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Microbiology & Immunity > 31- Vaccines: Bacterial & Viral > Flashcards

31- Vaccines: Bacterial & Viral Flashcards

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1
Q

list the different vaccines included in the UK immunisation schedule

A

6-in-1 for diphtheria, tetanus, pertussis, polio, haemophilus influenzae b/ hepatitis B
pneumococcal
MMR - mumps, measles and rubella
rotavirus
influenza - seasonal vaccine
HPV
4-in-1 pre-school booster (tetanus, diphtheria, whooping cough, polio)
3-in-1 teenage booster (tetanus, diphtheria, polio)

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2
Q

what type of vaccine is the 6-in-1 vaccine? when is it given?

A

for diphtheria, tetanus, pertussis, polio, haemophilus influenzae b, hepatitis B and tetanus

type: inactivated vaccine

age: 1st at 8 weeks & two more booster doses

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3
Q

what type of vaccine is the MMR vaccine? when is it given?

A

type: live attenuated

age:
- one dose at 1yrs
- another at 3yr and 4 months to increase number of immunised children, ensures coverage

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4
Q

what type of vaccine is the rotavirus vaccine? when is it given?

A

type: oral live vaccine given by syringe - ensures mucosal IgA response

age: babies, after 6mths

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5
Q

what causes meningitis?

A

Neisseria meningitidis - six different serotypes can cause disease: A, B, C, W-135, X & Y

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6
Q

what are the current MenC vaccinations available?

A

Hib/MenC combined vaccine = Menitorix

Men-ACWY vaccines - Menveo or Nimenrix

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7
Q

describe the Hib/MenC vaccine Menitorix - type? age given?

A

given at one year

conjugated bacterial polysaccharide with tetanus toxoid

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8
Q

decribe the Men-ACWY vaccines - types? age given?

A

types:
- Meneveo contains polysaccharides from men A, C, W-135, Y conjugated to diphtheria toxoid
- Nimenrix contains “ conjugated to tetanus toxoid

age: given at 14 yrs

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9
Q

why were meningitis vaccines difficult to develop?

A

polysaccharide for MenB - the most common strain in the UK - was too similar to that on some human cells

risk of autoimmune response

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10
Q

what is the DTP vaccine for?

A

prevents diphtheria, tetanus and pertussis

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11
Q

what micro-organism causes diphtheria?

A

Corynebacterium diphtheriae

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12
Q

pathogenesis/ effects of Corynebacterium diphtheriae?

A

diphtheria toxin is produced locally by the bacteria, enters lymphatic system and spreads throughout the body

effects:
- kills epithelial cells, form a thick, grey necrotic exudate called a pseudomembranes which can obstruct airways
- pseudomembranes cause significant local inflammation and lymph node swelling = causes a bull-neck appearance
- further damage to heart, kidneys and nerves

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13
Q

constitution of diphtheria vaccine - type?

A

toxoid vaccine conjugated to aluminium salts to enhance immunogenicity
- diphtheria toxin is inactivated by formaldehyde

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14
Q

forms of the diphtheria vaccine?

A

either in DTaP (higher amount of diphtheria toxoid) or dTaP (lower diphtheria amount)

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15
Q

what micro-organism causes tetanus?

A

Clostridium tetani - gram-positive rods, anaerobic, commonly found in soil and forms spores

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16
Q

pathogenesis of tetanus?

A

Clostridium tetani produces tetanus toxoid - acts as a neurotoxin and inhibited release of GABA and glycine form inhibitory neurons
- prevents release of NTs for muscle relaxation

causes uncontrolled, spastic paralysis as motor neurons are constantly stimulated without inhibition

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17
Q

constitution of tetanus vaccine - type?

A

tetanus toxoid (inactivated toxin) and conjugated with aluminium salts

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18
Q

what causes pertussis/ whooping cough?

A

Bordetella pertussis

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19
Q

pathogenesis/ effects of whooping cough?

A

Bordetella pertussis bacterium adheres to ciliated epithelial cells in the upper resp tract, multiplies, and produces Pertussis toxin which acts as a virulence factor

causes severe persistent coughing with a ‘whoop’ noise

can descend into the lungs in children and lead to death

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20
Q

constitution of pertussis vaccine - type?

A

acellular vaccine with pertussis toxoid, filamentous haemagglutinin and pertactin

filamentous haemagglutinin and pertactin promote adhesion to cells - block adhesion of the bacterium to epithelial cells of the resp tract

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21
Q

constitution of the DTP vaccine?

A

diphtheria = diphtheria toxoid conjugated with aluminium salts
- prevents respiratory obstruction and the formation of necrotic exudate/ pseudomembranes or killing healthy resp epithelial cells

tetanus = tetanus toxoid conjugated with aluminium salts
- prevents severe muscle spasms from preventing inhibitory NT release

pertussis = acellular vaccine composed of pertussis toxoid, filamentous haemagglutinin and pertactin
- haemagglutinin and pertactin prevent adhesion of Bordetella pertussis to epithelial cells

22
Q

target groups for the influenza vaccine?

A

elderly - over 65+
pregnant women
healthcare workers and caregivers
household contacts of the immunosuppressed
children from 2-10 yrs = high transmission rate
poultry workers to prevent new strains

23
Q

describe the influenza virus

A

RNA virus with two main surface proteins - haemagglutinin and neuraminidase which mediate virus entry and exit with host cells

24
Q

how many types of haemagglutinin?

A

18

25
Q

how many types of neuraminidase?

A

11

26
Q

what is antigenic drift?

