Module 4 - Types of Immunizing Agents and Their Composition

Question 1

What are the 3 main types of vaccines?

Answer 1

• live attenuated vaccines
• inactivated vaccines
• subunit vaccines

Question 2

What does attenuated mean ?

Answer 2

that the virus is weakened

Question 3

What type of vaccine is the closest to developing immunity from a an actual infection?

Answer 3

live attenuated vaccine

Question 4

What advantages to live vaccines have over other vaccines?

Answer 4

• they grow in the body and are transmitted to other areas of the body so the immune system develops an effective immune reaction to them, just like if you were to come in contact with a natural infection
• these vaccines lead to high antibody levels and most will only need one or two doses to lead to long-term immunity

Question 5

Who cannot receive live vaccines?

Answer 5

• immunocompromised

- pregnant patients

Question 6

When is corticosteroid use and live vaccines not contraindicated ?

Answer 6

• short-term therapy
• low dose therapy
• administered topically, inhaled, or locally injected (ex. to a joint)

Question 7

Live vaccines have live agents so ____ conditions are especially important in order for them to maintain their full potency.

Answer 7

storage

Question 8

List some examples of live attenuated vaccines.

Answer 8

Vaccines for:

• influenza (nasal spray form)
• measles
• mumps
• polio
• rotavirus
• rubella
• typhoid
• yellow fever
• varicella
• herpes zoster

Question 9

______ vaccine contains a suspension of whole-killed bacteria or virus

Answer 9

Inactivated

Question 10

Is there a risk of uncontrolled replication of an inactivated vaccine?

Answer 10

No - therefore you can give to immunocompromised patients

Question 11

T or F: inactivated vaccines tend to have a lower immune response than live vaccines

Answer 11

true

Question 12

Is the site and route of admin more important with live vaccines or with inactive vaccines?

Answer 12

With inactive vaccines because non-live vaccines activate an innate response ONLY at their sites of injection

Question 13

Would an IM or SC injection be better for non-live vaccines?

Answer 13

IM - want to give them in well vascularized muscles

Question 14

Inactivated vaccines almost always require _____ doses

Answer 14

multiple

Question 15

With inactivated vaccines, dose the 1st dose provide protection?

Answer 15

No - it primes the immune system. A protective immune response develops after the second or third dose

Question 16

Why do some inactivated vaccines require boosters?

Answer 16

Protection provided by an inactivated vaccine may diminish over time

Question 17

List some examples of inactivated vaccines

Answer 17

Vaccines for:

• hep A
• rabies
• cholera

Question 18

_____ vaccines contain purified products that usually come from the bacterium or virus that causes the natural infection but may also be synthesized using recombinant technology

Answer 18

Subunit

Question 19

The end products of subunit vaccines include ???

Answer 19

• proteins
• polysaccharides
• protein-polysaccharide conjugates

Question 20

What are the main differences between subunit vaccines and the other 2 types ?

Answer 20

• subunit vaccines contain only a small portion of bacterium or virus and are very safe and can be given to immunocompromised patients
• subunit vaccines do not elicit as high of an immune response compared to live and inactive vaccines so usually require multiple doses and boosters

Question 21

Benefit of using combination vaccines?

Answer 21

-fewer injections and a simpler regimen for patients, parents and HCPs

Question 22

Do rates of adverse events increase with combination vaccines?

Answer 22

No

Question 23

Is the immune response altered at all with combination vaccines compared to individual vaccines?

Answer 23

No

Question 24

List some examples of subunit vaccines

Answer 24

Vaccines against:
-diptheria 
-tetanus
-hep B
-acellular pertussis
-some influenza vaccines
-HPV
etc

Question 25

What 2 types of vaccines are adjuvants commonly added to?

Answer 25

- subunit | - inactivated

Question 26

What is the purpose of adding an adjuvant to a vaccine?

Answer 26

it enhances, acerbates, and prolongs the immune response

Question 27

The only adjuvants currently used in routine immunization are the _______ salts

Answer 27

aluminum

Question 28

Are adjuvants safe?

Answer 28

Yes

Question 29

When would preservatives be appropriate ?

Answer 29

- multi-dose vaccines - killed or subunit vaccines to prevent serious secondary infections as a result of bacterial or fungal contamination in the field

Question 30

What are the 3 preservatives used in current preparations of vaccines?

Answer 30

- thimerosal (only in trivalent influenza vaccine) - phenol - 2-phenoxyethanol

Question 31

Why are additives added?

Answer 31

to help the stability and delivery of the product ex. - prevent immunogenicity from adhering to the side of the vial, thus making them less available to the immune system

Question 32

List some additives used

Answer 32

- sugars - amino acids - proteins

Question 33

List 3 residuals found in vaccines

Answer 33

- antibiotics - formaldehyde - residual proteins

Question 34

What is the concern with antibiotics as a residual in vaccines?

Answer 34

That some patients allergic to those antibiotics would have an allergic reaction (the amounts are minuscule and are unlikely to cause an allergic reaction)

Question 35

Formaldehyde is used in the manufacturing of _____ and inactivated ______ vaccines. These infectious agents are killed with formaldehyde.

Answer 35

pertussis, polio

Question 36

what are the antibiotics used during vaccine manufacture?

Answer 36

- neomycin - streptomycin - polymixin B - chlortetracycline - gentamycin - amphotericin B

Question 37

What influenza vaccine is recommended for those with egg allergy?

Answer 37

TIV (trivalent inactivated vaccine) | QIV (quadrivalent inactivated vaccine)

Question 38

Can ppl with egg allergy receive MMR or MMRV as they are grown in chick embryos?

Answer 38

Yes - the amount of egg protein is 500 times less than the influenza vaccine

Question 39

What type of vaccine can be a part of combination vaccines?

Answer 39

subunit