Vaccinations: Concepts, principles and details

Question 1

The concept of herd immunity means _

Answer 1

Disease reintroduction doesn’t lead to spread of disease

Question 2

Eradication of an organism (virus) requires 4 things. They are _

Answer 2

Low antigenic drift / strains of virus
No animal reservoir
Early diagnosis of new cases
High collaboration

Question 3

Current vaccines what best for intracellular or extracellular bacteria?

Answer 3

Extracellular

Question 4

2 major goals of vaccinations are _

Answer 4

Antibody response

Memory

Question 5

A good vaccine will _

Answer 5

Mimic route of delivery

Question 6

Current vaccines target _ types of structures on bacteria. What are the examples provided (3)

Answer 6

External structure
Capsular poly saccharides
Surface proteins
LPS

Question 7

Regarding whole organism vaccines, a pro and a con are _

Answer 7

Broadest immune response

More potential toxicity

Question 8

Compared to whole organism vaccines, purified proteins are {more/less] toxic, [more/less] protective]

Answer 8

Less

Less

Question 9

A major draw back to using purifed protein as a vaccine is _

Answer 9

Genetic variation between strains, if protein switches, no longer immune

Question 10

Pure capsular polysaccharides elicit what type of immune response? What population would this type of vaccine be ineffective for/

Answer 10

T-independent.

Children under 2

Question 11

What problem to conjugate vaccine solve?

Answer 11

Get children under 2 to develop immunity to calsular polysaccharides

Question 12

What type of antibody is most likely to effectively engage / activate the complement system?

Answer 12

IgM

Question 13

What is a serotype?

Answer 13

A natural product of genetic mutation

Question 14

Why is a whole cell vaccine better than a purified protein?

Answer 14

You generate antibodies to various component of the bacteria. Protects agains serotype switching, as you have antibodies to various components of the bacteria

Question 15

Under what circumstance is IgG able to effectively activate the complement cascade?

Answer 15

Requires high density of the surface antigen. Antigens can be different

Question 16

Pure polysaccharides are detected by what type of immune response? What is the product of this response? What is a major limitation

Answer 16

T-independent
IgM antibodies
No memory

Question 17

2 major advantages of the T-dependent response are _

Answer 17

Able to respond to intracellular pathogens

Long term memory

Question 18

How to APC respond to a pure polysaccharide antigen?

Answer 18

No response. Cannot present the peptide on MHC

Question 19

What is the immune response to a pure polysachharide antigen? What is the mediating cell? Product?

Answer 19

T-independent
B cells
IgM and some IgG

Question 20

A way to circumvent the inability to respond to pure polysaccharide antigens is via _

Answer 20

Conjugate vaccines

Question 21

The example provided where conjugate vaccines reduced incidence in iowa was of _

Answer 21

Bacterial meningitis

Question 22

An example of a vaccine that uses a toxoid is _

Answer 22

Tetanus

Question 23

2 examples where a live attenuated vaccine is used are _. What are contraindications?

Answer 23

Measles
Polio
Can’t use in immune suppressed, including pregnancy

Question 24

3 examples of inactivated vaccines are _

Answer 24

Influenza
Rabies
Hep A

Question 25

3 examples of subunits of the vaccine being used are _

Answer 25

Hep B Pertusis Tetanus

Question 26

3 examples of conjugate vaccines are _

Answer 26

Hemophilus Influenza Strep Pneumo Nisseria Meningiditis

Question 27

What 3 vaccines are required of healthcare personnel?

Answer 27

Varicella Zoster Hep B Influenza (Annual)

Question 28

The primary response to a toxin occurs over what time frame? What is the main product?

Answer 28

7-10 days | IgM

Question 29

The secondary response to an initial exposure to a toxin occurs over what time frame? What is the main product

Answer 29

2 weeks | IgG

Question 30

What antibodies are increased during the primary phase of the immune response? Secondary phase?

Answer 30

IgM IgG These can be used clinically to determine disease phase

Question 31

What is the source of any IgM found in the fetus? Why?

Answer 31

From fetus. IgM doesn't cross membranes

Question 32

What is the source of IgG in the fetus?

Answer 32

Maternal and fetal. IgM is able to cross membrane

Question 33

What is the source of IgA in the fetus?

Answer 33

From fetus. IgM doesn't cross membranes

Question 34

What is the significance of high IgM in the fetus?

Answer 34

Infection in utero

Question 35

A fetus can make igM and IgG shortly after birth. What is the caveat?

Answer 35

Only to proteins

Question 36

What is the significance of having the half life of maternal antibodies waning after 1-3 months?

Answer 36

A window appears where the child is suceptible to infection because no longer protected by maternal antibodies

Question 37

What is the benefit of administering conjugate vaccine to a mother during the 3rd trimester?

Answer 37

Allows for the mother to generate antibodies, protect the child for longer

Question 38

How does herd immunity relate to vaccination for the entire population?

Answer 38

Means that the population can be protected without having to vaccinate everyone

Question 39

What are the factors that influence the probability of disease transmission? (6)

Answer 39

``` Suceptible population # Contact frequency Duration of infection Agent stability in environment # of organisms for infection Super spreader ```

Question 40

The major factor determining probabilty of infection is _

Answer 40

The number of suceptible individuals

Question 41

Super spreaders usually have high organism load. What is their relative set point compared to controls?

Answer 41

Shifted down and right

Question 42

What is immune escape? How can it be prevented?

Answer 42

Mutations confer resistant to strains of bacteria. | Use whole organism vaccines, increase chance some component is immunogenic

Question 43

What component of the complement cascade does IgM use to initiate a response to polysaccharide antigen?

Answer 43

C1q

Question 44

What component of the immune response is deficient in children under 2?

Answer 44

T-independent response, allows for response to polysaccharide antigens

Question 45

An infants GI tract is protected by _

Answer 45

Maternal IgA from breastmilk

Question 46

There are 4 assumptions of herd immunity theory. They are _

Answer 46

Closed population Interactions are random Anyone can get infected Infection leads to immunity

Question 47

What is the effect of vaccine on death rate following infection? How does vaccination reduce death rate?

Answer 47

It doesn't change death rate after infection | It reduced # of people who die by reducing # of people who get infected

Question 48

What is the meaning of endemic level? Hypoendemic level? Hyperendemic?

Answer 48

Endemic - Basal level in population Hypo - lower than reference population Hyper - Higher than reference population