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Fundamentals of P > Vaccines - Bacterial & Viral > Flashcards

Vaccines - Bacterial & Viral Flashcards

1
Q

Men B Vaccine - describe administration

A

All new born babies
2 and 4 months; Booster 12 months
Catch up programme for babies born after 1ST May 2015

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2
Q

Bexsero® Components

A
  • outer membrane vesicles (OMV) - N. meningitidis group B strain Z98/254 menZB
  • Surface proteins (non-variant) of the bacteria – recombinant :
    • Factor H Binding Protein (fHbp)
    • Neisseria Heparin Binding Antigen (NHBA)
    • Neisseria Adhesin A (NadA)
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3
Q

Men B Vaccine - issues

A

Other groups remain vulnerable – cost effectiveness, shortages of supply, JCVI
more reactogenic;
not all serotypes of group B covered (unlike menC)
Some cross-protection against menW
£75 per dose – needs to be £20 for cost effectiveness.
88% efficacy and strain coverage
Duration of protection – 10 years

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4
Q

Men ACWY - define

A

Highly virulent invasive strain W

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5
Q

Haemophilus influenza type B - define

A

Paediatric disease - usually 6 mo - 3 yrs 1/600

Initially, a nasopharyngitis (often starting with viral infection)

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6
Q

Haemophilus influenza type B - describe spread

A

spreads to an otitis media,
sinusitis, bronchitis, pneumonia or
sometimes epiglottitis (requiring a
tracheotomy):- croup

Spreads : bacteraemia,
septic arthritis,
meningitis (60% cases)

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7
Q

Haemophilus influenza type B - effect if not treated

A 
Neurological disorders (33%) or
  death (5%) if not vigorously treated
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8
Q

Haemophilus influenza type B - describe treatment

A

Vaccine effective: (99% cases are type b)

type b - capsule polysaccharide linked to conjugate:-
diphtheria/tetanus toxoids + outer membrane proteins

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9
Q

Diphtheria - define

A

Corynebacterium diphtheriae

Pharynx - non-invasive multiplication

Toxin produced locally but acts at a distance

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10
Q

Diphtheria - describe effects

A
  • absorbed by lymphatics – systemic effects
    damages heart, kidney, nerves, adrenals
    • kills epithelial cells and polymorphs
      gelatinous exudate
    • ulcer - necrotic exudate - Pseudomembrane
    • local inflammation ,swelling, lymph nodes - Bull Neck
    • Respiratory obstruction
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11
Q

Clostridium tetani - define

A

Clostridium tetani Gram +ve rods,
terminal drumstick spores
anaerobe
Soil dweller

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12
Q

synaptobrevin - enzyme

A

Tetanospasmin
Zn2+ endopeptidase
for synaptobrevin

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13
Q

Neurotoxins

Clostridium tetani and tetanus - effect

A

Blocks release of
inhibitory transmitters-
GABA and glycine

Unopposed continuous
excitation

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14
Q

Whooping Cough – Pertussis - define

A

Multi-toxin disease

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15
Q

Whooping Cough – describe action of old vaccine

A

DTaP vaccine

Whole cell vaccine - killed organisms toxicity ?

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16
Q

Whooping Cough – describe action of new vaccine

A

New low risk acellular vaccine
adhesin + pertussis toxoids + outer membrane proteins

Blocks adhesion and neutralises toxin - antibody role

Very effective

17
Q

Influenza programme - aim

A

Aim:

To protect those who are most at risk of serious illness
or death should they develop influenza

To reduce the circulation of the virus

18
Q

Influenza programme - who gets it

A

Who gets it?

