2 Principles of Vaccination

Question 1

This one might get a little long, he had a word document and a long PPT. Hopefully I won’t overlap too many but will be doing both because Densen’s questions…..well its Densen.

Answer 1

Make sure you watch this lecture—also on the handout there is a little case with questions and stuff. you may want to look up those things.

Question 2

What affects the probability of disease and is an impotent consideration in vaccination strategy?

Answer 2

Herd immunity

Question 3

Maternal-fetal immunological relationships affect the risk of infection when? Can the maternal immune system be manipulated to enhance the neonates?

Answer 3

1. Neonatal period

2. Yes

Question 4

what does the neonatal immune response require?

Answer 4

Maturation

Question 5

T-F…Elicitation of vaccine T cell responses provides more robust immunity?

Answer 5

True

Question 6

Wat does conjugation of polysaccharides to proteins do?

Answer 6

Converts a T cell independent response to a T cell dependent one.

Question 7

Densen gives 3 very important concepts of vaccines, but then does not talk much more about them. What are they?

Answer 7

1. Protective vaccination
2. attenuation a. natural development b. genetically engineered
3. immunologic cross reactivity

Question 8

What are the 3 population goals of vaccination?

Answer 8

1. Protect the individual
2. Develop Herd Immunity
3. Eradication

Question 9

What are the 3 immunologic goals of vaccination?

Answer 9

1. elicit antibody response
2. elicit T cell response in addition to B cell for long term memory
3. Mimic typical route of exposure [systemic vs. mucosal]

Question 10

T-F…Vaccines can vary from a single component to a whole organism?

Answer 10

True

Question 11

For a pure single component vaccine to be highly effective what do they need?

Answer 11

1. To be protein [T dependent antigen]
2. Multiple antigenic epitopes [multiple IgG specificities]
3. mediate the effects of the disease

Question 12

T-F—pure polysaccharides elicit immune response in children under 2 years of age?

Answer 12

False

Question 13

T-F—whole organism vaccines induce single-antigen responses?

Answer 13

False–multi-antigen

Question 14

Whole organism vaccines offer better protection but what is the con?

Answer 14

more side effects

Question 15

If you purify a single type of protein from an organisms membrane will usually have limited efficacy despite immune response…why?

Answer 15

1. genetic variability among strains

2. Organism mutation rates are high and high amounts of division

Question 16

What is the solution to the genetic variability of strains and high mutation rate problem in vaccines?

Answer 16

include multiple different surface structures in the vaccine—>more included the less like a multi-resistant strain will be found

Question 17

T-F…organisms grown in vitro always recapitulate expression of relevant microbial structures involved in pathogenesis?

Answer 17

False

Question 18

Live vaccines should never been given to who?

Answer 18

immunocompromised individuals—ie PREGNANT WOMEN

Question 19

What can be given to pregnant mothers during 3rd trimester to induce maternal IgG transport across placenta?

Answer 19

single component or killed vaccines

Question 20

What are the advantages of T cell responses in vaccines?

Answer 20

1. effective against intracellular organisms

2. Induce long term memory

Question 21

Are pure polysaccharides T dependent antigens?

Answer 21

No- independent

Question 22

Pure polysaccharide vaccines have what characteristics?

Answer 22

1. IgM response
2. limited anamnestic response [rapid production on 2nd response]
3. no long term memory

Question 23

Conjugated vaccines are very good at what?

Answer 23

converting T independent response to polysaccharides to T cell dependent one

[this is what allows neonates to respond to polysaccharide vaccines before 2 years of age]

Question 24

what type of vaccine is given for tetanus toxin?

Answer 24

toxoid

Question 25

What type of vaccine is given for measles and oral polio?

Answer 25

Live and live-attenuated

Question 26

What type of vaccines are given for influenza, hepatitis A, and rabies?

Answer 26

inactivate [killes]

Question 27

What type of vaccines are given for Hep B, pertussis.

Answer 27

Molecular [subunit vaccines]

Question 28

What type of vaccines are given for H. influenza, N meningiditis, S pneumonia?

Answer 28

Conjugated

Question 29

What are agents that augment the immune response called? What are the 2 general categories?

Answer 29

1. adjuvants | 2. a. recruit T cell help and b. cause antigen persistence

Question 30

Is he IgG response sooner and less pronounced in the secondary response?

Answer 30

Sooner and drastically more pronounced. [In the primary response there is a 10 day latency period and the IgM rises and begins falling IgG then kicks in. In the secondary response the latency is only 3 days and as IgM is peaking there is a drastic upswing in IgG until it completely dominates]

Question 31

How long does IgG that has crossed the placenta protect neonates for?

