections 54
Intravenous immunoglobulin 388
Intussusception monitoring 262
Invalid contraindications to immunization 105
Invariant natural killer T cells 41
Invasive
Hib disease 229
pneumococcal disease 241, 244
Issue of
adverse events following immunization 552
vaccines to session sites 97
J
Jacobson’s case 589
Japanese encephalitis 21, 60, 63, 364, 367, 386, 527, 586
Jaundice 274, 434
Jet injections 140
K
Keyhole limpet hemocyanin 403
Killed oral
cholera vaccines 425
vaccines 427
Koplik’s spots 266
L
Laboratory
confirmed pertussis 195
diagnosis of typhoid fever 307
Lack of exposure variation 104
Lactic acid bacteria 490
Lamina propria 69, 70f
Lapsed immunization 505
Laryngeal
and carpopedal spasms 187
diphtheria 176
Lassa fever 387
Legal issues in immunization 588
Length of protection 141
Leptospirosis 387
Lethal midline granuloma 435
Life cycle of the parasite 115
Limitations of
current vaccines 314
efficacy trials 203
Lipid-core-peptide 484, 492
Lipopolysaccharide 486
Liposomes 128, 488
Live
attenuated influenza vaccine 349
efficacy 350
safety 349
transmissibility of 350
HAV vaccine 298, 299, 300
influenza vaccine 348
injectable vaccine 60
oral Ty21a vaccine 312
oral vaccines 427
recombinant vaccines 456
vaccines 428, 473, 481
Liver cancers 404
Localized tetanus 185
Low birth rate infants 169
Low endemicity 293
Low-grade squamous intraepithelial lesion 335
Lymphadenitis 85t
Lymphoproliferative disease 435
Lyssavirus 375
M
Magic bullet 588
Maintenance of the vaccine refrigerator 94
Major histocompatibility complex 26, 403, 455, 488
Malaria vaccines 460
Management of AEFI 82
Managing
cold chain at session site 97
vaccine and logistics 97
Mandatory adolescent vaccines 519
Manifestations of severe malaria 461t
Mannose-binding lectin 26
Manufacturing basics 544t
Manufacturing of vaccines 541, 544
Marburg and Ebola fever 387
Market fluctuation in stocks 561
Marketing of vaccines 599
Maternal
and child health 118
antibodies 58
IgG antibodies 34
immunization 206
Maximum stock level 97
Maximum-minimum inventory control system 97
Measles 517
Measles
and MMR vaccine 525
and rubella initiative 279
cases global 266
containing vaccine 563
diagnosis of 267
diphtheria, pertussis 520
epidemiology of 267
initiative 279
mumps and rubella vaccine 58, 63, 277, 282, 587, 589
mumps-rubella-varicella 329
vaccination coverage 267
Measurement of immunogenicity 275, 285, 337
Mechanisms of antibody-mediated vaccine immunity 38
Medical
institution level 85
negligence in vaccination 591
profession 599
subject heading 604
Melanoma antigen-1 402
Melanomas 404
Memory
B cell response 38
T cells 40
Meningeal and miliary tuberculosis 141
Meningitis 226
Meningococcal
disease 357, 360
polysaccharide vaccine 358, 359
serogroup 360
vaccine 60, 63, 357, 360, 517
for travelers 525
Meningococcus serogroup 358
Merozoite surface protein 463, 464
Mesenteric lymph nodes 68, 70f
Method of disposal 106t
Methods of delivering transcutaneous vaccine 493
MF 59 486
MHC tetramer assays 40
Mild
immunodeficiency 512
immunosuppression 501
Minimum stock level 97
Minor genetic reversion 154
Misconceptions about
vaccine safety 106
Misinformation about vaccine safety 106
Mode of
action 121
transmission 74
Moderate
immunodeficiency 512
immunosuppression 501
Modern
inactivated polio vaccine 149
tissue culture vaccines 375
Modes of
transmission 164, 292
Monitoring
impact 561
temperatures 96
temperatures inside the refrigerators 93
Monophosphoryl lipid 486
Monovalent human G1 rotavirus vaccine 253
Mortality associated with pertussis 194
Mosquito
borne flavivirus disease 364
stage vaccines 464
Mucosal
immune response 65, 268, 275, 286, 337
immunity 68, 71, 155, 157
protection 70, 150, 157
surfaces 65
vaccines 66
Multidose vials 53
Multiple
epitope constructs 463
HCV gene products 446
puncture technique 140
sclerosis 405, 435
vaccines 522
vesicular lesions on the palm in HFMD 413
Multiplex bead arrays 40
Mumps
and rubella 269, 518
vaccination—global 287f
Murray valley encephalitis virus 386
Mycobacterium leprae 25
Mycobacterium tuberculosis 393
Myelin
basic protein 405
bound protein 107
derived suppressor cells 402
Myocarditis 413
N
Nasal lymphomas of T cell 435
Nasopharyngeal carcinoma 402, 435
National Center for Immunization and Respiratory Diseases 108
National Center for Disease Control 51
National Child Survival 118
National Committees on Immunization Practices 574
National Control Laboratories 582
National Health Service 602
National Immunization Program 290, 338, 531, 585
