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4-Public Health > Vaccines & vaccination programs > Flashcards

Vaccines & vaccination programs Flashcards

1
Q

Is there a vaccination against S. pyogenes?

Why/ why not?

A

No effective vaccines

Explanations:

  • lack of interest due to penicillin efficacy
  • too many serotypes
  • capsule: is poor immunogen
  • M protein: immune response cross reacts with human tissue
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2
Q

Is there a vaccination against S.pneumoniae?

A

Yes, available and in use

  • based on capsular polysaccharides
  • active against common serotypes
  • Prevnar: 7-valent pneumococcal conjugate vaccine (7vPCV)
  • Prevnar 13®: 13-valent pneumococcal conjugate vaccine 13vPCV
  • Pneumovax 23: 23-valent Pneumococcal polysaccharide vaccine (23vPPV)
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3
Q

Which pathogens have live attenuated vaccines available?

A
  • Influenza (intranasal)
  • MMR
  • VZV
  • Rotavirus
  • Yellow fever
  • Small pox
  • Polio virus (Sabin)
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4
Q

Which pathogens have killed-pathogen vaccines available?

A
  • Influenza (injected)
  • HAV
  • Rabies
  • Polio (Salk)
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5
Q

Which pathogens have subunit vaccines available?

A
  • HBV (HBsAg)
  • HPV (6, 11, 16, 18)
  • …
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6
Q

Which vaccines are available for H.influenzae in Canada?

A

INFANRIX hexa

  • Conjugated HiB (w tetanus toxoid)
    • DTaP + polio + HepB

PEDIACEL

  • Conjugated HiB (w tetanus toxoid)
    • DTaP + polio (no HepB)
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7
Q

Which vaccines are available for N.meningitidis in Canada?

A

Menjugate

  • 1-valent conjugate
  • Oligosacch from group C conj to CRM197

Menactra

  • 4-valent conjugate
  • Polysaccharides from A,C,Y,W conjugated to DT protein
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8
Q

What vaccines are available for S.pneumoniae?

A

Prevnar13 (PCV13)

  • Conjugate vaccine
  • Recomm <2y, >=65

PneumoVax23 (PPSV23)

  • Polysacch vaccine
  • Recomm >=65
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9
Q

At what ages do we vaccinate against diphtheria?

A
  • 2m
  • 4m
  • 6m
  • 18m
  • 4y
  • 15y
  • Boosters q10y
  • Pregnancy
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10
Q

At what ages do we vaccinate against tetanus?

A
  • 2m
  • 4m
  • 6m
  • 18m
  • 4y
  • 15y
  • Boosters q10y
  • Pregnancy
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11
Q

At what ages do we vaccinate against pertussis?

A
  • 2m
  • 4m
  • 6m
  • 18m
  • 4y
  • 15y
  • Pregnancy

(No boosters, otherwise same as D+T)

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12
Q

At what ages do we vaccinate against polio?

A
  • 2m
  • 4m
  • 6m
  • 18m
  • 4y

(Same as early schedule for DPT)

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13
Q

At what ages do we vaccinate against HiB?

A
  • 2m
  • 4m
  • 6m
  • 18m

(= Same Infant schedule as DTP-IPV)

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14
Q

At what ages do we vaccinate against Hepatitis B?

A
  • 2m
  • 4m
  • 6m
  • Boosters as needed
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15
Q

At what ages do we vaccinate against S.pneumo?

A
  • 2m
  • 4m
  • 18m
  • >= 65y
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16
Q

At what ages do we vaccinate against N.meningitidis?

A
  • 12m
  • 15y (ACYW)
17
Q

At what ages do we vaccinate against MMR?

A
  • 12m
  • 4y
  • Boosters as needed
18
Q

At what ages do we vaccinate against Rotavirus?

A
  • 2m
  • 4m
  • 6m
19
Q

At what ages do we vaccinate against VZV?

A
  • 12m
  • >=65
20
Q

At what ages do we vaccinate against HPV?

