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Respiratory > 11. principles of Vaccination > Flashcards

11. principles of Vaccination Flashcards

1
Q

VACCINATION is the MOST …. PUBLIC HEALTH INTERVENTION

A

COST-EFFECTIVE
(besides clean water)

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2
Q

VACCINATION is the ONLY type of MEDICAL INTERVENTION that can…

A

COMPLETELY ELIMINTATE a disease from a population

(smallpox only eradicated so far)

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3
Q

who created the FIRST successful VACCINE (SMALLPOX)

A

EDWARD JENNER

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4
Q

what do VACCINATIONS INDUCE

A
  • an IMMUNE RESPONSE and PROTECTION against a disease with an ANTIGEN, WITHOUT DIRECT EXPOSURE to infective pathogen
  • SPECIFIC IMMUNITY to a pathogen: T and B CELL RESPONSES
  • IMMUNE MEMORY (MEMORY CELLS) leading to LONG-TERM PROTECTION
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5
Q

what do VACCINATIONS use to INDUCE IMMUNE RESPONSE

A

ANTIGEN
without direct exposure to the infective pathogen

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6
Q

how is the SECONDARY (MEMORY) IMMUNE RESPONSE

A
  • mostly IgG
  • HIGH AFFINITY
  • RAPID
  • LONG DURATION
  • HIGH TITRE ANTIBODIES
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7
Q

what is an ACTIVE VACCINATION and what type of PROTECTION does it give

A
  • Administration of an ANTIGEN resulting in ACTIVE PRODUCTION of IMMUNITY in the Host
    eg. Antibody, T Cell Immunity

LONG-TERM PROTECTION

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8
Q

what is PASSIVE VACCINATION and what type of PROTECTION does it give

A

Administration of ANTIBODY-CONTAINING PREPARATIONS
eg. Patient convalescent plasma, monoclonal antibodies

SHORT-TERM PROTECTION
(immediate)

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9
Q

which type of VACCINE provides LONG-TERM PROTECTION

A

ACTIVE

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10
Q

CLASSIFICATIONS of VACCINES

A
  • LIVE ATTENUATED
    (Not inducing disease but immunogenic)
  • INACTIVATED
    (Killed Organisms/viruses or Toxoid - derived from a Tonin)
  • SUBUNIT
    (derived from the Most Antigenic Components of a pathogen)
    (Polysaccharide or Recombinant Proteins)
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11
Q

examples of LIVE ATTENUATED VACCINES

A

MMR,
POLIO,
LAIV

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12
Q

2 TYPES of INACTIVATED VACCINES

A
  • using KILLED ORGANISMS (viruses)
    or
  • using TOXOID (derived from a TOXIN)
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13
Q

Examples of INACTIVATED VACCINES using KILLED ORGANISMS

A

CHOLERA, PERTUSSIS, INFLUENZA

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14
Q

Examples of INACTIVATED VACCINES using TOXOID

A

DIPTHERIA
TETANUS

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15
Q

2 TYPES of SUBUNIT VACCINES (derived from most antigenic components of a pathogen) with EXAMPLES

A

POLYSACCHARIDE
- eg Pneumococcal PS, Meningococcal PS

RECOMBINANT PROTEINS
- eg Hepatitis B

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16
Q

how do we get a WEAKENED VIRUS for a VACCINE (LIVE ATTENUATED)

A

virus weakened by being PASSED THROUGH ANIMAL/HUMAN CELLS until it picks up MUTATIONS
- that make it LESS ABLE TO CAUSE DISEASE (LOSE VIRULENCE)

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17
Q

how do we get an INACTIVATED VIRUS

A

using CHEMICALS eg FORMALDEHYDE
or HEAT

  • virus made UNINFECTIOUS
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18
Q

Types of VIRAL-VECTOR VACCINES

A

REPLICATING VIRAL VECTOR
or
NON-REPLICATING VIRAL VECTOR (eg Adenovirus, Oxford Astra-Zeneca vacc)
- infect but do not replicate

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19
Q

example of a VACCINE that uses a NON-REPLICATING VIRAL VENTOR to deliver Genetic Material