National Immunization Programs 563
National Immunization Schedule 563
National Immunization Technical Advisory Groups 538t
National Institute of Immunology 539
National Library of Medicine 604
National Network for Immunization Information 603t
National Pertussis Immunization Policy 208
National Regulatory Authority 572, 538t, 581
National Schedules for Hib Conjugate Vaccines 234t
National Technical Advisory Group for Immunization 272, 288, 572, 574, 578
National Tuberculosis Control Program 15
National Vaccine Policy 20, 531, 534
Natural killer 65, 402, 455
Need of
boosters 168
community 589
individual 589
vaccine 585
Negative
consent 591
effects of vaccination 78
Neisseria meningitidis 357
Neonatal
immunization 207
tetanus 185
Nephrotic syndrome 507, 511
Neuraminidase 341
Neuritis 176
Neurotropic
disease 388
human enterovirus 71 (HEV71) 411
Neurovirulence and
attenuation 154
infectiousness 155
Neutralization of unbound toxin 187
New England Journal of Medicine 605
New pertussis vaccine approaches 207
New technologies for vaccine development 475
New thinking on health and wealth 566
New vaccine into an immunization program 556
Newer
BCG vaccine 143
vaccine candidates in development 314
vaccine delivery systems 486
New-generation vaccines 311
NGO organize camps 596
Non-communicable diseases 588
Non-electrical cold chain equipment 92, 96
Non-enveloped ribonucleic acid (RNA) virus 448
Nonexperimental study 49
Nonimmune prevaccination 368
Noninfectious diseases 113
Nonlife-threatening diseases 520
Non-live
antigens 31
vaccines 29
Non-small cell lung cancer 131, 403
Novel
development strategies 66
influenza viruses in humans 342f
reassortant virus 341
sub-committees 578
NTAGI work-up recommendation 580
Nucleic acids 414
Nucleotide back-mutation 154
Number of immunogenic proteins 107t
Numbered enterovirus serotypes 412
O
Obstacles in the development of HIV vaccine 456t
Obstacles in the vaccine development 472
Ocular infections 413
Oncofetal antigens 402
Online search for articles 604
Operational feasibility 561
Opsonization 26
Optimal immunization coverage 548
Optional immunization 589
Oral
cholera vaccine 384
polio vaccine 54, 66, 70f, 75, 91t, 587
vaccine 140
Orthomyxoviridae family 341
Osteitis 85t
Osteomyelitis 85t
Outcome-related productivity gains 566, 569
P
Packing of vaccine carrier 97
Pan American Health Organization 279, 312
Pandemic H1N1 influenza 344
Pandemics of influenza 344
Parainfluenza virus vaccines 472
Paralytic
disease 69
rabies 376
Paramyxoviridae 284
Paranasal sinuses 241
Parenteral
transmission 164
Vi polysaccharide vaccine 312
Particulate delivery systems 478
Passive immunization 227, 285, 294, 458, 469
Pathogenesis of
associated molecular patterns 122, 486
associated molecular patterns 26
hepatitis A virus infection 291
life cycles 116f
related barriers 473
respiratory syncytial virus infections 472
typhoid fever 306
Patient’s immune system 507
Patterns of
infectious diseases
endemic 44
epizootic 45
holoendemic 44
hyperendemic 44
pandemic 45
recognition receptors 26, 122
Pediatric
dengue vaccine initiative 419
diarrheal diseases 422
Pediatrician must 596
Pentavalent WC3-based bovine-human reassortant vaccine 253
Peptides
based vaccines 403
immunogens 404
vaccines 418
Peptidoglycans 26
Perinatal transmission 163
Peripheral T cell lymphomas 435
Persistence of antibodies 297
Pertusis and tetanus 58
Pertussis
and diphtheria cases 215
in adolescents 195
outbreaks 195
vaccination 194
vaccination 194, 196, 204, 207, 525
Petechiae and purpura 412
Peyer’s patches 68, 70f
Phagocytosis 406
Pharmaceutical industries 599
Pharyngeal and tonsillar diphtheria 176
Phases of vaccine trials 102
Picornaviridae 412
Placebo groups 405
Placement of refrigerator 93
Plasmid DNA vaccines 546
Plasmodium
falciparum sporozoite 463
vivax vaccine projects 465
Pneumococcal
conjugate vaccines
cost effectiveness 245
dosing schedules 245
effectiveness 244
efficacy of 244t
recommendations for use 246
safety 245
serotype replacement 245
disease and rotavirus 563
pneumonia 241
polysaccharide vaccine (PPSV 23) 60
vaccines 63, 240, 517
epidemiology 241
pathogenesis 240
pneumococcal vaccines 242
serotype distribution 242
Pneumococcus 561
Pneumonia and meningitis case definitions 223
Polio and measles 563
Polio and rotavirus (RV) 58
Polio
eradication 161, 162
under global eradication 148
vaccine 563
Poliomyelitis 146, 152, 153
Poliovirus
pathogenesis 68
receptor 68
Politician/Officer Vaccinate 596
Polylactic-co-glycolides acid 486