A

small gradual changes/ mutations in surface proteins that build up over time and cause an antigenic change - lead to epidemics

27
Q

describe antigenic DRIFT in influenza and how it leads to epidemics

A

small gradual mutations in the viral genome, for genes encoding HA and NA - alter their epitopes

neutralising antibodies produced by the immune system for one HA/NA epitope become ineffective with the epitope change

causes seaosnal flu epidemics

28
Q

what is antigenic shift?

A

major gene reassortment between different strains - creates a novel strain with no-pre-existing immunity, can lead to a pandemic

29
Q

describe antigenic SHIFT in influenza and how it leads to pandemics

A

abrupt change in influenza virus genome as NA segments are exchanged/ recombination between two flu strain genomes

reassortment creates an influenza virus with novel HA/NA epitopes = creates a new antigenic strain

no pre-existing immunity means the population is highly susceptible - can lead to pandemics

30
Q

composition of flu vaccine?

A

quadrivalent vaccines - protect against two influenzas A subtypes, two influenza B subtypes = four strains

mostly inactivated/ killed whole organisms

one live attenuated vaccine administered as a nasal spray (live attenuated organism multiplies between at the cooler temp of nasal passages)

FLUAD specifically formulated for the elderly - quadrivalent, enhanced immune response

31
Q

effectiveness of the flu vaccine?

A

effectiveness varies by year and age group, affected by antigenic drift/ shift causing mismatches

32
Q

what causes pneumonia?

A

Streptococcus pneumoniae

33
Q

pathogenesis/ effects of S. pneumoniae?

A

causes many other conditions - arthritis, sinusitis, invasive pneumococcal disease, peritonitis…

occurs when the bacterium can be isolated from blood/CSF or from another location which is normally sterile - invasive, infection can indicate a more serious systemic infection

34
Q

what are the different pneumonia vaccines available?

A

pneumococcal polysaccharide vaccine PPV23

pneumococcal conjugate vaccine PCV13

35
Q

pneumococcal polysaccharide vaccine PPV23 - describe? type?

A

contains polysaccharides for 23 different serotypes of S. pneumoniae

for at risk adults and children over 2 - children under 2 can’t produce a strong. long-lasting immune response against polysaccharides

36
Q

pneumococcal conjugate vaccine PCV13 - describe? type?

A

conjugate vaccine - polysaccharides from 13 of the most common pneumococcal capsule types conjugated to diphtheria toxoids to enhance toxigenicity

37
Q

which HPV types are the most dangerous?

A

HPV 16 and 18 - linked to cervical cancer

HPV 6 and 11 - linked to genital warts

38
Q

which HPV types are linked to cervical cancer?

A

16 and 18

39
Q

which HPV types are linked to genital warts?

A

6 and 11

40
Q

what are the two vaccines available for HPV?

A

Cervarix
Gardasil

41
Q

describe Cervarix

A

HPV vaccine, protects against HPV 16 and 28 (linked to cervical cancer)

42
Q

describe Gardasil - type? generation? age/ vaccine schedule?

A

HPV vaccine against 6, 11, 16 and 18 - protects against both genital wars and cervical cancer

recombinant subunit vaccine with adjuvant aluminium salts - contains recombinant capsid L1 protein of HPV 6, 11, 16 and 19 expressed in transformed yeast cells, and then self-assembled into virus-like particles

given to boys and girls at ages 12-13yrs in two doses

43
Q

what type of vaccine is Gardasil?

A

recombinant subunit vaccine with adjuvant aluminium salts

44
Q

what is a recombinant subunit vaccine?

A

when genes are taken from a particular pathogen and inserted into a different organism to produce a recombinant subunit

  • e.g. HPV vaccine Gardasil, Hib and HepB from DTaP vaccine
45
Q

describe the importance of vaccination during pregnancy

A

normal tetanus can occur due to infection of the umbilical cord - administering tetanus toxoid vaccine to mothers during late pregnancy can prevent this

Boostrix IPX is a vaccine for tetanus, diphtheria, pertussis and polio = provides protection for new-borns through placental transfer of maternal antibodies

influenza vaccine prevents complications in pregnant women that may affect birth/ health of baby

vaccination during pregnancy is important for maternal and new-born health, as well as protecting the community

46
Q

what causes tuberculosis?

A

Mycobacterium tuberculosis

47
Q

what is the vaccine for tuberculosis? - type? vaccine schedule?

A

not part of UK immunisation schedule - based on certain criteria instead

vaccine is BCG bacteria - a live attenuated vaccine derived from Mycobacterium bovis

48
Q

what is the criteria for TB vaccination?

A

infants from 0-12mths living in areas with high TB incidence OR with a parent/ grandparent born in a country with high TB incidence

at risk secondary school children

previously unvaccinated new immigrants from high-prevalence TB countries

49
Q

describe the test used to diagnose TB

A

Mantoux test

  • a purified protein derivative/ PPD of tuberculin with a combination of M. TB proteins is injected and measured after 72 hours
  • if memory T cells are reactivated by tuberculin peptides, they’ll secrete cytokines and recruit other immune cells = produce a localised inflammatory response as a hard, red skin bump = positive for TB

weaker response from previously vaccinated individuals, stronger response from those with TB

50
Q

why isn’t chicken pox currently part of the UK immunisation schedule?

A

less natural boosting and natural immunity = higher chance on adult-onset shingles

childhood chickenpox vaccine could prevent childhood cases but may increase the risk of adult-onset chickenpox and shingles

more childhood chickenpox vaccine programmes mean increased susceptibility for adults - lesser of two evils by allowing some natural boosting to prevent shingles

Microbiology & Immunity (37 decks)

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