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302 SBM: Infection & Immunity > Vaccinology > Flashcards

Vaccinology Flashcards

1
Q

How can we tell that vaccines have been succcessful as a global preventative strategy?

A
  • there has been a reduction in number of cases of diseases

- reducing vaccination would greatly increase the burden of disease within a generation or less

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2
Q

Name 5 conditions for which we have vaccines for

A
  • Diphtheria
  • H. Influenza
  • Hepatitis A
  • Hepatitis B
  • Measles
  • Mumps
  • Pertussis
  • Polio
  • Rubella
  • Smallpox
  • Tetanus
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3
Q

What is a vaccine?

A
  • a preparation that confers acquired immunity to a disease
  • without the same risks and side effects as the infection
  • make it so that “the first encounter with an infectious pathogen is a secondary exposure”= memory response
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4
Q

What you must ensure about a vaccine before it can be disseminated into routine use?

A
  • it is safe to use (non-toxic)
  • it doesnt cause the disease its aimed to prevent
  • minimal side effects
  • its effects are long lasting
  • easy to store and transport
  • cheap
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5
Q

How do active vaccines work?

How do passive vaccines work?

A

Active: organism causes an immune response to be mounted as if infection had taken place

Passive: provides the vaccinee with a “prefabricated” immune response e..g anti-Hep B antibodies post exposure

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6
Q

Describe live vaccines in terms of:

  • preparation
  • MOA
  • contraindication
  • advantages
A
  • agents have been weakened but not killed.
  • Cannot normally causes disease but can still replicate to produce a strong immune response
  • avoid in immunocompromised individuals (risk of actual infection)
  • produce strong immune responses, offer lifelong protection, closely mimic natural infection
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7
Q

Give an example of live attenuated vaccine

A
  • BCG (TB)
  • Shingles
  • MMR
  • Nasal spray influenza
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8
Q

Describe inactivated vaccines in terms of:

  • preparation
  • MOA
  • contraindication
  • disadvantages
A
  • agents have been chemically destroyed/ heat
  • agent cannot replicate in vivo but immune system can recognise it and mount response
  • mount a weaker response so takes several doses (booster) to maintain immune response
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9
Q

Give an example of an inactivated vaccine

A
  • Influenza
  • Pertussis
  • Poliomyelitis
  • Typhoid
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10
Q

Give an example of a subunit/conjugate vaccine

A
  • Hep B (polysaccharide plus protein)

- TB (experimental stage)

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11
Q

Give an example of a toxoid vaccine

A
  • Tetanus

- Diphtheria

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12
Q

Novel Hep B vaccinations have been made. What kind of vaccines are they?

A
  • protein/virus like particle

- Subunit vaccine

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13
Q

DNA/RNA vaccines are being used against which types of diseases?

A
  • Infections

- Tumours

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14
Q

HPV Vaccines are of what category?

A
  • Protein/virus like particle
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15
Q

How did Edward Jenner create the first vaccine?

A
  • used pus from a milkmade who had contracted cowpox
  • he inoculated a boy with this cow-pox virus containing material
    HE USED AN ACTIVE FORM OF VACCINATION
    (he also injected the boy with actual smallpox virus material which could have been lethal)
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16
Q

What is the virus used in vaccine of smallpox?

A
  • Vaccinia virus: laboratory made

- Superior to variola virus (the lethal virus that actually causes smallpox)

17
Q

Human hyper-immune serum is superior to horse serum. Why is it not used?

A
  • Large, serious side effect profile e.g. disseminated intravascular coagulation (DIC), immune haemolysis
18
Q

Outline when childhood diphtheria vaccinations are given

A

At 8,12, and 16 weeks
- A 6 in 1 vaccine administers as 3 seperate doses

At 3y4month
- 4 in 1 pre-school booster

At 14 years
- 3 in 1 teenage booster

19
Q

Give 4 examples of vaccines given to confer passive immunity

A
  • Hep B hyperimmune serum after exposure
  • Tetanus hyperimmune serum after exposure
  • Rabies hyperimune serum after exposure
  • Anti-venoms, anti toxins given after exposure
20
Q

What has replaced Hep A hyperimmune serum which used to be given after exposure?