Polymerase
chain reaction 274, 292, 346, 403, 422, 469
lamellar substrate particles 487
Polysaccharide
antigens 29
conjugate vaccines 428
contained in vaccines 107t
selected serotypes of pneumococcus 240
vaccine in developing countries 313t
Poor immunogenicity 501
Postexposure
immunization 171, 163, 326, 458
prophylaxis 378, 380
Post-infectious encephalitis and vitamin A deficiency 266
Postlicensure evaluation of vaccine safety 103
Postmarketing studies 103
Postvaccination seroconversion 367
Potential vectors for live recombinant vaccine 457t
Power failure 95
Pregnancy 327
Prelicensure evaluation of vaccine safety 101
PreP vaccination schedule 381
Preterm infants 163, 169
Prevention of
AEFI 87
disease 587
neonatal tetanus 191
typhoid fever 311
Preventive maintenance of vaccine refrigerator 94t
Primary
bacteremia 306
health center 90f
humoral response, persistence of 31
immunodeficiency patients 507
Prime-boost concept 458
Priming of humoral and cellular (CD4 and CD8) immune responses 446
Principal indicators of eradicability 113
Principles of good manufacturing practices 105
Prioritization of
public health 557
vaccines in private sector 585
various diseases 57
Private sector and vaccination 21
Probable meningitis 230
Prodrome 376
Product
development 101
presentation 149
Program errors leading to adverse events 81t
Program for appropriate technology in health 541, 576, 603t
Program implementation and monitoring 535
Progressive rubella panencephalitis 273
Prolonged cholestatic phase 291t
Prophylactic
and therapeutic vaccine 445
antibiotics 358
intubation 188
measures 375
Prostatic carcinomas 404
Protective antibody levels 39t
Protein-based vaccines 403
Prothrombin
test 291
time 291
Provincial disease burden in Vietnam 304f
Pseudomembrane formation 174
Public health
considerations 271, 288, 338, 470
foundation of India 579
implications 50
Pulmonary tuberculosis 141
Purified
chick embryo cell vaccine 375, 378
polyribosylribitol phosphate 476
vero cell rabies vaccine 378
Purpose-built refrigerator 95f
Purulent discharge 222
Pyogenic meningitis 366
Pyothorax associated lymphoma 435
Q
Quadrivalent
meningococcal polysaccharide vaccines 361
RRV-based rhesus-human reassortant vaccine 252
vaccine 363
Quality of the immune response 402
R
Rabies
immunoglobulin 377, 378
vaccine 57, 375
Radiolucent bone disease 274
Randomized controlled trial 201, 415, 605
Rapid fluorescent focus inhibition test 378
Rational antigen discovery 479
Reaching every community 589
Reactogenicity of diphtheria toxoid 181
Reasons for
resurgence 205
vaccine failure 168
Recognize individual vaccine refrigerator 93
Recombinant
human immunodeficiency virus 457t
subunit human immunodeficiency virus 458t
vaccines 477
varicella-zoster virus 436
Recommendation
for catch-up vaccination 518t
vaccination strategies 474
Recurrent disease 330
Red blood cells 463
Refrigerator before stocking 93
Regional elimination 113
Regulatory T-cells 402
Relapsing hepatitis 291t
Releasing antimicrobial cytokines 36
Reliable
information regarding immunization 602
resources on vaccines and immunization practices 603t
Replicons and DNA plasmids 473
Reporting of
AEFI 84
serious AEFI cases 84f
Research and development 539
Respiratory
diphtheria 176
failure 174
syncytial virus vaccines 472, 489
Response to
action threshold 310t
alert threshold 310t
Responsible for
adverse effects 596
inadequate protection 592
Retrospective study 50
Review Committee on Genetic Manipulation 582
Rhabdoviridae 375
Rhesus rotavirus vaccine 481
Rheumatoid arthritis 401, 406
Ribonucleic acid 68, 250, 273, 375, 411
Rickettsia 387
Rift valley fever 387
Risk factors for typhoid fever 305
Risk of transmitting human immunodeficiency virus 296
Role of
academic organizations 597
hepatitis B immune globulin 171
national technical advisory group for immunization 572
of government 597
of immunization 79
pediatrician in office practice 88
pharmaceutical industry 596
society 597
the innate immune response 133
the provider 104
RotarixTM (GSK biologicals)
adverse events 254, 256
coadministration with other vaccines 254
contraindications 255, 256
dosage and composition 254, 255
immunodeficiency 254, 257
immunogenicity in India 254
porcine circovirus 255, 256
preterm infants 257
spitting or regurgitation 256
storage and stability 254, 255
vaccination schedule 254, 255, 256
vaccine strain 254, 255
Rotavirus
classification of 250
disease burden 250
epidemiology 250
age distribution 251
burden of disease 251
clinical features 251
