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IMM005 > Vaccination > Flashcards

Vaccination Flashcards

1
Q

What is the goal behind vaccination?

A

Stimulate memory in the immune system

So encounter with the same antigen protects from disease

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2
Q

What concept in nature does vaccination play on?

A

Encounter with a pathogen leads to disease, but also protection from the same pathogen through formation of memory

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3
Q

Who was the documented inventor of vaccines?

A

Jenner

Surgeon

In 1796

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4
Q

Why was Jenner not the true inventor of vaccines?

A

Jetsy the farmer discovered vaccines before Jenner

1774

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5
Q

Describe the first vaccine discovered

A

Smallpox

Using innoculations of scabs from milkmaids with cowpox

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6
Q

What is the most effective means of controlling infectious disease?

A

Vaccination

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7
Q

Which diseases have been eradicated by vaccines?

A

Smallpox

Rinderpest

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8
Q

What are vaccines?

A

Harmless versions of disease-causing organisms

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9
Q

Advantages of the specific immune responses induced by vaccines

A

Prevents infection

Controlling existing infection

Prevent disease developing post-exposure

Prevent foetal infection through vaccinating the mother

Prevent or control cancer

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10
Q

Which cells do successful vaccines boost?

A

T cells

B cells

CTLs

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11
Q

Describe how vaccines work

A

Small immune response is triggered upon vaccination

The response is not big enough to protect you

But production of memory cells

The second time, the immune system is poised to act against the antigen

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12
Q

What happens regarding T and B cells following infection?

A

B cells:

Some B cells become plasma cell factoriess for antibodies

Some B cells hide ready for the next encounter = memory B cells

T cells:

Some T cells become immediate effectors

Some become memory cells

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13
Q

Describe the immunological process following vaccination

A
  1. Vaccine delivery
  2. Uptake and processing by APCs (B cells and DC)
  3. B cell activation and proliferation, CD4 T cell response and CD8 T cell response
  4. B cell and T cell memory established
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14
Q

Describe why herd immunity works

A

If a lot of people are vaccinated, then the disease can’t spread very far

So the whole community stays safe

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15
Q

Attributes of an effective vaccine

A

Memory and specificity

Activate different T cells

Induces antibody production by plasma cells

Inexpensive

Safe

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16
Q

What are the different types of vaccine?

A

Live attenuated

Killed/ inactivated

Sub-unit

Peptide

Inactivated toxin

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17
Q

What is a live attenuated vaccine?

A

Anti-virulent, weaker form of the agent

Comprises of the whole organism undergoing treatment with acid or alkali

Protein coats are still there to cause immune response

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18
Q

Example of a live attenuated vaccine

A

MMR vaccine

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19
Q

What is a killed vaccine?

A

Chemically inactivated form of the agent

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20
Q

Example of a killed vaccine

A

Polio

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21
Q

What is a sub-unit vaccine?

A

Isolated components of the agent

Conjugated

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22
Q

Example of a sub-unit vaccine?

A

Hib

Hepatitis

23
Q

What is a peptide vaccine?

A

Immunogenic peptide

24
Q

Example of a peptide vaccine

A

Under development for autoimmune disease

25
Q

What is an inactivated toxin vaccine?

A

Toxin inactivated to make a toxoid

26
Q

Example of an inactivated toxin vaccine

A

Tetanus

27
Q

Role of adjuvants

A

Make the antigen presenting cells interested in the antigen presented through the vaccine

In a non-specific way

Activation of these APCs cause them to secrete stimulatory factors

28
Q

What is the disadvantage of live attenuated vaccines?

A

Still contain a small part of the weakened live virus

Cannot inject into an immunocompromised host

Since this could cause disease

Reversion/compensatory mutations

Spread disease to other immunocompromised hosts

29
Q

How could peptide vaccines be used for autoimmune conditions?