A

OXFORD ASTRA-ZENECA covid vaccine

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20
Q

what are NUCLEIC ACID VACCINES

A

DNA Vaccine or RNA Vaccine (Pfizer)

  • RNA often encased in a LIPID COAT so it can ENTER CELLS

-> cells produce Viral proteins (presented by APCs)

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21
Q

what type of VACCINE is the PFIZER COVID VACCINE

A

mRNA VACCINE

  • NUCLEIC ACID
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22
Q

some VACCINES NEED … along with Antigen to ENHANCE AG-SPECIFIC RESPONE

A

ADJUVANT

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23
Q

what does ADJUVENT do

A

ACTIVATES ANTIGEN-PRESENTING CELLS
(eg dendritic)

to INITIATE STRONG/SPECIFIC IMMUNE RESPONSE
(APC activate T CELLS)

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24
Q

T CELL ACTIVATION requires 2 SIGNALS:

A

SIGNAL 1:
TCR (T-Cell Receptor Activation)

SIGNAL 2:
CO-STIMULATORY MOLECULE ACTIVATION
(on dendritic cell and naive T cell)

25
Q

how does CO-STIMULATORY MOLECULE ACTIVATION activate T CELLS and using which CO-STMULATORY MOLECULES

A

B7 on DENDRITIC CELL
&
CD28 on T-CELL

  • BIND and activate
26
Q

CO-STIMULATORY MOLECULE on DENDRITIC CELL

A

B7

27
Q

CO-STIMULATORY MOLECULE on Naive T-CELL

A

CD28

28
Q

how do ANTIBODIES PREVENT/REDUCE Infections
(Antibody Mediated Immunity)

A
  • NEUTRALISE TOXINS
  • NEUTRALISE VIRUS REPLICATION,
    PREVENT VIRUS BINDING to host cell
  • promote OPSONOPHAGOCYTOSIS of Bacteria (by Neutrophils/Macrophages)
  • Activate COMPLEMENT CASCADE
29
Q

how do CD8+ T CELLS Control and Clear Intracellular Pathogens
(T-CELL MEDIATED IMMUNITY)

A
  • DIRECT KILLING of INFECTED CELLS
    using Perforins, Granzymes etc
  • INDIRECT killing of Infected Cells
    through ANTIMICROBIAL CYTOKINE RELEASE
30
Q

how do CD8+ INDIRECTLY KILL infected cells

A

by Releasing ANTIMICROBIAL CYTOKINES

31
Q

how do CD4+ T CELLS Control and Clear Intracellular Pathogens
(T-CELL MEDIATED IMMUNITY)

A

produce CYTOKINES
- help B CELLS, CD8+ T CELLS, MACROPHAGES

32
Q

Examples of VACCINES AGAINST RESPIRATORY PATHOGENS

A
  • PNEUMOCOCCAL vaccines
  • INFLUENZA Vaccines
  • PERTUSSIS
  • MEASLES
33
Q

what helps ADHESION to HOST CELLS of PNEUMOCOCCAL / STREPTOCOCCUS PNEUMONIAE bacteria (causes pneumonia and sepsis)

A

CAPSULAR POLYSACCHARIDE (PS)
- VIRULENCE FACTOR

helps adhesion and cell binding

34
Q

what do current vaccines target in PNEUMOCCOAL VACCINES

A

PS

  • ANTI-PS ANTIODIES to prevent infection
    (bacteria cannot bind to host cell)
35
Q

how do POLYSACCHARIDE VACCINES work

A

DIRECTLY BING to and ACTIVATE B CELLS (Antibody production)

  • do NOT activate T cells
36
Q

DISADVANTAGES of POLYSACCHARIDE VACCINES

A

NO T CELL ACTIVATION

NO MEMORY B/T cell formation
- NO LONG-TERM PROTECTION

NO RESPONSE in YOUNG CHILDREN (<2years)

37
Q

how is MEMORY RESPONSE in POLYSACCHARIDE VACCINES

A

NO MEMORY CELL formation

(no T cell activation, ONLY B)