pathogenesis 252
strain distribution 251
transmission 250
example 481
structure and classification 250
vaccination in the developing world 260t
vaccine development 252
vaccine introduction 259
Route of administration 297
Routine postvaccination testing 171
Routine vaccination 524
Rubella
infection 276
vaccination 275, 517
virus 284
RV3 neonatal strain vaccine 253
S
Safe
injections 105
motherhood program 118
Safeguard the power source 93
Safety of
adjuvanted licensed vaccines 132
assessment 132
biovac A 298
evaluation of vaccines 131f
modern IPV 150
Salmonella
paratyphi infection 527
typhi 101, 304
typhimurium 445
Schedules of
pertussis 208
tOPV 161
Scientific feasibility 112
Scope of a vaccine policy 534
Seasonal
and pandemic influenza vaccines 341
influenza vaccine types of 348
Secretory antibodies 69
Selection of the appropriate antigen 123
Semliki forest virus expressing NS3 445
Sensitivities of vaccines to heat and cold 91f
Sensorineural hearing loss 284
Sepsis 85t
Serious
adverse events 415
vaccine reactions 79, 81t
Seroconversion 268, 323
Serologic testing 506
Serotypes of
and disease 414
composition of the pneumococcal conjugate vaccine 243
distribution 242
pneumococcus 241, 242
replacement 245, 560
Serum of
bactericidal activity 361
glutamate pyruvate transaminase 291
glutamic-oxaloacetic transaminase 291
vaccination 563
vibriocidal antibodies 383
Severe
acute respiratory syndrome 8, 51
combined immunodeficiency disease 255
immunodeficiency 507, 511
immunosuppression 501
local reaction 85t
Sexually transmitted disease 335
Shifting endemicity of hepatitis A virus 293f
Shigella vaccines 429
Shigellosis 427
Sickle cell disease 512, 592
Sickness
rate 98
effects 591
Simian immunodeficient virus 456
Simultaneous vaccines 393
Single dose
effectiveness in argentina 301
of inactivated HAV vaccine 300
short-term efficacy 301
tetanus toxoid 485
Skeletal muscle paralysis 156
Skin sensitivity test 377
Skin-associated lymphoid tissue 493
Smallpox eradication from india 15
Smooth muscle cell tumor 435
Sociopolitical and economic factors 572
Solid organ transplantation 512
Southeast Asia region 279
Specific issues related to immunization 592
Spectrum of disease control 111
Spontaneous reporting systems 103
Spread of
communicable infections 74
microorganisms 77
St Louis encephalitis virus 386
Stabilize the temperature 93
Stages of
infection 455
vaccine testing in humans 102t
Standard dose chemotherapy 507, 508
State expanded program on immunization officer 86
Status of pertussis 194
Stem cell transplants 507
Steps in vaccine manufacturing 545
Stomach flu 422
Storage of
equipment in the cold chain room 99f
protocol in domestic refrigerator 94f
vaccines in an ice lined refrigerators 97, 98t
Strains of pneumococci 241
Strategic Advisory Group of Experts 383, 602
Strengthen
service delivery 118
vaccine preventable disease surveillance system 23
Streptococcus mutants surface protein antigen A 450
Streptococcus pneumoniae 240
Subacute sclerosing pan-encephalitis 265
Suboptimal vaccine coverage 214
Subunit
HEV vaccines 450
vaccines 456, 473
Supplementary immunization activity 265
Supporting Independent Immunization and Vaccine Advisory Committees 576
Supportive intensive care 188
Supratentorial involvement 284
Synthetic peptides
EBNA3 436
human immunodeficiency virus 458t
vaccine 415, 456, 477
Systemic
corticosteroids 511
lupus erythematosus 366, 405, 435
T
Tackle vaccine challenges 123
TB vaccines 144t
T-cells
chronically 402
costimulatory molecules 402
line-adapted 456
vaccination 405
Tdap vaccine 219
Technical
assistance and surveillance 283
guidance for UIP in india 19
Technology of microneedle-based vaccine 493
Temperature
monitoring 93f
sensitivity of different vaccines 91
Tetanus
and diphtheria toxoids 517
bacilli 184
control 183
immunoglobulin 50
prevention 183
toxoid
containing vaccine 53
immunization 532
injection 377
vaccines 183, 189, 191, 192, 214
Thalassemia diseases 592
The Plan Builds on the Global Polio Eradication Initiative 282
The United Nations Children’s Fund 279
T-helper cells 26
Therapeutic vaccines 339, 401, 546
Thrombocytopenia 85t, 275, 291
Thrombospodin-related adhesion protein 463
Timeline of
major vaccination events in india 13t
smallpox eradication in india 16t
vaccination 522
Tips for better vaccine storage 93
Tobacco addiction 406
Tolerogenic vaccination 401, 405
Toll-like receptor 4, 70, 122, 261, 403
Tonsillar and laryngeal regions 174
Topical lidocaine-prilocaine emulsion 53
Total leukocyte count 455
