Public Health Pharmacy - Immunization

Flashcards about Public Health Pharmacy, focusing on immunization and the role of pharmacists as immunizers. These cards cover key concepts, vaccine types, and considerations for pharmacy-based immunization services.

Triple Burden of Disease

The simultaneous presence of infectious diseases, non-communicable diseases, and disaster-related health problems in the Philippines.

Neglected Tropical Diseases (NTDs)

The Philippines has 13 out of 17 WHO-recognized NTDs that are still endemic.

Health Indicators in the Philippines

High incidences of key communicable diseases, increasing levels of non-communicable diseases, and being the third highest disaster-prone country.

Factors Contributing to Infectious Diseases

Malnutrition, increased immunocompromised patients, nosocomial infections, emergency situations during disasters, and poverty.

Hepatitis A Vaccine

Provides 90% protection against symptomatic disease and asymptomatic infections.

Sterilizing Immunity

Complete prevention of infection, such as with the HPV vaccine.

Vaccines Prevent Annually

Almost 6 million deaths worldwide.

Herd Protection

Protection of unimmunized individuals by reducing pathogen shedding and through contact immunization.

Common Vaccine-Preventable Diseases Among Travelers

Influenza and Hepatitis A

Totally Eradicated Disease

Smallpox

Combined MMR Vaccine

Could eliminate rubella and mumps.

Challenges to Immunization Programs

Environmental reservoirs (tetanus), animal reservoirs (Japanese encephalitis and rabies), misconceptions, and the anti-vaccination movement.

Pharmacists' Role in Immunization

Advocate for immunization, provide alternative resources, act as a resource person, and serve as an entry point into the health system.

Levels of Pharmacist Involvement in Vaccine Advocacy

Educator, facilitator, and immunizer.

Guidelines for Pharmacy-Based Immunization Advocacy

Prevention, partnership, quality, documentation, and empowerment.

Good Manufacturing Practices for Vaccines

More stringent than those for other pharmaceutical products due to the biological nature of vaccines.

Biologicals

Products produced using materials that are part or were parts of a living material.

Vaccine Formulation Development

The process of discovering a potential vaccine immunogen and developing it into a fully approved vaccine, converting vaccine antigens to medicines.

Live Attenuated Vaccine (LAV)

Derived from weakened disease-causing pathogens.

Subunit (Purified Antigen) Vaccine

Contains only the antigenic parts of the pathogen necessary to elicit a protective immune response.

Inactivated (Killed Antigen) Vaccine

Made from microorganisms that have been killed through physical and chemical processes.

Toxoid Vaccine

Uses a protein-based toxin rendered harmless to elicit immunity.

Examples of Live Attenuated Vaccines

Tuberculosis (BCG), Oral Polio Vaccine (OPV), Measles, Rotavirus, Yellow fever.

Examples of Subunit Vaccines

Acellular pertussis (aP), Haemophilus influenzae type B (HiB), Pneumococcal (PCV), Hepatitis B (HepB).

Examples of Inactivated Vaccines

Whole-cell Pertussis (wP), Inactivated Polio Virus (IPV).

Examples of Toxoid Vaccines

Tetanus Toxoid (TT), Diphtheria Toxoid.

Immune Response with LAVs

Provide continual antigenic stimulation, giving sufficient time for memory cell production; excellent immune response.

Safety and Stability Concerns with LAVs

Potential reversion to original form, harm to immunocompromised individuals, sustained infection, contamination, immunization errors; less safe than inactivated vaccines.

Immune Response with Inactivated Vaccines

May not always induce immune response at first dose, response may not be long-lived; less strong immune response compared to LAVs.

Safety and Stability of Inactivated Vaccines

No live components, no risk of inducing the disease; safer and more stable than LAVs, excellent stability profile.

Immune Response with Subunit Vaccines

Need to determine the effective combination of antigenic properties. Less strong immune response compared to LAVs.

Stability of Subunit Vaccines

Excellent stability profile

Immune Response with Toxoid Vaccines

May require several doses and usually need an adjuvant; not highly immunogenic.

Vaccine Safety of Toxoid Vaccines

Vaccine cannot cause disease it prevents, very rare local and systemic reactions; Usually stable and long lasting.

Antigens in vaccines

Derived from the disease-causing organisms.

Stabilizers

Maintain vaccine effectiveness by ensuring stability during storage.

Adjuvants

Stimulate antibody production against the vaccine to enhance its effectiveness.

Antibiotics in vaccines

Prevent bacterial contamination during manufacturing.

Preservatives in multi-dose vaccines

Added to multi-dose vaccines e.g. thimerosal

Role of Immunizing Pharmacists

Provide public access to vaccines, educate patients, screen patients, manage adverse reactions, design workflows, and develop safety protocols.

Magnesium chloride (MgCl2)

Example of stabilizer used for OPV

Magnesium Sulfate (MgSO4)

Example of stabilizer used for Measles

Ethyl mercury-containing compound

Example of preservative - thimerosal

Formaldehyde

Used to inactivate viruses (IPV) and to detoxify bacterial toxins (diphtheria and tetanus)

Route of administration of Vaccines

Evaluated and optimized during Vaccine Formulation Development Path in clinical trials and animal models

Pharmacist as educator

Motivating people to be immunized

Pharmacist as facilitator

Hosting others who immunize

Pharmacist as immunizer

Administering the vaccine to the patient

Contact immunization

Where vaccine viruses may infect more individuals than those administered vaccine

Potency

Development of stability-indicating assays including this as part of the Vaccine Formulation Development Path

Perinatal and early infancy period

Enhancing Equity in Immunization