Flashcards in Vaccination Deck (29)
Childhood Vaccination Schedule
2 Months - DTaP/IPV/HiB - Pneumococcal conjugate vaccine
3 Months - DTaP/IPV/HiB - Meningitis C
4 Months - DTaP/IPV/HiB - PCV - Mengitis C
12-13 Months - HiB/Men C - PCV - MMR
3 Years 4 Months - DTaP/IPV - MMR
13-18 Years - Td/IPV
Girls 12-13 Years - HPV
D - Diphtheria
T - Tetanus
aP - acellular Pertussis
IPV - Inactivated Polio
HiB - Haemophilus influenze type b
Vaccinations given to at risk groups?
Anthrax, Hep A/B, Men ACWY, Rabies, Varicella (if not immune)
Cholera, Hep A/B, Jap Encheph, Tick-Bourne Encheph, Typhoid, Yellow Fever
Central Memory cells - where are they found?
Found in Lymph nodes and tonsils - roll along and extravasate in High Endothelial Venules (HEVs)
Central Memory Cells - what do they produce?
Produce IL-2 (to support other cells)
Central Memory Cells - in which population CD4/CD8 are they more prevalent in?
More central memory in CD4 population
Central Memory Cells - CCR7? CD62?
CCR7+ and CD62L+
Allow entry via HEVs to lymph nodes
Effector Memory Cells - Where are they found?
Liver and Lungs and Gut
Effector Memory Cells - CCR7? CD62?
CCR7-ve and CD62 low (therefore not found in lymph nodes
Effector Memory Cells - What do they produce?
Perforin and IFN- gamma
Effector Memory Cells - in which population CD4/CD8 are they more prevalent in?
More effector memory in CD8 population
How does CCR7 have its effects?
binds CCL19 and CCL21 present on the luminal surface of endothelial cells in lymph nodes which causes firm arrest and the initiation of extravasation
how does CD62L have its effects?
Interacts with a molecules on HEV, which mediates attachment and rolling
B cell Memory - what are they? what are their effects/ what do they produce?
Memory cells that can differentiate into plasma cells
Quicker response, more antibodies, higher affinity antibodies, more IgG and generally better antibodies
T helper cell response - Th1?
Cell mediated, involved cytokines IL-2, IFN-gamma, TNF
T helper cell response - Th2?
Humoral response, involves cytokines IL-4/5/6
Live Vaccines - Advantages?
Life long immunity - no booster required
Immune response to several antigens and protection against cross reactive strains
Live Vaccines - Disadvantages?
Careful in immunodeficent patients
Reversion to Virulence
Harder to store
Live Vaccines - Examples?
Sabin polio (oral no longer used)
Chicken pox (varicella)
Inactive Vaccines - Advantages?
Safe in ID patients
Can eliminate wild-type virus from community
Inactive Vaccines - Disadvantages?
Poorer and shorter immunity
Repeated boosters, adjuvants to combat this
Inactive Vaccines - Examples?
Inactivated - Salk (polio), Anthrax, Cholera, Bubonic Plague, Hep A, Rabies, Pertussis
Component - Hep B (HbS antigen), HPV (Capsid), Influenza (haemagglutinin, Neuraminidase)
Conjugate - Tetanus (exotoxin), HiB
Toxoids - Diphtheria, Tetanus
What are Adjuvants in Vaccination?
Increase the immune respomnse without altering its specificity
ALUM Adjuvant - how does it work?
Provides slow release antigen to help prime the immune response. Activates Gr1+ cells to produce IL-4 -> helps prime naive B cells.
Generally safe and mild, therefore commonly used
CpG Adjuvant - how does it work?
Unmethylated motif with 2 Purines at 5' end and 2 pyrimidines at 3' end - acts as an immunostimulatory adjuvant. Activates TLRs on APCs stimulating expression of costimulatory molecules
Complete Freund's Adjuvant - how does it work?
Water-in-oil emulsion containing mycobacterial cell wall components. Mainly for animals, painful in humans
Immune Stimulating Complex (ISCOMS) Adjuvant - How does it work?
Experimental, multimeric antigen with adjuvant built in
How is the Mantoux test carried out?
- Inject 0.1ml of 5 tuberculin units intradermally, examine arm after 48-72hrs
- A positive result is indicated by redness and an iduration (swelling that can be felt) of at least 10mm in diameter. This implies previous exposure to tuberculin protein - thus it could represent previous BCG exposure