Toxic shock syndrome 80, 85t
Transcutaneous
immunization 492
vaccine delivery 492
Transforming growth factor-β 402
Transmembrane ion channel 346
Transmission of vaccine type virus 324
Transportation of a vaccine 90f
Transverse myelitis 284
Traveler’s risk of
adolescent vaccines 519
cholera 527
Japanese encephalitis 527
rabies 527
typhoid fever 527
vaccinators 12
yellow fever 525
Treatment of
autonomic dysfunction 188
uncomplicated vivax malaria 461
Tremendous impact on morbidity 214
Tripolyphosphate 491
Trivalent inactivated influenza vaccine
efficacy of 349
safety 349
True adolescent vaccines 518
Tubercular meningitis 143, 144
Tuberculosis vaccines 139, 144
Tuberculosis, tetanus, diphtheria 516
Tumor
associated antigens 402, 404
microenvironment 402
necrosis factor 456
necrosis factor-alpha 490
Ty21a vaccine in developing countries 312t
Types of
BCG vaccine 140
currently used adjuvants 125
Typhoid fever 387, 527
case surveillance definitions 309t
vaccines 63, 304, 517
Tyrosinase 402
U
Ubiquitous distribution of tetanus spores 192
Ulcers on the oral mucosa in HFMD 413f
Under trial vaccines 588
Uniform resource locaters 606
United Nations Children’s Fund 312
United States Food and Drug Administration 46, 403, 591
Universal Immunization Program 85, 95t, 284, 265, 531, 556, 576
Universal Immunization Program Schedule in India 21t
Universal immunization Program in India 17
Upper respiratory infection 324
Use of
antibiotics 520
boolean commands 604
boolean operator 604
vaccines 556
V
Vaccination
against malaria 546
aim of 48
by intradermal route 169
containment 48
control 48
document 524
during
an acute illness 53
lactation 52
pregnancy 52
elimination 48
eradication 48
extinction 48
HIV infected children 502
in India 9t
information statements 588
issues 514
new immigrants 524
of adolescents 205
of children previously vaccinated outside India 55
of children with chronic disorders 55
of preterm and low birth weight infants 54
perturbs epidemiology herd
effect 47
immunity 47
post-independent india 15
practiced in India 12
preterm 169
programs 563
schedule 254, 522
strategies for
travelers visiting friends 523
under special circumstances 54
with current licensed rotavirus vaccines 254
Vaccines
adverse event reporting system 103, 287
antigen
dosage schedule 39
nature of 39
associated
adverse events 79
paralytic poliomyelitis 154, 593
virus 327
attempts targeting EBV 433
based on HCV DNA 444
carriers 96
cause of
allergic diseases 107
asthma 107
autoimmune diseases 107
characteristics 559
immunogenic efficacy 46
protective efficacy 46
seropositivity 46
seroprotection 46
seroconversion 46
combination 5
complexities of combination 6
cycle 600
delivery systems 484
dendritic cell 7
derived illness 501
development
and manufacturing 541
for human 4t
history of 274
programs 123
discovery and development 476
DNA 7
education center 108
effectiveness and impact in high-and middle-income countries 257
efficacy and formulation 556
epidemiology 139
failure
primary vaccine failure 47
secondary vaccine failure 47
for travelers 523t
for typhoid fever 311
formulations 336
history of 3, 414
immunity mediated by antibodies 38
immunogenicity and efficacy 243
immunology 25
incidence guidelines 604
induced immunity, mediators of 38
industry 533, 542
introduction 3
live recombinant 7
monitoring tool 90
policy related issues 578
polioviruses 154, 155
presentation 561
preventable disease surveillance 20, 101t, 323, 508, 520, 602
pricing strategies 544
production and distribution in India 90f
reaction 79
related research 597
research and development 535
risk communication 108
safety and efficacy of combination 5
safety and quality 560
scare-related adverse events 82
scheduling of 57
security 561
storage and handling 332
storage pattern 94f
strain 254
T-cell receptor peptide 7
trials 102
type 39, 58
vial monitors 90, 96
Vaccinia virus 445
Vaginal and conjunctival infections 214
Value of vaccination 563, 566
Vapocoolant 53
Varicella
and herpes zoster 323
vaccination 323
vaccines 518
zoster
immunoglobulin 507
virus 74, 323
Varicelliform rash 324
Vascular endothelial growth factor receptor 405
Vasculitis 291t
Vaxigrip 349, 352
Vector-based vaccines 404
Venezuelan hemorrhagic fever 387
Vertical transmission 164, 165
Vibrios
bacteriology 424
cholerae 382
diagnosis 424
treatment 424
Vicarious liability 591
Viral
antigens 402
hepatitis 387
infections 163, 164
life cycle 434
vectored vaccines 477
Virosomes 128
Virus
bearing B cell migrates 434
