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Chapter 12: Bacterial Vaccines

PRINCIPLES OF BACTERIAL VACCINES

Several bacterial diseases can be prevented by using immunizations that induce either active or passive immunity. Active immunity is induced by vaccines prepared from bacteria or their products. This chapter presents a summary of the types of vaccines (Table 12–1); detailed information regarding each vaccine is located in the chapters on the specific organisms. Passive immunity is provided by the administration of preformed antibody in preparations called immune globulins. The immune globulins useful against bacterial diseases are described later. Passive–active immunity involves giving both immune globulins to provide immediate protection and a vaccine to provide long-term protection. This approach is described later in the section on tetanus antitoxin.

Table 12–1Current Bacterial Vaccines
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Table 12–1 Current Bacterial Vaccines
Usage Bacterium Disease Antigen
Common usage Corynebacterium diphtheriae Diphtheria Toxoid
Clostridium tetani Tetanus Toxoid
Bordetella pertussis Pertussis (whooping cough) Acellular (purified proteins) or killed organisms
Haemophilus influenzae Meningitis Capsular polysaccharide conjugated to carrier protein
Streptococcus pneumoniae Pneumonia Capsular polysaccharide or capsular polysaccharide conjugated to carrier protein
Neisseria meningitidis Meningitis Capsular polysaccharide or capsular polysaccharide conjugated to a carrier protein; factor H binding protein for group B meningococci
Special situations Salmonella typhi Typhoid fever Live organisms or capsular polysaccharide
Vibrio cholerae Cholera

Live organisms in United States

Killed organisms in countries where cholera is endemic
Yersinia pestis Plague Killed organisms
Bacillus anthracis Anthrax Partially purified proteins
Mycobacterium bovis (BCG) Tuberculosis Live organisms
Francisella tularensis Tularemia Live organisms
Rickettsia prowazekii Typhus Killed organisms
Coxiella burnetii Q fever Killed organisms

ACTIVE IMMUNITY

Bacterial vaccines are composed of capsular polysaccharides, inactivated protein exotoxins (toxoids), killed bacteria, or live, attenuated bacteria. The available bacterial vaccines and their indications are described next. Table 12–2 lists the bacterial (and viral) vaccines recommended for children from 0 to 6 years of age as of 2017. Table 12-3 lists some important bacterial (and viral) vaccines recommended for travelers. Location and duration of travel are important factors when determining whether a vaccine should be recommended. Additional information regarding vaccines for travelers can be found at the website for the Centers for Disease Control and Prevention: www.cdc.gov/travel.

Table 12–2Vaccines Recommended for Children Age 0–6 Years1
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Table 12–2 Vaccines Recommended for Children Age 0–6 Years1
Bacterial Vaccines Viral Vaccines
Diphtheria toxoid, tetanus toxoid, acellular pertussis (DTaP) Hepatitis A
Haemophilus influenzae type b (Hib) Hepatitis B
Meningococcal (only for children with high-risk conditions)2 Influenza
Pneumococcal Measles, mumps, rubella (MMR)
  Poliovirus, inactivated
  Rotavirus
  Varicella

1Vaccines are listed in alphabetical order. A complete description of the vaccine schedule is available on the Centers for Disease Control and Prevention website, www.cdc.gov.

2High-risk conditions such as asplenia and HIV infection. Meningococcal vaccine for children without high-risk conditions should be given at age ...

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