A

Active, pre-exposure vaccine

21
Q

What prophylactic agent is available for babies born to mothers who develop varicella 1 week before or after delivery?

A

VZV hyperimmune glubulin (VZVIG)

- confer spassive immunity

22
Q

State the known measles vaccine complications

A
  • pneumonia in 6/100
  • encephalitis in 1/1000 (also caused by MMR to a lesser extent)
  • death in 2/1000
    (apperently damages B cell memory to a number of infections)
23
Q

Outline the concept of herd immunity

A
  • Virus spread stops when probability of infection drops below a given threshold
  • The more immune persons the less likely an infected person will transmit to a susceptible person
  • This threshold is virus and population specific
  • outbreaks of disease can still occur even when threshold is reached
24
Q

What is the herd immunity threshold for measles?

How does this correspond to those vaccinated?

A
  • Threshold is 93-95%

The vaccine is not 100% effective so if 80% are immunized only 76% are actually immune

25
Q

Prior to immunisation how did the Ro (number of secondary transmissions from a single case) compare between the following diseases

  • Diphtheria, measles, mumps, pertussis, polio, rubella, smallpox
A 
Measles (12-18)
Pertussis (12-17)
Diphtheria (6-7)
Rubella (6-7)
Polio (5-7)
Smallpox (5-7)
Mumps (4-7)
26
Q

What is the herd immnity threshold for the following diseases

-Diphtheria, measles, mumps, pertussis, polio, rubella, smallpox

A
  • Diphtheria: 85%
  • Measles: 83-94%
  • Mumps: 75-86%
  • Pertussis: 92-94%
  • Polio: 80-86%
  • Rubella: 83-85%
  • Smallpox: 80-85%
27
Q

Describe the severe but rare side effect of the swine flu vaccine

What was the cause?

A

Narcolepsy

  • 1/55,000
  • severe sleep disruption, loss of concentration, social difficulties and in severe cases complete loss of muscle control (cataplexy)

ASO3 adjuvant

28
Q

What is an adjuvant?

A

Substances added to a vaccine to increase the bodys immune response to the agent

29
Q

Give an example of micro-fluidized detergent: emulsion, saponin adjuvant

Where has it been used?

A

AS03

  • in 2009 swine flu vaccine
  • in current H5N1 influenza vaccine BLA
30
Q

Give an example of a TLR agonist adjuvant

Where has bee used?

A

CpG (TLR9)

- used in current Hep B vaccine BLA

31
Q

The HPV vaccine contains a combination adjuvant. What is it?

A

ASO4

  • contains MPL which is a TLR4 agonist
  • and Aluminium hydroxide
32
Q

What is the aim of vaccination?

A
  • Direct aim: provide individual protection

Indirect aim: provide herd immunity

33
Q

What is the serious complication of anti-sera vaccination?

A
  • Can cause anaphylaxis upon repeated administration

response to non self protein- as in anti-diphetheria horse serum

34
Q

In which populations of people might adjuvants be of particular relevance

A

Those with reduced immunity

  • elderly
  • children
  • transplant recipients
35
Q

What is the relevance of the route of administration of a vaccination?

A
  • many infections are acquired via mucosal surfaces
  • sensible to induce immune responses at these surfaces
  • oral administration can result in tolerance
36
Q

Consider meningitis B

What is it?
Whos most likely to have it?
Complications if left untreated

A
  • Medical emergency: an aggressive strain of bacterial meningitis which infects the protective membranes of the brain and spinal cord
  • Children <5, babies <1
  • Septicaemia, severe brain damages
37
Q

Consider meningitis B

What are the signs and symptoms in babies?

A
  • fever with cold hands/feet
  • agitated
  • continuous crying
  • sleepy and difficult to wake up
  • confusion, unresponsiveness
  • blotchy red rash which doesnt fade when you roll a glass on it

302 SBM: Infection & Immunity (4 decks)

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