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Flashcards in Vaccination Deck (29)
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1

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

2

Vaccinations given to at risk groups?

Anthrax, Hep A/B, Men ACWY, Rabies, Varicella (if not immune)

3

Travel Vaccinations?

Cholera, Hep A/B, Jap Encheph, Tick-Bourne Encheph, Typhoid, Yellow Fever

4

Central Memory cells - where are they found?

Found in Lymph nodes and tonsils - roll along and extravasate in High Endothelial Venules (HEVs)

5

Central Memory Cells - what do they produce?

Produce IL-2 (to support other cells)

6

Central Memory Cells - in which population CD4/CD8 are they more prevalent in?

More central memory in CD4 population

7

Central Memory Cells - CCR7? CD62?

CCR7+ and CD62L+

Allow entry via HEVs to lymph nodes

8

Effector Memory Cells - Where are they found?

Liver and Lungs and Gut

9

Effector Memory Cells - CCR7? CD62?

CCR7-ve and CD62 low (therefore not found in lymph nodes

10

Effector Memory Cells - What do they produce?

Perforin and IFN- gamma

11

Effector Memory Cells - in which population CD4/CD8 are they more prevalent in?

More effector memory in CD8 population

12

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

13

how does CD62L have its effects?

Interacts with a molecules on HEV, which mediates attachment and rolling

14

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

15

T helper cell response - Th1?

Cell mediated, involved cytokines IL-2, IFN-gamma, TNF

16

T helper cell response - Th2?

Humoral response, involves cytokines IL-4/5/6

17

Live Vaccines - Advantages?

Life long immunity - no booster required

Immune response to several antigens and protection against cross reactive strains

18

Live Vaccines - Disadvantages?

Careful in immunodeficent patients

Reversion to Virulence

Harder to store

19

Live Vaccines - Examples?

Sabin polio (oral no longer used)

MMR

Chicken pox (varicella)

Yellow fever

BCG

Typhoid

20

Inactive Vaccines - Advantages?

Easy Storage

Cheaper

Safe in ID patients

No Mutation/reversion

Can eliminate wild-type virus from community

21

Inactive Vaccines - Disadvantages?

Poorer and shorter immunity

Repeated boosters, adjuvants to combat this

22

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

23

What are Adjuvants in Vaccination?

Increase the immune respomnse without altering its specificity

24

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

25

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

26

Complete Freund's Adjuvant - how does it work?

Water-in-oil emulsion containing mycobacterial cell wall components. Mainly for animals, painful in humans

27

Immune Stimulating Complex (ISCOMS) Adjuvant - How does it work?

Experimental, multimeric antigen with adjuvant built in

28

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

29

Passive Vaccines - Giving Immunoglobulins - what diseases are they given for?

Hep A and Measles - HNIG
Hep B - HBIG
Rabies - HRIG
Varicella - VZIG
RSV - Paviluzimab