evolution and selective pressure 262
like particle 414, 456, 477, 484, 488
sharing problem involving indonesia 553
shedding and transmission 156
vectors 473
Viscerotropic disease 388
Voluntary code 598
VP7 serotypes 252
VPV infection 154, 156, 157
W
Walk in coolers 91
Waning of immunity 203
Water bottles to increase cool mass 93f
Weakened immune systems 343
Web sites containing
Google scholar 604
Pubmed 604
WHO
case definitions for typhoid fever 308t
global influenza surveillance and response network 347
regional measles 280
Whole cell
cancer vaccines 402
organism approaches 463
pertussis vaccines 106, 194, 196, 197, 198, 204
Wild birds 341
Wild poliovirus 118f, 154
World Health Assembly 15, 111
World Health Organization 57, 111, 273, 279, 341, 388, 556, 573
Worldwide malaria cases and mortality 2010 461t
Wound management 190
X
Xanthan 254
X-linked lymphoproliferative syndrome 435
Y
Yeast and other cells 450
Yellow fever-dengue virus 417
Yellow fever vaccine for travelers 526
Z
Zeta of T cell receptor 435
Zonula occludens toxin 383
Zoonosis 341
Zoster vaccine 331
Zoster-preventive effect of vaccination 323
×
Chapter Notes

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1IAP Textbook of VACCINES
2

Disclaimer

The views expressed by the authors on different vaccines and issues pertaining to immunization shall be considered as their own personal opinions. They should not be construed or cited as official stand of the Indian Academy of Pediatrics.
3IAP Textbook of VACCINES
Editor-in-Chief Vipin M Vashishtha MD FIAP Director and Consultant Pediatrician Mangla Hospital and Research Center Bijnor, Uttar Pradesh, India Editors Rohit Agrawal MBBS DCH MD Director, Chandrajyoti Childrens Hospital, Mumbai Consultant Pediatrician, Kohinoor Hospital Mumbai, Maharashtra, India TU Sukumaran MD DCH MNAMS Professor, Department of Pediatrics Institute of Child Health and Children Hospital Government Medical College, Kottayam, Kerala, India Academic Editors Nitin K Shah MBBS MD DCH Consultant Pediatric Hemato-Oncologist PD Hinduja National Hospital and Medical Research Center Mumbai, Maharashtra, India Naveen Thacker MD (Ped) FIAP Director, Deep Children Hospital and Research Center Head, Department of Pediatrics, Sahyadri Ramkrishna Specialty Hospital Kutch, Gujarat, India Panna Choudhury MBBS DCH MD FIAP FIMSA FRSTMH FAMS Consultant Pediatrician Vice Chairman, Child Health Foundation Executive Director, Indian Academy of Pediatrics New Delhi, India Vijay N Yewale MD DCH Consultant Dr Yewale Multispecialty Hospital for Children Navi Mumbai, Maharashtra, India Associate Editors CP Bansal MD PD DAP FIAP Director and Consultant Pediatrician Shabd Pratap Hospital Gwalior, Madhya Pradesh, India A Parthasarathy MD DCH MNAMS Senior Consultant Pediatrician, AP Child Care, Chennai Ex Distinguished Professor, The Tamil Nadu Dr MGR Medical University Retired Senior Clinical Professor of Pediatrics, Madras Medical College Deputy Superintendent, Institute of Child Health and Hospital for Children Chennai, Tamil Nadu, India Foreword Stanley A Plotkin
4
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© 2014, Editors
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IAP Textbook of Vaccines
First Edition: 2014
9789350909478
Printed at
5Dedication
This endeavor of the Academy is dedicated to:
“The children of this great country—The future of our nation”
6
7IAP Committee on Immunization (IAPCOI), 2011–13
CHAIRPERSONS
Rohit Agrawal
TU Sukumaran
CONVENER
Vipin M Vashishtha
MEMBERS
Amarjeet Chitkara
Manjori Mitra
S Sanjay
SG Kasi
Suhas V Prabhu
ADVISORS
Nitin K Shah
Raju C Shah
Naveen Thacker
A Parthasarathy
EX-OFFICIO
Panna Choudhury (Chairman, IAPCOI, 2009–11)
Vijay N Yewale (Convener, IAPCOI, 2009–11)
Sailesh Gupta, Honorary Secretary General, IAP
Ritabrata Kundu, Chairperson, Infectious Diseases Chapter of IAP
Abhay K Shah, Secretary, Infectious Diseases Chapter of IAP
8
9IAP Advisory Committee of Vaccines and Immunization Practices (ACVIP), 2013–14
CHAIRPERSON
CP Bansal
CO-CHAIRPERSONS
Rohit Agarwal
Vijay N Yewale
CONVENER
Vipin M Vashishtha
IAP COORDINATOR (HSG)
Sailesh Gupta
MEMBERS
Shashi Vani
Anuradha Bose
Ajay Kalra
AK Patwari
Surjit Singh
CONSULTANTS
Narendra K Arora
Naveen Thacker
Rajesh Kumar
Ajay Gambhir
VG Ramachandran
HP Sachdev
RAPPORTEUR
Panna Choudhury
10
11Editorial Board
Editor-in-Chief
Editors
Academic Editors
Associate Editors
13Contributors 19Foreword
