Vaccines and Vaccine Development

Question 1

What is a vaccination?

Answer 1

• exposure to a non-pathogenic microbe

- allows body to make memory B and T cells against this for future

Question 2

There are a number of different types of vaccinations. ‘antitoxins and immunoglobulins which provide immediate source of antibody’ is the definition of one type of vaccine, is this active or passive vaccination?

Answer 2

• passive

- body doesn’t need to mount an immune response, just used provided antibodies

Question 3

What is passive immunisation?

1 - injected with antibodies directly for immediate response
2 - injected with T and B cells to develop memory immunity
3 - injected with WBC to initiate an immune response
4 - injected with plasma cells to produce antibodies

Answer 3

1 - injected with antibodies directly for immediate response

- provides immediate response in patients who may not be able to produce the antibodies

Question 4

Passive immunity is when a patient is injected with antibodies from an external source directly for an immediate response. What 2 methods can be used to administer these?

1 - subdermal and intramuscular
2 - intravenously and intramuscular
3 - intravenously and subdermal
4 - intravenously and orally

Answer 4

2 - intravenously and intramuscular

Question 5

Passive immunity is when a patient is injected with antibodies from an external source directly for an immediate response. Does this approach provide long or short term immunity?

Answer 5

• short term, lasting as long as the antibodies last

- no natural production of the antibodies so when the antibodies are gone thats it

Question 6

Passive immunity is when a patient is injected with antibodies from an external source directly for an immediate response. Give an example of passive immunisation using a mother?

Answer 6

• mum breast feeding gives baby IgA antibodies

- when mum stops breast feeding the antibodies also stop

Question 7

Varicella Zoster immunoglobulin are antibodies that can be given to a patient who as been exposed to the viruses and is an example of passive immunisation. Is Varicella Zoster dangerous?

Varicella = chickenpox
Zoster = shingles 

1 - can be dangerous in adults
2 - can be dangerous in children
3 - can be dangerous in adults and children

Answer 7

1 - can be dangerous in adults

• essentially viruses that can causes chickenpox or shingles
• in children nothing major

Question 8

Varicella Zoster immunoglobulin are antibodies that can be given to a patient who as been exposed to the viruses and is an example of passive immunisation. In order for a patient to be administered though, 3 specific criteria from the list below must be met. Which 3 are they?

Varicella = chickenpox
Zoster = shingles 

1 - immunocompromised patient
2 - older healthy patient
3 - exposure to chickenpox or shingles but had when young
4 - born in a 3rd world country
5 - no varicella-zoster virus (VZV) antibodies confirmed via antibody testing
6 - increased risk of severe chickenpox (immunocompromised, neonates, women exposed in first 20w of pregnancy)

Answer 8

1) increased risk of severe chickenpox (immunocompromised, neonates, women exposed in first 20w of pregnancy)
5 - no varicella-zoster virus (VZV) antibodies confirmed via antibody testing
6 - increased risk of severe chickenpox (immunocompromised, neonates, women exposed in first 20w of pregnancy)

Question 9

Does passive or active immunisation cost more?

Answer 9

• passive and not as available as active immunisation

Question 10

What is active immunisation?

1 - injected with antibodies directly for immediate response
2 - injected with vaccine or antigen and body produces antibodies against it
3 - injected with vaccine and antibodies produced immediately
4 - injected with plasma cells to produce antibodies

Answer 10

2 - injected with vaccine or antigen and body produces antibodies against it
- the aim is to make the body produce antibodies and initiate long term immunity

Question 11

Active immunisation is when a person is injected with vaccine or antigen and body produces antibodies against it. There are 2 main types of active immunisation, what are they?

1 - active and hyperinactive
2 - inactive and hyperactive
3 - inactive and active
4 - active and hyperactive

Answer 11

3 - inactive and active

• active = weakened microorganisms are introduced into the body
• inactive = dead microorganism or parts of microorganisms like PAMPs is introduced into the body

Question 12

Is the hepatitis B (HBV) immunisation an example of active or passive immunisation?

