Scientific Basis of Vaccines Flashcards

(65 cards)

1
Q

What are the 4 principles from Jenner’s experiments?

A

1) challenge dose - proves protection from infection
2) Concept of attenuation
3) Concept that prior exposure to agents boosts protective response
4) cross species protection - antigenic similarity

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2
Q

What were the three things that contributed to smallpox eradication?

A

➝ They had vaccination programmes
➝ Case finding (surveillance)
➝ movement control

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3
Q

What were the 5 things that made the eradication of smallpox possible?

A

1) No subclinical infecitons (no asymptomatic spreaders)
2) after recovery the virus was eliminated - no carrier states
3) No animal reservoir
4) effective vaccines
5) slow spread and poor transmission

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4
Q

What is the definition of a vaccine?

A

➝ material from an organism that will :
➝ actively enhance adaptive immunity
➝ produces an immunologically primed state that allows for rapid secondary immune response on exposure to the antigen
➝ prevent disease but not infection

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5
Q

What are the 4 complications in measles?

A

➝ 1 in 15 pneumonia
➝ otitis media
➝ bronchitis
➝ 1 in 5000 encephalitis

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6
Q

What are the 2 complications of the measles vaccine?

A

➝ 1 in 1000 fever/convulsions

➝ 1 in 400,000 meningo-encephalitis

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7
Q

What is one complication of diphtheria?

A

➝ 5% mortality

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8
Q

What is one complication of the diphtheria vaccine?

A

➝ occasional swelling

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9
Q

What are the 2 complications of whooping cough?

A

➝ 0.1% mortality

➝ frequent pneumonia, encephalopathy

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10
Q

What is one complication of the whooping cough vaccine?

A

➝ 1 in 600,000 encephalopathy

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11
Q

How can active immunity be induced?

A

➝ Natural exposure
➝ Infection
➝ Vaccination

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12
Q

What is the duration of active immunity?

A

➝ long term

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13
Q

How does passive immunity occur?

A

➝ prophylaxis / treatment

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14
Q

What is the duration of passive immunity?

A

➝ short term

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15
Q

Give three examples of passive immunity?

A

➝ anti-tetanus serum from horses in WW1 decreased mortality by 30x
➝ post-exposure protection in rabies + vaccine
➝pooled human immune serum with high amounts of antibodies to protect babies from VZV

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16
Q

How long does it take for an antibody response during primary exposure?

A

➝ 5-7 days

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17
Q

How long does it take for a full response during primary exposure?

A

➝ 2 weeks

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18
Q

What class switching occurs in antibodies during a primary exposure?

A

➝ IgM ➝ IgG

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19
Q

How long does a full response take during secondary exposure?

A

➝ 2 days

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20
Q

What components are used to make a vaccine from a bacteria or a virus and why?

A

➝ usually surface proteins
➝ if you use a protein from inside the bacteria or virus, the body never comes into contact with the protein because it is internal

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21
Q

What are good targets for vaccines?

A

➝ Surface proteins
➝ polysaccharides
➝ toxins

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22
Q

What are 4 important considerations when vaccinating?

A

1) inducing the correct type of response
2) Inducing the response in the right place
3) duration of protection
4) age of vaccination

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23
Q

What kinds of responses are induced with polio and TB?

A

➝ Polio : antibodies

➝ TB : cell mediated immunity

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24
Q

Where should the immune response be with flu, polio and yellow fever?