Answer 31

6 months--- loss of that antibody leads to increased risk and occurrence of infection

Question 32

Does infectiousness or virulence determine transmission?

Answer 32

Infectiousness….virulence determines the severity

Question 33

What are the 6 factors of infectiousness or probability of transmission? Seems long, but think logically about this and they all make sense before even studying it.

Answer 33

1. # of susceptible people 2. freq. of contact 3. duration of infectiousness in an infected individual 4. stability of agent in environment 5. # of organisms required to establish infection 5. effective/efficient spreaders of disease

Question 34

What are the 4 assumptions of the Reed-Frost model of epidemics in closed populations?

Answer 34

1. No migration in/out 2. random interaction of individuals 3. each person has = susceptibility 4. infection produces immunity

Question 35

What is the proportion of all individuals in a population who must be immune in order to prevent spread of infection to non-immune individuals?

Answer 35

Herd Immunity

Question 36

T-F---the proportion of immune individuals to provide herd immunity varies among organisms?

Answer 36

true

Question 37

Does the more infectious organism require a higher level of herd immunity?

Answer 37

Yes

Question 38

What is a widespread occurrence of an infectious disease in a community at a given time?

Answer 38

epidemic

Question 39

What is a disease or condition regularly found amend particular people or in a certain location?

Answer 39

endemic

Question 40

What denotes a population or area in which a disease incidence is sufficiently low that the population has limited or no immunity to it?

Answer 40

Hypo-endemic

Question 41

What is the main obstacle to the economic development of poor countries? Why doesn't this take place?

Answer 41

absence of health ---low potential revenue

Question 42

The purified individual surface component is less toxic but is also less effective due to what key differences?

Answer 42

1. chemical nature of antigen 2. topography of antigen on surface 3. difference of organisms in vivo and in vitro

Question 43

What are bacterial capsules made from?

Answer 43

repeating polysaccharide units

Question 44

Purified polysaccharide used in vaccine initiates what response?

Answer 44

T cell independent with IgM production

Question 45

Bound IgM to polysaccharide units binds what and initiates what?

Answer 45

C1q and initiates complement activation

Question 46

T-F---natural infection by polysaccharide encapsulated organism leads to an anti-capsular IgG production too?

Answer 46

true

Question 47

Efficacy of a single component protein vaccine depends on what?

Answer 47

epitopic density of antigen | [if low density--->IgG can't effectively bind C1q or productively engage Fc receptors]

Question 48

T-f---IgG has to be specific for a single antigen or antigenic epitope on an organism

Answer 48

False- the greater number of antigenic targets then the more IgG will bind and will initiate dependent effector functions more effectively i.e. bing C1q and activate complement

Question 49

why is a t-cell dependent response so important?

Answer 49

1. effective vs intracellular | 2. Induce long term memory

Question 50

What are the steps to a conjugated vaccine working?

Answer 50

1. APC precents protein component to T cell 2. B cell selected by specificity for polysaccharide processes associated protein and presents on MHC II 3. Activated CD4 T cell binds presented MHCII from Bcell [signal 1] 4. CD40 binds ro CD40R on B cell [signal 2] 5. CD4 releases cytokines [signal 3] 6. Production of hi affinity antibody and long term immunologic memory

Question 51

T-f----conjugate vaccines protect individual and reduce transmission?

Answer 51

True

Question 52

What vaccines are required for medical personnel?

Answer 52

varicella zoster hepB influenza virus yearly

Question 53

T-f---the origin of fetal IgM and IgA is from the mother?

Answer 53

False--too big to cross placenta---it is from fetus (recall neonate gets IgA in breast milk tho)

Question 54

T-F---the origin of fetal IgG is from the fetus and the mother?

Answer 54

True

Question 55

If you are considering in utero infection of fetus and you are suspecting several pathogens…what Ig should you examine in the serum for?

Answer 55

IgM---only the fetus creates. IgG will represent mother's too and won't give you the specificity you are looking for

Question 56

What supplies maternal IgA to infant's GI tract?

Answer 56

breast feeding--mother's repertoire determines degree and spectrum of protective mucosal immunity

Question 57

When is the greets risk for bacterial meningitis in the child?

Answer 57

greatest in the first 2 years of life

Question 58

What are the key super spreaders?

Answer 58

1. high organism load 2. secretion and coughing 3. Lots of contacts--day care and grandparents

Question 59

Is the complication rate (death) constant?

Answer 59

Yes

Question 60

What is the effect of vaccination on death secondary to?

Answer 60

reduction of the number of people infected

Question 61

What is one of the main societal issues with HPV vaccine?

Answer 61

That is will encourage girls to participate in actions they may normally not have engaged in.