  • all those aged 65 years or over
  • all those aged 6 months or over in a clinical risk group
  • those living in long-stay residential facilities
  • those who care for elderly or disabled persons
  • household contacts of immunocompromised individuals
  • those working within health and social care settings
  • those who work in close contact with poultry
  • all children 2 – 9 years (most infections and transmission source)
19
Q

Tetravalent vaccines will contain the following viruses:

A

• A/Michigan/45/2015 as the H1N1-like component (as last year)
A/Singapore/INFIMH-16-0019/2016 as the H3N2-like component
B/Colorado/06/2017
B/Phuket/3073/2013

20
Q

Tetravalent vaccines - effective composition

A

Effectiveness

- variable by year/age group
- antigenic drift and shift; 
- prior exposure; cross-reacting antibodies
- Vaccine production issues
21
Q

Fluenz Tetra - define

A

Live attenuated Influenza vaccine (LAIV)
Nasal spray
It is a cold-adapted virus
- cannot replicate at body temperature

22
Q

Fluenz Tetra 2016/17 - describe active ingredients

A

A/California/7/2009 (H1N1)pdm09-like virus
A/Hong Kong/4801/2014 (H3N2)-like virus
B/Phuket/3073/2013-like virus
B/Brisbane/60/2008-like virus

23
Q

What is pneumococcal vaccine?

A

Streptococcus pneumoniae

24
Q

Pneumococcal Polysaccharide Vaccine PPV23 - for who?

A

The 23-valent pneumococcal polysaccharide vaccine (PPV)
for at risk adults and children over the age of 2

Children under 2 can’t make a long-lasting protective immune response
to polysaccharide vaccines.

25
Q

HPV Vaccination - list licensed vaccines

A

Two licensed vaccines:
Gardasil: protects against HPV 6,11,16,18 - used now
Cervarix: protects against HPV 16,18

26
Q

HPV Vaccination - subunit

A

Recombinant capsid L2 protein in Virus-like particles - subunit

27
Q

HPV Vaccination - schedule

A

Schedule: Sept 2008 – all 12-13y and 17-18 year old girls 3 doses over 6 months
booster not currently thought necessary - so now 2 doses

28
Q

HPV Vaccination - results from clinical trials

A

Clinical trials show high efficacy, well tolerated:

66% reduction in prevalence high grade pre-cancerous lesions
76% reduction in cervical cancer deaths
Will save 400 lives/year

29
Q

Neonatal tetanus - define

A

Neonatal tetanus :- Disease of the 8th Day
360,000 deaths/yr

Tetanus toxoid to mother in late pregnancy
→ high titres of maternal IgG in neonate

30
Q

Neonatal tetanus - why no live vaccine

A

Don’t want live vaccines during pregnancy - ?damage to foetus
e.g. rubella (MMR)

31
Q

TdaP/polio - whooping cough - describe use in pregnancy, why, when, uptake rate

A
  1. TdaP/polio - whooping cough - Boostrix IPV
    In response to the current UK outbreak of whooping cough
    pregnant women
    -to protect their babies before routine immunisation
    28 – 32 weeks stage up to 38 weeks
    Introduced in 2012
    Uptake rate ~ 70%
    Of 18 babies died of pertussis since 2013, 16 were from non-vaccinated mothers
32
Q

Flu - describe use in pregnancy, uptake rate

A

Flu - mother and baby protection – earlier the better
Pregnant women = 13% of all H1N1 flu deaths
Most childhood deaths in <6 month-olds
Uptake rate only ~42% in 2015-16; ~70% 2017 in UK

33
Q

NEW POLICY From 1 September 2005,

to provide an improved targeted BCG vaccination programme for –

A

• All infants (0 - 12 months) living in areas where the incidence of TB
is 40/100,000 or greater

• All infants (0 - 12 months) with a parent or grandparent who
was born in a country where the incidence of TB is 40/100,000 or greater

at risk secondary school children

Previously unvaccinated new immigrants from high prevalence countries for TB

34
Q

Explain why no BCG in USA

A

USA – no BCG comprehensive infection control policies
skin testing not compromised
treatment if PPD +ve

Fundamentals of P (62 decks)

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