Diseases preventable by vaccination are disappearing all over the world as vaccine coverage increases. Certain infectious diseases have been essentially eliminated from the Americas, and although Europe is lagging behind in some respects, even there, epidemics of diseases, for which we have vaccines are unusual. That is not to say that the picture is completely rosy. Failure to vaccinate is a problem in isolated populations and some of our vaccines do not give high efficacy, owing to poor immune responses in particular patient groups or incomplete knowledge about the correlates of protection.
India and neighboring countries have presented special problems. Until recently, governmental interest in the introduction of new vaccines has been limited, perhaps because of a focus on polio eradication. In addition, the vast number of potential vaccinees does not make either routine or campaign distribution easy. Fortunately, the situation is changing for several reasons: the growing interest of physicians, the manifest importance of Asian vaccine manufacturers, and a greater understanding by governments that vaccination carries economic as well as health benefits.
Like politics, all vaccination must be local. Although the sixth edition of an international vaccine textbook, which I had the honor to edit, was published last year (Vaccines, Elsevier), disease epidemiology, vaccine schedules, medical practice, and vaccine administration differ according to local practices. Thus, a book that focuses on vaccination in Asia, where the majority of the world's population lives will serve an important purpose, and I hope it will be read widely throughout this huge geographical area. Moreover, Asian physicians and scientists should contribute even more to the body of knowledge concerning vaccination in all its aspects, from basic immunology to vaccine development and clinical trials. In that way, vaccine science will grow and benefit people in all corners of the world.
Stanley A Plotkin md
Emeritus Professor of Pediatrics, University of Pennsylvania
Emeritus Professor, Wistar Institute
Adjunct Professor, Johns Hopkins University
Pennsylvania, USA
20
21From the Desk of IAP President, 2013
Indian Academy of Pediatrics (IAP) has always accorded a very high priority to the various issues related to pediatric immunization in the country—be it framing recommendations for practicing fraternity or issuing guidelines on the need of inclusion of a particular vaccine in the national immunization schedule or training of program managers involved with delivery of vaccines in the field. The Academy has also played a proactive role in taking on misinformation campaign against vaccines in media. We, as an academic body, have contributed a lot in the success of Global Polio Eradication Initiative in the country, and now giving technical support to the ongoing Measles and Rubella Elimination Initiative. In fact, the Academy has never shrugged off its responsibility of a serious civil society organization, committed to the wellbeing of the children of this country. The amount of significance accorded to immunization can be gauged by the fact that a separate subcommittee of the Academy, now rechristened as Advisory Committee of Vaccines and Immunization Practices (ACVIP), has been purposely constituted to deal with all the issues related to the practice of immunization in the country for last many years.
The Academy is regularly publishing its recommendations on licensed vaccines and other aspects related to the pediatric immunization in the form of a compact booklet, IAP Guidebook on Immunization. This book is one of the most sought after publications of the Academy. Not only the practicing pediatricians, but even the vaccine manufacturers and policy makers cite the recommendations contained in the book. However, the need of a comprehensive book on the contemporary Indian scenario of vaccine-preventable diseases, vaccines, and practice of vaccination was felt for quite some time. As Chair of the ACVIP, and also as President of the Academy in this Golden Jubilee year, I think this book is a perfect gift by the committee to all the stakeholders involved in the field of immunization in the country and abroad. I am pretty sure that this venture shall fulfill the great void in our understanding of vaccine sciences and would serve as a reference material to all concerned. In the last, I congratulate all the contributors from the country and abroad, and the editors who have worked very hard to bring out this precious publication.
