Live and dead vaccines

and Sabine Schrör, medical journalist

Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

More about the experts All content is checked by medical journalists.

When vaccinating, either live or dead vaccines are given. Here you can find out what is meant by this, what advantages and disadvantages the different types of vaccine have and what diseases are vaccinated against with live or dead vaccines!

Live vaccine

Live vaccines contain reproductive but weakened ("attenuated") pathogens. These can multiply, but usually no longer make you sick. Nevertheless, the immune system reacts to the weakened pathogens in the vaccine by producing specific antibodies.

Advantages and disadvantages of live vaccines

Advantage: The vaccination protection after a live vaccination lasts for a long time, sometimes even for life (after complete basic immunization).

Disadvantage: It is very rare, but still possible, that the vaccination causes symptoms similar to the disease itself. However, the symptoms are very mild and only last a few days. Compared to the past, today's live vaccines are very well tolerated.

Side effects typically occur one to two weeks after the live vaccination!

Live vaccines and other vaccinations

Live vaccinations can be given at the same time as other live vaccines. A well-known example is the basic immunization against measles, mumps, rubella and varicella - all of them live vaccinations. At the first vaccination appointment, the children receive the MMR vaccination and a chickenpox vaccination at the same time. A quadruple vaccine (MMRV) at the second vaccination appointment.

If live vaccinations are not administered at the same time, there must be an interval of at least four weeks between two live vaccinations!

The interval between two live vaccinations is necessary because certain processes could impair the development of immune protection. For example, the measles vaccine is said to have a temporary weakening effect on the immune system. In addition, researchers assume that messenger substances released after a live vaccination prevent immune cells from absorbing and reacting to further vaccine viruses that have been injected too early.

The four-week interval does not apply to live vaccines that are swallowed (e.g. rotavirus vaccination). The combination of live and dead vaccines is also possible without a minimum distance.

Live vaccines and pregnancy

Live vaccinations should not be given during pregnancy. The weakened pathogen could possibly harm the unborn child. Also, avoid getting pregnant for four weeks after receiving appropriate immunization.

Live vaccination, however, is possible during breastfeeding. Although the mother can transmit the vaccine virus with breast milk, this does not pose a risk to the child according to the current state of knowledge.

Read more about vaccinations and pregnancy here.

Dead vaccine

There are different types of inactivated vaccines:

Whole particle vaccine: whole, killed / inactivated pathogens

Split vaccine: Inactive fragments of pathogens (often better tolerated as a result)

Polysaccharide vaccine: sugar chains from the pathogen envelope (they only activate the immune cells to a limited extent and are therefore only sufficiently effective in older children and adults)
Conjugate vaccine: Also sugar chains of the pathogen envelope, now bound to certain proteins (carrier proteins), whereby the defense reaction is strengthened
Subunit vaccine: Contains only a certain amount of protein (antigen) of the pathogen

Toxoid vaccine: Inactive components of the pathogen poison
Adsorbate vaccine: Here the dead vaccine is also bound to adsorbents (e.g. aluminum hydroxide), which increases the immunization effect.

In recombinant vaccines, the pathogen antigens contained in them, on which the immune system builds immune protection, are genetically engineered. In all cases the following applies: The dead vaccine can no longer cause disease.

Advantages and disadvantages of dead vaccines

Advantage: As a rule, inactivated vaccines have fewer side effects than live vaccines. That is why most vaccines today fall into this category. In contrast to live vaccines, there is no need to keep a distance to other vaccinations (see above).

Disadvantage: The vaccination protection decreases over time and has to be refreshed regularly - sometimes after a few years (TBE vaccination), sometimes only after a long time (tetanus / diphtheria vaccination).

Unwanted side effects typically show up in the one to three days after vaccination with a dead vaccine!

Overview: live and dead vaccines

In the following table you will find the most important diseases against which a dead or live vaccine is available:

Dead vaccines	Live vaccines
cholera	measles
diphtheria	mumps
TBE	rubella
Flu (influenza)	Chickenpox (varicella)
Hepatitis A and B	Typhoid (oral vaccination)
HiB	Yellow fever
HPV
Japanese encephalitis
Polio
Whooping cough (pertussis)
Meningococci
Pneumococci
tetanus
rabies
Typhus (injection vaccination)