Answer 12

• both
• mum could have had HBV vaccine and shared antibodies with baby
• baby will then be immunised at 8, 12 and 16 weeks as well as a form of active immunisation

Question 13

Live vaccines have a reduced virulence. What does virulence mean?

Answer 13

• ability of an organism to infect the host and cause a disease
• influenza and Varicella/Zoster are examples

Question 14

Are the Varicella/Zoster viruses given as live attenuated vaccines or as antibody therapy?

Varicella = chickenpox
Zoster = shingles

Answer 14

• both

Question 15

What are the 2 main benefits of administering live vaccines?

Answer 15

• strong long lasting immune response evoked

- provides local and systemic immunity

Question 16

What are the 4 main disadvantages of administering live vaccines?

Answer 16

• potential to revert to virulence (return to dangerous form, such as polio)
• contraindicated in immunosuppressed patients
• interference from passive antibodies (babies receiving antibodies from mum)
• poor stability (storage and transport)

Question 17

In babies why is the delivery of some live vaccines delayed in babies?

Answer 17

• baby will have passive immunisation from mothers antibodies during pregnancy and breast feeding
• passive antibodies can interfere with active antibodies found in vaccines

Question 18

What is an inactivated vaccine?

Answer 18

• vaccine containing dead or inactivated microorganism, but intact enough to cause an immune response
• chemicals or heat is used to kill or inactivate

Question 19

Inactivated vaccines are those where a microorganism has been killed or inactivated using heat or chemicals, but it retains enough of its structure to elicit an immune response. There are a number of different types of inactivated vaccines. Which of the names below fits this definition: ‘a toxin produced by the microorganism has been rendered harmless (toxoid) in order to elicit immunity. For example tetanus and diphtheria vaccines’.

1 - Toxoid vaccines
2 - Subunit or acellular vaccines
3 - Conjugate vaccines

Answer 19

1 - Toxoid vaccines

Question 20

Inactivated vaccines are those where a microorganism has been killed or inactivated using heat or chemicals, but it retains enough of its structure to elicit an immune response. There are a number of different types of inactivated vaccines. Which of the names below fits this definition: ‘use the parts of the killed organism thought to induce an immune response (e.g. pertussis and pneumococcal polysaccharides, lipid vaccines)’.

1 - Toxoid vaccines
2 - Subunit or acellular vaccines
3 - Conjugate vaccines

Answer 20

2 - Subunit or acellular (not containing any cells) vaccines

Question 21

Inactivated vaccines are those where a microorganism has been killed or inactivated using heat or chemicals, but it retains enough of its structure to elicit an immune response. There are a number of different types of inactivated vaccines. Which of the names below fits this definition: ‘use the parts of the killed organism thought to induce an immune response joined on to a protein carrier to stimulate a better immune response (e.g. meningococcal, pneumococcal and Hib vaccines)’.

1 - Toxoid vaccines
2 - Subunit or acellular vaccines
3 - Conjugate vaccines

Answer 21

3 - Conjugate vaccines

• protein added to polysaccharide that immune system can recognise
• child’s immune response can recognise the the protein and then attack the microorganism

Question 22

What is Pertussis, a nasty respiratory disease more commonly known as?

1 - common cold
2 - whooping cough
3 - bronchitis
4 - infant respiratory distress syndrome

Answer 22

2 - whooping cough

Question 23

Pertussis, a nasty respiratory disease more commonly known as whooping cough is administered how?

1 - live virus vaccine
2 - subunit or acellular vaccines
3 - toxoid vaccine
4 - conjugate vaccines

Answer 23

2 - subunit or acellular vaccines

- administered at 8, 12 and 16 weeks

Question 24

Pertussis, a nasty respiratory disease more commonly known as whooping cough has been delivered as active and passive immunity for babies since 2012 in the UK. How is this a form of both active and passive vaccination?

Answer 24

• passive = mum has vaccine as acellular vaccines, so she produces antibodies to pertussis that will cross the placenta and provide passive immunity for the baby
• active = baby is born and reaches specific age (when passive antibodies have gone) they will be given the acellular vaccine for pertussis meaning they then have active immunity

Question 25

Conjugate vaccines are vaccines that use the parts of the killed organism thought to induce an immune response joined on to a protein carrier to stimulate a better immune response (e.g. meningococcal, pneumococcal and Hib vaccines). These are important in some virus for children. Why is this?