CP Bansal md pd dap fiap
President, Indian Academy of Pediatrics, 2013
Director and Consultant Pediatrician
Shabd Pratap Hospital
Gwalior, Madhya Pradesh, India
22
23Preface
There seems no exaggeration in William Foege's words when he uttered, “Vaccines are the tugboats of preventive health”. Apart from sanitation and safe water, no other intervention seems as powerful as vaccination in providing insulation to humankind from dreadful diseases. Vaccination has been so effective in taking on some of the formidable diseases that people became complacent about vaccine-preventable diseases (VPDs) in many developed countries. It is kind of “out-of-sight, out-of-mind” situation for many VPDs owing to effective vaccination as quite eloquently described by David Neumann. Yet, this phrase is applicable only for the children residing in less than half of the globe. For majority living in far more hostile and challenging conditions of the third world, the VPDs are still very much on the horizon. In fact, the children of the less developed countries need the umbrella of modern vaccination much more than their counterparts of developed world. The full potential of modern-day vaccines in making humankind disease-free, cannot be exploited until they are employed in the regions of the globe where their needs are felt the most.
The need of the vaccines is felt the most in India, which accounts for 20% of the world's child population, and responsible for 24% of all under-five deaths globally. India has been using vaccines since late 70s in its National Immunization Program (NIP) and currently running one of the largest mass immunization programs in the world. However, the performance of the overall program in many fields is still far from satisfactory. Coverage of many traditional vaccines remains disconcertingly low and many new vaccines that protect against today's some of the greatest threats to children, including pneumococcal disease and rotavirus have yet to be introduced into NIP. There are many barriers to achieve desired results; paucity of trained health professionals and workers in the field of vaccination is one of them. Furthermore, there is scarcity of good quality training and reliable resources in the field of vaccinology in the country.
Resistance to vaccination is almost as old as Jenner's smallpox vaccine. Misinformation campaigns against vaccine's safety may be detrimental to a well-established vaccination program of any nation. However, it may prove to be fatal to a developing country's ongoing vaccination initiatives as experienced in India in recent times. This phenomenon is growing worldwide and needs to be tackled with deft risk communication. One must not forget James Shannon's words, “The only safe vaccine is a vaccine that is never used.”
The Indian Academy of Pediatrics has been at the forefront of advocacy and training pertaining to vaccination, particularly in the private sector of the country. It has been periodically issuing its recommendations for both public and private health care sectors in the form of bundled guidelines contained in a ‘Guidebook of Immunization’. However, the need of a publication containing detailed region-specific information on the epidemiology of VPDs and vaccines has been felt for quite long. This endeavor of the Academy in the form of a comprehensive textbook on vaccines must be viewed as an attempt to fill this void.
The first edition of the book is in your hands for your perusal. It covers almost all the aspects related to modern vaccinology including currently available licensed vaccines and general aspects of immunization. Sections are also devoted to vaccines in the pipeline along with newer vaccine techniques. A separate section of the book deals with issues related to vaccine policies, trials, ethics and regulatory needs.
The book shall provide in-depth information to the professionals working in the field of vaccination in India and neighboring South-Central and South-Eastern Asian countries. Special emphasis is provided to disease epidemiology and vaccine needs of India and neighboring countries. This publication should also serve as a reference material for international health agencies, government health establishments, vaccine developers, immunization program managers, and vaccine funding agencies. At the same time, the book should also be of great utility to postgraduate students, faculty members of medical institutions, and practicing pediatricians of the country.24
A galaxy of national and international experts in the field of immunization has contributed enthusiastically to this project. We are grateful to all of them for sparing their invaluable time for the book and sharing their vast expertise in the respective fields of immunization. We apologize for irksome requests and ultimatums, if any in order to meet the deadline. We do sincerely hope this edition will be considered as a useful resource in the field for all those who recognize the need and the value of vaccines in the arena of child health.
Vipin M Vashishtha
Rohit Agrawal
TU Sukumaran
Nitin K Shah
Naveen Thacker
Panna Choudhury
Vijay N Yewale
CP Bansal
A Parthasarathy
25Acknowledgments
The editors are highly thankful to the dedicated team of publishers, particularly Dr Neeraj Choudhary and Ms Madhvi Thakur for their untiring efforts that culminated in publication of this book in time. The assistance provided by Dr Ajay Kalra and Dr Chandrakant Lahariya in reviewing many manuscripts is also thankfully acknowledged.