A
  • 12y (x2 doses)
  • 15y (x3 doses, girls only) {}
21
Q

What types of vaccines are: Diphtheria & Tetanus vaccines

A

Toxin/toxoid

22
Q

What type of vaccine is the IPV vaccine?

A

Inactivated

23
Q

What type of vaccines are: Rotavirus, MMR, VZV

A

Live attenuated

24
Q

What kind of vaccines are: S.pneumo, N.meningitidis MenC, MenACYW, and HiB?

Why?

A

Conjugate of bacterial polysaccharide to CRM197.

(HiB is to Tetanus toxoid)

{}

25
Q

What kind of vaccine is: HBV, HPV, Pertussis

A

Subunit

26
Q

Which pathogens are covered by routine childhood immunization in Canada?

Starting at which ages?

A

Starting at 2mo:

  • DTaP + polio + HiB + HBV
  • Rotavirus
  • Pneumococcus (PneuC-13)

Starting at 4mo:

  • Meningococcus (MenconC)

Starting at 6mo:

  • Influenza

Starting at 1y:

  • MMRV

Starting at 12y (Grade 6):

  • HPV

Starting at 15y (Grade 9):

  • Meningococcus (MenC-ACYW)
27
Q

Which VPDs require booster shots? When?

A

Diphtheria & Tetanus

  • Td = q10y
  • dTap = 1 dose as an adult + 1 dose in every pregnancy

As needed & if at-risk: HBV, Rubella

(Influenza isn’t really a booster shot, but annual/repeated vaccination is recommended)

28
Q

Which pathogens require adult immunization?

A

Pneumococcus (Pneumo-P= 1 dose ~=65yo)

Shingles, if prior VZV infection

29
Q

Which pathogens’ vaccines are contraindicated for those who are immune compromised?

A

Live vaccines for:

  • MMRV
  • Rotavirus
  • Varicella
  • Shingles
  • Influenza (but inactivated available)

… if traveling:

  • YFV
  • Cholera (but inactivated available)
  • S.Typhi (but inactivated available)

… if risk:

  • Smallpox
30
Q

Which pathogens’ vaccines will not be effective in children <2 years old?

Why?

A

Unconjugated polysaccharide-based vaccines are not effective in infants <2.

  • E.g. Pneumococcal PSP23 vaccine for seniors, not kids.
  • Infants are able to mount good B cell-driven responses, but their T cell-based responses aren’t fully developed until ~2yo.
  • In the meantime, they rely on aT cell-independent pathway.
  • B cells recognize whole/unprocessed polysaccharide antigens and develop a weak, short, IgM-based response.
  • But because Thelper cells don’t help B cells switch Ab classes, it never switches to IgG (for memory).

(In contrast, protein antigens are presented to CD4 T cells on MHC-II molecules. Conjugate vaccines activate both B and T cells. Immunologic memory should be lifelong.)

31
Q

What is the difference between the different diphtheria/tetanus/pertussis vaccine formulations? {}

A

DTaP-IPV-Hib-HB

DTaP-IPV-Hib

dTap-IPV

dTap

Td

= +/- polio, +/- HiB, +/- hepatitis B virus

and

= Tdap is used to boost immunity for ~10yo (lower dose of diphtheria toxoid).

32
Q

What are the pros & cons of live attenuated vaccines?

A

PROS:

  • Induce both humoral and cell-mediated immunity.
  • No booster needed

CONS:

  • Dangerous to immunocompromised or their close contacts.
  • Have reverted to virulence on rare occasion.
33
Q

What are the pros & cons of killed-pathogen vaccines?

A

PROS:

  • Easier production.

CONS:

  • Induce humoral immunity only.
  • Require boosters.
34
Q

When are children routinely vaccinated for H.influenzae in Canada?

A

INFANRIX hexa

  • @ 2+4+6 mo

PEDIACEL

  • @ 18mo
35
Q

When are children routinely vaccinated for N.meningitidis in Canada?

A

MenC

  • @ 4 + 12mo

MenACYW

  • @ Grade 9
36
Q

What is the TB vaccine?

A

Bacille Calmette-Guerin (BCG): a live attenuated M.bovis strain

4-Public Health (4 decks)

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