A

Induces tolerance through stimulation of MHC II In the absence of co-stimulation

30
Q

Advantages of live attenuated vaccines

A

Induces a systemic and local response

Long lasting

Often cheap

31
Q

What are the advantages of inactivated/subunit/conjugate vaccines?

A

Helps to convert a T independent response to a T dependent response

No possible reversion

Safe to immunocompromised

32
Q

What are the disadvantages of inactivated/subunit/conjugate vaccines?

A

Adjuvants required

Multiple doses - short-lived

CTL response is poor

IgG only - no local or mucosal response

33
Q

Describe the two processes which makes it difficult for flu vaccine development

A

Antigenic drift

Antigenic shift

34
Q

Describe antigenic drift

A

Mutations to epitopes in haemagglutinin so that neutralising antibodies no longer binds

35
Q

Describe antigenic shift

A

Big chunks of DNA change

Antigenic shift occurs when RNA segments are exchanged between viral strains in a secondary host

No cross-protective immunity to virus expressing a novel hemagglutinin

36
Q

What manufacturing process is used to make flu vaccines?

A

Egg-based process

The candidate viruses are injected into a fertilised hens eggs and incubated to allow the virus to replicate

The virus is isolated and killed and the virus antigen is purified

37
Q

What flu vaccine is given to children?

A

Live attenuated

38
Q

What flu vaccine is given to adults?

A

Inactivated

39
Q

How is the strain of virus for the flu vaccine decided?

A

Sophisticated form of bioengineering using mathematical modelling

Inspired guess work - which vaccine is most useful

40
Q

What tempetature are flu vaccines stored at?

A

4 degrees

41
Q

What is important to look at when deciphering a vaccines efficacy?

A

Obtain data from elderly patients

Since this has higher social cost and is life-threatening

42
Q

Which diseases do vaccines still need to be developed for?

A

Malaria

Schistosomiasis

Tuberculosis

HIV

43
Q

What is the main hurdle in the development of an effective vaccine?

A

Development of an immunisation strategy that introduces:

  • broad and long-lasting CTL immunity
  • broadly neutralizing antibodies for all the proteins that the virus produces
44
Q

What is important to consider when developing a new vaccine?

A

The impact of the vaccine

It is a very costly process

Need to develop vaccines for relevant conditions

45
Q

How are vaccines and timing related?

A

It is important to employ vaccines at the correct timing

  • travel vaccines
  • elderly vaccines
  • infant vaccines
46
Q

Future goals of vaccine development

A

Eradication of polio

Effective vaccines for HIV, TB and malaria

Broadly-specific influenza vaccine

Vaccines against parasites

47
Q

Which vaccines are recommended for the elderly?

A

Flu

Pneumococcus

Tetanus

Shingles

48
Q

What is important regarding vaccines in the elderly?

A

Vaccination in the elderly results in lower antibody titre and reduced antibody efficacy

49
Q

Evidence of decreased immunity during ageing

A

Increased infection rates amongst the elderly

Shingles reactivation due to immune senescence

Increased rates of cancer

50
Q

Antibody profiles of primary, secondary and tertiary immune boosters

A

First vaccination = IgM

Second = more IgG

Third = increased affinity and quantity of IgG

51
Q

Link between inflammageing and decreased immune responses

A

Inflammageing results in elevated baseline inflammation

This is bad for antigen specific immunity

52
Q

What is inflammaging?

A

Nonspecific inflammation characteristic in the elderly

Considered a major target for anti-aging therapies

53
Q

Way to assess the activation of the inflammatory pathway

A

Measuring the concentration of C-reactive protein

54
Q

Clinical trial proving inflammageing as a good target for increasing the immune response in vaccination

A

VZV skin infection in elderly showed decreased response

The antibodies are present, but show reduced activity

Anti-inflammatory medication was used

Following immune suppression, reactivation of VZV infection on the skin showed increased response

= inflammatory suppression increases immune response

IMM005 (17 decks)

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