38
Q

ADVANTAGES of CONJUGATE POLYSACCHARIDE VACCINATIONS

A
  • MORE IMMUNOGENIC than PS vaccines
  • ACTIVATE both T and B CELLS
  • T CELL INVOLVEMENT
  • Immunological MEMORY
    -> LONG TERM PROTECTION
  • EFFECTIVE in YOUNG CHILDREN too1
39
Q

how do CONJUGATE-PS VACCINES differ from PS-vaccines

A

CARRIER PROTEIN is BOUND to POLYSACCHARIDE

40
Q

What is the MAIN VIRULENCE FACTER / IMMUNODOMINANT PROTEIN in INFLUENZA

A

HA
(HAEMAGGLUTININ)

41
Q

what causes SEASONAL FLU / EPIDEMICS

A

MINOR MUTATIONS of influenza virus
- ANTIGENIC DRIFT

42
Q

what causes PANDEMICS of influenza

A

MAJOR MUTATIONS
- ANTIGENIC SHIFT

43
Q

What is ANTIGENIC DRIFT

A

MINOR Mutations of Influenza

  • causes EPIDEMICS / SEASONAL

(HA HEAD STRUCTURE CHANGES)

44
Q

what is ANTIGENIC SHIFT

A

MAJOR Mutations of Influenza
(H1 -> H2 -> H3)
- causes PANDEMICS

45
Q

INFLUENZA VACCINES INDUCE which ANTIBODIES against Flu Virus

A

ANTI-HA and -NA ANTIBODIES

46
Q

what is the HA RECEPTOR in ells

A

SIALIC ACID

47
Q

how do HA ANTIBODIES from flu vaccines work

A

INHIBIT BINDING of HA to SIALIC ACID (Receptor)

48
Q

what does NA do in Influenza

A

allows CLEAVAGE of SIALIC ACIDS (bind HA)
and VIRAL BUDDING

49
Q

how do NA-ANTIBODIES in INFLUENZA VACCINE work

A

BLOCK NA

  • INHIBIT CLEAVAGE of SIALIC ACIDS and VIRAL BUDDING
50
Q

FLU VACCINES are either:

A
  • LIVE ATTENUATED (LAIV)
    or
  • INACTIVATED
51
Q

FLU VACCINES are mostly QUADRIVALENT meaning they have..

A

2 A STRAINS and 2 B STRAINS

(Trivalent: 2A and 1B)

52
Q

how are INACTIVATED FLU VACCINES Implemented and what are they PREDOMINANTLY

A
  • by INJECTION
  • predominantly ANTIBODY-MEDIATED / ANTI-HA ANTIBODY

mainly susceptible population and >65 years

53
Q

how are LIVE ATTENUATED INTRANASAL VACCINES (LAIV) implemented? who are they used in?

A

NASAL SPRAY

CHILDREN, 2-17 YEARS

54
Q

LIVE ATTENUATED INTRANASAL VACCINES (LAIV) Induce..

A

ANTIBODY and CELLULAR IMMUNITY

both SYSTEMIC and LOCAL MUCOSAL IMMUNITY

55
Q

LIVE ATTENUATED INTRANASAL VACCINES (LAIV) ACTIVATE which tissues (where) for immunity

A

LOCAL MUCOSAL Immune Tissues
in the NASOPHARYNX

(NALT - NASOPHARYNX ASSOCIATED LYMPHOID TISSUE)

56
Q

PERTUSSIS caused by which BACTERIA and what is the SYMPTOM

A

BORDETELLA PERTUSSIS

  • Whooping COUGH

respiratory infection

57
Q

2 TYPES of PERTUSSIS VACCINE (part of DTP)

A
  • using whole KILLED B.PERTUSSIS Bacteria
  • ACELLULAR Vaccine: TOXOID and other components
58
Q

which Vaccination has been extended to PREGNANT WOMEN in order to protect NEWBORN BABIES

A

PERTUSSIS VACCINATION

59
Q

what is MEASLES

A

HIGHLY INFECTIOUS Respiratory infection

  • high FEVER, COUGH, RASHES

Respiratory (16 decks)

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