Answer 25

- children >2 years have B cells that cannot penetrate the polysaccharide coatings - baby or young child’s immature immune system to see and respond to the bacterium inside - antigen from killed organism in vaccine can be detected by PRR - PRRs can initiate complement pathway, phagocytosis and adaptive immunity

Question 26

What are the 4 main advantages of conjugated vaccines?

Answer 26

1 - induce immunity in young children 2 - long term immunological memory 3 - reduction in carriage of organism 4 - indirect protection to unvaccinated (herd immunity)

Question 27

Streptococcus pneumoniae are lancet-shaped, gram-positive, facultative anaerobic bacteria with more than 100 known serotypes. Most S. pneumoniae serotypes can cause disease, but only a minority of serotypes produce the majority of pneumococcal infections. There are 2 different vaccinations against Streptococcus pneumoniae. - Pneumococcal Polysaccharide Vaccine (PPV23) contains polysaccharide from each of 23 capsular types of pneumococcus - Pneumococcal Conjugate Vaccine (PCV13) contains polysaccharide from 13 common capsular types of pneumococcus conjugated to CRM197 protein (a non-toxic form of diphtheria toxin) Which patients would receive PPV23 and PCV13?

Answer 27

- PPV23 = >65 y/o - PCV13 = <2 y/o as their immature immune cells cannot detect the polysaccharide alone - both have lower immunity, but children may need recognising and binding the foreign bodies

Question 28

What are the 3 main downsides of inactivated vaccines?

Answer 28

1 - need several doses with shorter immunity 2 - local reactions common (skin reactions) 3 - adjuvant needed

Question 29

What are the 3 main advantages of inactivated vaccines?

Answer 29

1 - stable for transport and storage 2 - they do not cause the infection 3 - cannot spread infection to others

Question 30

What is a hexavalent vaccine? 1 - vaccines in the shape of a hexagon 2 - vaccines placed in a hexagon shape for delivery 3 - vaccine that can protect against 6 different diseases 4 - vaccines built in a specific way

Answer 30

4 - a vaccine that can protect against 6 different diseases

Question 31

A hexavalent vaccine is a vaccine that can protect against 6 different diseases. Infanrix hexa is the common example of this in the UK. What does this protect against? 1 - diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B and hepatitis B 2 - tetanus, pertussis, polio, Haemophilus influenzae B and hepatitis B and C 3 - diphtheria, pertussis, polio, Haemophilus influenzae B and hepatitis B and D 4 - diphtheria, tetanus, pertussis, Haemophilus influenzae B and hepatitis B and C

Answer 31

1 - diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B and hepatitis B

Question 32

A hexavalent vaccine is a vaccine that can protect against 6 different diseases. Infanrix hexa is the common example of this in the UK, protecting agains diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B and hepatitis B. When is this generally administered to babies? 1 - 8, 12 and 16 weeks of age 2 - 1, 2 and 16 weeks of age 3 - 8, 12 and 16 year of age 4 - 8, 12 and 16 months of age

Answer 32

1 - 8, 12 and 16 weeks of age

Question 33

There are some novel approaches to vaccinations, one of which is nucleic acid vaccines. What are these vaccinations? 1 - genetic info from virus used to trigger immunity 2 - human DNA added to virus to reduce immunity 3 - virus DNA is added to human cells to induce immunity 4 - genetic info from virus is used to learn about viruses

Answer 33

1 - genetic info from virus used to trigger immunity

Question 34

There are some novel approaches to vaccinations, 2 of which are nucleic acid and vector vaccines which is where genetic info from virus used to trigger immunity. How does this genetic info from a virus initiate an immune response?

Answer 34

- genetic info from virus is inserted into host cells - genetic info is used by the cell to create immune response - if the virus is encountered again the host can elicit an immune response

Question 35

What are vaccine adjuncts, such as aluminium salts?

Answer 35

- antigen and adjunct are administered together - the adjunct can amplify the immune effect caused by the antigen - results in prolonged immune memory