• Inactivated (killed or component) viral vaccines primarily generate a humoral immune response against extracellular viral antigens, preventing viral entry into the cell.
• In contrast, live attenuated viral vaccines can generate a strong cell-mediated immune response that can kill virally-infected cells, in addition to providing humoral immunity.
• Because inactivated viral vaccines do not infect host cells, they are not processed by the MHC class I pathway and do not stimulate a potent CD8+ T-cell response.  In contrast, live attenuated influenza vaccines replicate in nasopharyngeal cells and are displayed on MHC class I molecules, thereby generating a strong cytotoxic T-cell response that results in the destruction of the infected cell.

<aside> 💉 Inactivated vaccines: “Beware of Hepatitis A on your TRIP:” Hepatitis A, Typhoid fever, Rabies, Influenza and Poliomyelitis

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• Live attenuated vaccines are generally contraindicated in immunocompromised patients

• HIV patient can receive live vaccines if

  1. Asymptompatic
  2. CD4 percentage is ore than 15 % in children less than 5 years
  3. If CD4 count is more than 200 cell/microliter in children above 5 years
  • Oral polio and BCG are absolutely contraindicated in HIV patients

As general rules • Live vaccines: subcutanous • Killed vaccines: intramusular • BCG: intradermal • Oral: polio, rota

• Vaccine Reactogenicity

• Vaccine Response

• Post Vaccination Syncope: Vasovagal-related hypotension vs Anaphylaxis

• Precautions

• Contraindications

• Approach to Vaccine Hesitancy ★

• Hepatitis Vaccines
• Meningococcal
• HPV Vaccine