A

➝ flu, polio : mucosal

➝ yellow fever : systemic

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25
Why do you need a mucosal response with the flu and polio?
➝ Flu affects the respiratory system | ➝ polio affects the gut
26
Which one of paraenteral and oral vaccines provide the best mucosal immunity?
➝ oral vaccines because they are processed by MALT (mucosal associated lymphoid tissue) and have good IgA
27
What are short term vaccines and why do you need them?
➝ during travel | ➝ only antibodies
28
Why do you need booster vaccines?
➝ natural immunity decreases | ➝ seasonal epidemics
29
What disease has a long incubation time?
➝ measles
30
Which disease has a short incubation time?
➝ cholera
31
Where is it difficult to induce long-lasting immunity?
➝ at mucosal surfaces
32
What antibodies are in breast milk and how long do they last?
➝ IgA | ➝ 6 months
33
Why are maternal antibodies in neonates a problem with live attenuated vaccines?
➝ the virus is neutralised by the maternal antibody
34
What are 5 examples of live attenuated vaccines?
``` ➝ BCG ➝ polio ➝ MMR ➝ yellow fever ➝ VZV ```
35
What is a monotypic infection?
➝ measles is not very different across the types of measles (low antigenic variability) so you only get it once
36
What is a polytypic infection?
➝ flu and gonorrhoea (high antigenic variability) so you can get it multiple times
37
What are most antigens?
➝ immunogenic but not immunoprotective
38
How many mutations does polio have?
➝ 57
39
What are 5 examples of killed whole organism vaccines?
``` ➝ pertussis ➝ flu ➝ polio ➝ cholera ➝ hep A ```
40
Why does a live vaccine not need boosting?
➝ the live vaccine survives long enough to induce good protective immunity ➝ virus keeps multiplying so the immune response is greater
41
What do subunit vaccines use?
``` ➝ Proteins ➝ Toxoids ➝ Peptides ➝ polysaccharides ➝ recombinant ➝ sub-cellular fractions ➝ surface antigens ➝ virulence determinant ```
42
What modifications do polysaccharide vaccines have to undergo and why?
➝ Conjugated to a toxoid + outer membrane protein | ➝ because children under the age of two don't recognise polysaccharides
43
What are recombinant vaccines?
➝ proteins that are injected into yeast or bacteria to replicate
44
Which vaccines use surface antigens?
➝ Hepatitis B ➝ influenza haemagglutinin ➝ meningitis B
45
What is a virulence determinant example?
➝ aP pertussis ➝ adhesion + toxoid + OMMP
46
How are toxoids formed?
➝ toxins inactivated with formaldehyde
47
What 3 diseases are toxin mediated?
➝ Diphtheria ➝ whooping cough ➝ tetanus
48
What do toxoid vaccines induce?
➝ antibody responses that neutralise toxins
49
Why are bacterial capsular polysaccharides not used?
➝ poor antigens and short term memory ➝ no T cell immunity ➝ less immunogenic in children less than 2 years old ➝ poor IgG2 responses
50
What is the function of IgG2?
➝ IgG2 promotes opsonisation and major recognition of polysaccharides
51
How do you enhance the immunogenicity of bacterial capsular polysaccharides?
➝ protein conjugation
52
What do toxoids + outer membrane proteins lead to?
➝ long lasting immunity and response in children
53
What is the MenC vaccine?
➝ Neisseia Meningitidis group C
54
What is the Hib vaccine?
➝ Haemophilus influenzae type B
55
What does conjugation do?
➝ links polysaccharide antigen to protein carrier that the infant's immune system already recognises in order to provoke an immune response
56
What happens if you only use a polysaccharide in a vaccine?
➝ poor recognition and no T cell help
57
What happens if you link a polysaccharide to a protein in a vaccine?
➝ The B cell recognises the protein ➝ it presents the protein to a T cell that recruits cytokines to help the B cell make much more specific and potent antibodies
58
What are vaccine adjuvants?
➝ Chemical or lipid structures that enhance the immune response using the vaccine components
59
What are the 3 functions of vaccine adjuvants?
➝ enhance the immune response to antigens ➝ promote uptake and antigen presentation ➝ stimulate correct cytokine profiles
60
What is an example of a vaccine adjuvant?
➝ aluminium salts
61
What are the 3 functions of aluminium salts?
➝ Form trapped particles ➝ slow release of antigen ➝ large number of Mps exposed
62
What are the advantages of live attenuated vaccines?
➝ long lived immunity | ➝ good immune response
63
What are the disadvantages of live attenuated vaccines?
``` ➝ requires cold chain ➝ insufficient attenuation ➝ reversion ➝ immunosuppressed ➝ foetal damage ```
64
What are the advantages of whole killed organisms?
➝ short or long ➝ IgG ➝ poor CMI ➝ stable
65
What are the disadvantages of whole killed organisms?
➝ inactivation and immunogenicity ➝ contamination ➝ toxicity/allergy ➝ autoimmunity