Anti-Viral Vaccines

Poliomyelitis—United States, 1950-2002

• Poliomyelitis—United States, 1950-2002

• Inactivated vaccine

• Live oral vaccine

• Last indigenous case

Vaccines in General Use

• Rubella
• Live attenuated virus. Rubella causes a mild febrile illness in children, but if infection occurs during pregnancy, the fetus may develop severe congenital abnormalities. Two vaccination policies have been adopted in the first world. In the USA, the vaccine is administered to all children in their second year of life (in an attempt to eradicate infection), while in Britain, until recently, only post pubertal girls were vaccinated. It was feared that if the prevalence of rubella in the community fell, then infection in the unimmunized might occur later - thus increasing the likelihood of infection occurring in the child-bearing years. This programme has since been abandoned in Britain and immunization of all children is the current practice.
• MMR — live measles virus, live mumps virus, live rubella virus, chick embryo, human foetal cells, neomycin, sorbitol, gelatine.

Rubella—United States, 1966-2002

• Rubella—United States, 1966-2002

Vaccines in General Use

• Rabies
• No safe attenuated strain of rabies virus has yet been developed for humans. Vaccines in current use include:
• The neurotissue vaccine - here the virus is grown in the spinal cords of rabbits, and then inactivated with beta-propiolactone. There is a high incidence of neurological complications following administration of this vaccine due to a hypersensitivity reaction to the myelin in the preparation and largely it has been replaced by
• A human diploid cell culture-derived vaccine (also inactivated) which is much safer.
• There are two situations where vaccine is given: a) Post-exposure prophylaxis, following the bite of a rabid animal: A course of 5-6 intramuscular injections, starting on the day of exposure. Hyperimmune rabies globulin may also administered on the day of exposure.
• b) Pre-exposure prophylaxis is used for protection of those whose occupation puts them at risk of infection with rabies; for example, vets, abbatoir and laboratory workers. This schedule is 2 doses one month apart ,and a booster dose one year later. (Further boosters every 2-3 years should be given if risk of exposure continues).