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PCBM M1T3 > Immunization and Vaccinations > Flashcards

Immunization and Vaccinations Flashcards

1
Q

What types of immunity are there?

A

Self vs non-self
Protection from infectious disease
Indicated by the presence of antibody
Specific to a single organisms

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2
Q

Antigen

A

A liven or inactivated substance capable of producing an immune response

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3
Q

Antibody

A

Protein molecule (immunoglobulin) produced by B lymphocytes to help eliminate an antigen

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4
Q

Passive immunity

A

Transfer of antibody produced by one human or other animal to another
Temporary protection

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5
Q

What are the most important sources in infancy of passive immunity?

A

Transplacental transfer and breastfeeding

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6
Q

What are some sources of passive immunity?

A

All blood or blood products
Homologous pooled human antibody (immune globulin)
Homologous human hyperimmune globulin
Heterologous hyperimmune serum (antitoxin)

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7
Q

Monoclonal antibody

A

Derived from a single type of antibody-producing cells (B cells)

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8
Q

What are monoclonal antibodies used for?

A

Used for diagnosis and therapy of certain cancers, autoimmine, and infectious disease

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9
Q

Active immunity

A

Produced by vaccine

Immunity and immunologic memory similar to natural infection (without disease risk)

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10
Q

1st principle of vaccination

A

The more similar a vaccine is to the disease-causing form of the organism , the better the immune response to the vaccine

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11
Q

What are some considerations when developing a new vaccine?

A

Common disease?
Safe and effective production of a vaccine?
Side effects worse than disease?

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12
Q

How long does preclinical testing for a new vaccine last?

A

2 - 4 years

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13
Q

What must the volunteers for a new vaccine agree to?

A

Vaccine administration, follow-ups for eval and physical testing, provide blood samples

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14
Q

How long to clinical trials for vaccinations last?

A

5 - 7 years

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15
Q

What is phase 1 for vaccine clinical trials?

A

Safety - candidate vax tested in small numbers to healthy adults to assess short term and adverse effects and correct dose

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16
Q

What is phase 2 for vax clinical trials?

A

Multiple stages of several hundred appropriate-age volunteers in multiple centers which assess expanded safety parameters and provocation of an immune response

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17
Q

What is phase 3 for vax clinical trials?

A

Thousands required to confirm degree of immune response/side effects, eval of vax in general population and potential value and use of the vaccine for general public health practice

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18
Q

What is phase 4 for vax clinical trials?

A

Monitoring

Detect rare/unexpected reactions, measure program effects

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19
Q

What is a live attenuated vaccine?

A

Weakened form of the wild virus or bacterium

Generally works in one dose (exclude oral)

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20
Q

What must a vax do to be considered live attenuated?

A

Must replicate to be effective, produce immune response similar to natural infection

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21
Q

What are some complications of a live attenuated vax?

A

Severe rxns, interference from antibodies

Vax is fragile - stored and handled carefully

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22
Q

Examples of live attenuated viral vax

A

Measles, mumps, rubella, varicella/zoster, yellow fever, rotavirus, intranasal influenza, rotavirus, vaccinia

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23
Q

Examples of live attenuated bacterial vax

A

BCG, oral typhoid

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24
Q

What parts may be used (fractional) can be used in an inactivated vax?

A

Protein-base: toxiod, sub-unit

Polysaccharide-based: pure, conjugate

25
Q

Characteristics of inactivated vax

A

No replication, less interference by antibodies, 3 -5 doses, humoral response mostly, antibody titer may dimish

26
Q

Examples of inactivated whole-cell vax

A

polio, hepatitis A, rabies, influenza

27
Q

What does a fractional subunit vax contain?

A

Minimal amounts of nonvirus antigens derived from the culture medium
Less likely to cause adverse reaction than whole version

28
Q

Examples of fractional inactivated vax

A 
Hepatitis B
Influenza
Pertussis (acellular)
Human papillomavirus
Anthrax
29
Q

What does a fractional toxoid vax contain?

A

Treated to destroy vax toxic properties, but retain the capacity to stimulate production of antitoxins

30
Q

Examples of fractional toxoid vax

A

Diphtheria

Tetanus

31
Q

What is a polysaccharide vax?

A

Extracted and purified form of the bacterial outer polysaccharide coat

32
Q

What are the characteristics of the polysac vax?

A

Induce formation of circulating antibodies, promote phagocytosis, remove immune system macs
No booster but doesn’t always work for kids younger than 2

33
Q

Examples of pure polysac vax

A

Pneumococcal
Meningoccal
Salmonella Typhi (4)

34
Q

What are conjugated polysac vax?

A

Polysacs linked to purified protein carriers

Involve helper T cells in the polysac antigen response

35
Q

Examples of conjugated polysac vax

A

Tetanus toxoid
Diphtheria toxoid
H. influenzae B
Some forms of Pneumococcal and Meningococcal

36
Q

What are the general rules of vaccination?

A

Inactivated vax are generally not affected by circulating antibody to the antigen
Live attenuated vax may be affected by circulating antibody to the antigen

37
Q

What is the second principle of vaccination?

A

All vax can be administered at the same visit as all other vax (generally)

38
Q

When should administration of vax be separated?

A

2 live parenteral vax

39
Q

What are the third prinicples of vax?

A

Increase the interval between doses of multidose vax does not diminish the effectiveness of the vax
Decreasing the interval between doses of a mutlidose vax may interfere with antibody response and protection

40
Q

When are minimum intervals and ages used for vax?

A

When a pt is behind schedule on vax series

Vax doses should not be administered at intervals less than the minimum or earlier than minimum age

41
Q

Adverse rxn

A

Extraneous effect caused by vax

Side effect

42
Q

Adverse event

A

Any event following vax, may be coincidental or true rxn

43
Q

Local adverse rxn

A

Pain, swelling, redness at injection site
Common with inactivated vax
Mild, self-limiting

44
Q

System adverse rxn

A

Fever, malaise, headache, nonspecific

Maybe unrelated to vax

45
Q

Live attenuated vax adverse rxn

A

Must replicate for immunity so there may be symptoms that occur after incubation period (7-21 days)

46
Q

Allergic adverse rxn

A

Dude to vax or vax component, rare, risk minimized by screening

47
Q

Contraindication

A

Condition in a recipient that greatly inc the chance of a serious adverse rxn or effect the ability of the vax to produce immunity

48
Q

What are the permanent contraindications for vax?

A

Severe allergic rxn to vax component after a dose

Encephalopathy (pertussis)

49
Q

Should live vax be used in pregnant women?

A

No

50
Q

In pregger the HPV vax should be….

A

Deferred

51
Q

What diseases could cause immunosuppresion?

A

Congenital immunodeficiency
Leukemia or lymphoma
Malignancy

52
Q

What chemotherapies could cause immunosupression?

A

Alkylating agents
Antimetabolities
Radiation

53
Q

If a person has isolated B-cell deficiency they can have what vax?

A

Varicella

54
Q

Which type of vax is safe for an immunosupressed person?

A

Inactivated vax but possible dec in response

55
Q

Which vax can you give to an asymptomatic HIV pt?

A

Varicella, MMR, maybe yellow fever

56
Q

Does acute illness mean a vax can’t be used?

A

No, it doesn’t even reduce efficacy but should be delayed until illness is improved

57
Q

What is a adjuvant?

A

Pathogens, or parts of one, used to inc vax effectiveness

58
Q

Why are preservatives used in vax?

A

The prevent the growth of bacteria or fungi

Always used in multidose vax

PCBM M1T3 (22 decks)

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