immunization

Question 1

Two key public health measures have a major effect on lowering the incidence of infectious disease:

Answer 1

1. Public sanitation
2. Vaccines
   Potable water supplies, sewage disposal, improvements in housing
   Prevention of infectious diseases by inducing immune responses

Question 2

Vaccine

Answer 2

An immunizing agent derived from microorganisms

Question 3

Vaccine types

Answer 3

1. Live, attenuated microorganisms
2. Killed (irreversibly inactivated) microorganisms
3. Products or derivatives of microorganisms

Question 4

Types of immunization

Answer 4

Active immunization - administration of a vaccine

Passive immunization - administration of exogenously produced or preformed antibodies

Question 5

Passive immunization

newborns?

Answer 5

postexposure treatment

Injection of purified antibody or antibody-containing serum to provide rapid, temporary
protection or treatment.

Newborns receive natural passive immunization- maternal immunoglobulin that crosses the placenta and is present in breast milk

Question 6

Uses of passive immunization:

Answer 6

1. To prevent disease after a known exposure
2. To ameliorate the symptoms of an ongoing disease
3. To protect immunodeficient individuals
4. To block the action of bacterial toxins and prevent the diseases they cause

Question 7

Human Immune Globulins used against what diseases?

Answer 7

Hepatitis A
Hepatitis B
Rabies
Respiratory Syncytial Virus
Varicella
tetanus

Question 8

animal antitoxins used against

Answer 8

Botulism

Diphtheria

Question 9

passive immunization Limitations

Answer 9

sometimes antiviral antibody titers not high enough

contamination with other infectious agents

need to use early after exposure, often this is not possible

some viruses have a limited extracellular phase
herpesviruses, enteroviruses

Question 10

ab containing products and vaccines

Answer 10

Antibody-containing products can inhibit the immune response elicited by vaccines
Administration of vaccines should be delayed until passive antibody has degraded

Question 11

active/passive immunity for diseases with long incubation

Answer 11

For diseases with long incubation periods both active and passive immunization are
used for postexposure control
Hepatitis B, rabies, tetanus

Question 12

Active immunization

Answer 12

Use of vaccines to elicit immune responses

Inactivated, subunit, and killed vaccines
Live vaccines (attenuated)

Question 13

Inactivated, subunit, and killed vaccines

Answer 13

No risk of infection
Use large amounts of antigen
Inactivate or kill by chemical treatment (e.g. formalin) or heat
for bacteria, viruses, or bacterial toxins
Purify or synthesize subunits or components of the infectious agent

Question 14

Adjuvants
modern ones?
influence?

Answer 14

Adjuvants required to boost the immunogenicity of Inactivated, subunit, and killed vaccines
Alum (aluminum salt)

Modern adjuvants are designed to be or to mimic PAMPs
bacterial cell wall components
synthetic polymers
bacterial toxins (attenuated)

Adjuvants influence the type of immune response
Th1 or Th2
secretory IgA

Question 15

Some disadvantages of Inactivated, subunit, and killed vaccines

Answer 15

1. Immunity is not usually long-lived (generates a Th2 response that does not elicit effective immune memory)
2. Immunity may be humoral and not cell-mediated
3. The vaccine does not usually elicit a local IgA response
4. Booster shots are required
5. Larger doses must be used

Question 16

vaccines/dieases using these methods of immunization

toxoids?
inactivated?
capsular polysaccharides+?

Answer 16

toxoids: Corynebacterium diphtheriae, Clostridium tetani

inactivated (killed) bacteria: Vibrio cholera

capsule or protein subunits of bacteria
Capsular polysaccharide vaccines: Haemophilus influenzae B,

Conjugate these because polysaccharides are poor immunogens
Hib polysasccharide + diphtheria toxoid

Question 17

Viral vaccine types

Answer 17

inactivated viruses (polio, hepatitis A, influenza, and rabies)
protein subunits of viruses (hepatitis B)

Question 18

Active immunization: Live vaccines
use? 
host rxn? 
# doeses? 
longevity?
adjuvant?

Answer 18

Use avirulent or attenuated microorganisms
Immunization resembles the natural infection

host reaction progresses through Th1 and Th2 immune responses: humoral, cellular, and memory immune responses are developed

Only a single dose usually required
Immunity is generally long-lived
No adjuvant required

Question 19

live vax disadvantages

Answer 19

1. Vaccine microorganism may still be dangerous for immunosuppressed people or
   pregnant women, who do not have the immunologic resources to resolve even a
   weakened infection
2. The vaccine microorganism may revert to a virulent form (for viruses)
3. The viability of the vaccine must be maintained

Question 20

Live Bacterial vaccine example

why not used?

Answer 20

Calmette-Guerin bacillus (tuberculosis)
attenuated strain of Mycobacterium bovis

not routinely used in United States because vaccinated individuals show a false-positive reaction to
the tuberculosis test used in this country (PPD test = purified protein derivative test)

Question 21

live vax viral vax example

Answer 21

MMR vaccine
measles virus
mumps virus 
rubella virus
Varicella-zoster virus (also available as part of MMRV vaccine)

Question 22

correlates of protection

Answer 22

the host immune responses associated with disease protection

Question 23

Vaccines that protect solely or principally by induction of serum antibodies

Answer 23

hepA and tetanus

Question 24

Secretory antibodies play a role in protection against infections caused by
agents that must first replicate on mucosal surfaces, which disease

Answer 24

rotavirus

Question 25

Vaccines for which T-cell responses are essential include

Answer 25

measles and varicella

Question 26

SARS-CoV-2 vaccines for generating active immunity

Answer 26

mRNA, viral vector, and protein subunit vaccines encoding the Spike protein (or parts of)

Question 27

mRNA vaccine encoding the Spike protein

Answer 27

Pfizer - BioNTech & Moderna
mRNA enters cells and is translated into parts of Spike
active immunity

Question 28

Viral vector vaccine encoding the Spike protein

Answer 28

engineered harmless adenovirus (DNA virus) that infects
cells and then produces parts of Spike
Johnson & Johnson - Janssen
active immunity

Question 29

Protein subunit vaccine containing parts of the Spike protein

Answer 29

also contains adjuvants (saponins)
Novavax
active immunity

Question 30

Treatment for COVID-19 based on passive immunity to SARS-CoV-2

Answer 30

mAb- binds SARS-CoV-2 virions and“neutralizes” them, which means it blocks the virus from interacting with ACE2 receptors and entering cel