Bacterial and Viral Vaccines

Question 1

Define immunisation and the 2 types of immunity?

Answer 1

Immunisation is the process where individuals are made immune to an infection

Active immunity - immunity is induced by vaccination

Passive immunity - immunity is induced by administration of antibodies

Question 2

What are 6 different types of vaccines?

Answer 2

1)Live attenuated
- BCG, polio, MMR, Rotavirus, Yellow fever, VZ, Influenza (intranasal)

2) Inactivated whole-cell (killed antigen)
- whole cell pertussis, Inactivated polio, HepA, Influenza (injectable)

3) Toxoid (inactivated toxins)
- Tetanus/Diphtheria

4) Subunit (purified antigen)
- cellular pertussis (aP), Hib, HepB, HPV

5) Viral vectored
- adenoV, Ebola virus

6) Nucleic acid vaccines
- SARS-CoV-2 (mRNA)

Question 3

What is passive immunity? What are its vaccine types?

Answer 3

• Protection from disease through Ab transfer
• Provides immediate, short term protection
• Transfer of blood/blood products
• Hep B, tetanus, resp syncytial virus, rabies, varicella-zoster

Question 4

What is herd immunity?

Answer 4

• Indirect protection to unvaccinated people as vaccinated people reduce risk of transmission
• High vaccine coverage is needed to induce high levels of herd immunity (depends on vaccine and infection)

Question 5

What is the NHS vaccination schedule for babies under 1 year old?

Answer 5

8 weeks:
- 6-in-1 vaccine
- Rotavirus vaccine
- MenB

12 weeks:
- 6-in-1 vaccine (2nd dose)
- Pneumococcal (PCV) vaccine
- Rotavirus vaccine (2nd dose)

16 weeks:
- 6-in-1 vaccine (3rd dose)
- MenB (2nd dose)

Question 6

What is the NHS vaccination schedule for children aged 1 to 15?

Answer 6

1 year:
- Hib/MenC
- MMR
- Pneumococcal (PCV) vaccine
- MenB

2 to 10 years:
- Flu vaccine (every year)

3 years 4 months:
- MMR
- 4-in-1 pre school booster

12 to 13 years:
- HPV vaccine

14 years:
- 3-in-1 teenage booster
- MenACWY

Question 7

What is the NHS vaccination schedule for adults and pregnant women

Answer 7

65 years:
- pneumococcal vaccine
- flu vaccine (and every year after)

70 years:
- shingles vaccine

Pregnant women:
- Flu vaccine
- Whooping cough (pertussis) vaccine

Question 8

Which 6 serious childhood diseases does the 6-in-1 vaccine protect you against?

Answer 8

1) Diptheria
2) Hep B
3) Hib (haemophilus influenzae type b)
4) Polio
5) Tetanus
6) Whooping cough (pertussis)

Question 9

Describe diptheria, tetanus and pertussis vaccine. What is the type and how are they given?

Answer 9

Diphtheria vaccine:
- Cell-free purified toxin treated with formaldehyde, converts into diphtheria toxoid = absorbed onto an adjuvant
- Combined vaccine given in 5 doses

Tetatnus vaccine:
- Cell-free purified toxin treated with formaldehyde and absorbed onto an adjuvant
- Combined vaccine given in 5 doses

Pertussis vaccine:
- Cell-free purified B.pertussis and absorbed onto an adjuvant
- Combined vaccine given in 3 times plus booster dose at age 3

Question 10

Describe poliomyelitis and its vaccine regimen

Answer 10

• Caused by one of 3 poliovirus serotypes (1, 2, 3)
• Until 2004, the live attenuated OPV was used for UK routine immunization
• BUT OPV had risk of vaccine-associated paralytic polio, so was replaced by IPV as part of a combined vaccine
• A regimen of 5 IPV doses= long-term protection

Question 11

Describe Hib, rotavirus, MMR, HPV vaccine. What is the type and how are they given?

Question 12

Describe Hep b and its vaccine- how is it produced, what doses are given?

Answer 12

• Produced using recombinant DNA and adsorbed onto an adjuvant
• 3 doses at 0, 1 and 6 months for high risk individuals
• A hexavalent combo vaccine (Infanrix-hexa, DTaP/IPV/Hib/hepatitis B) introduced in 2017 for primary immunization
• Hep B Ig also available- passive and temporary immunity in those exposed to the virus

Question 13

What are the vaccines for pneumococcal disease? who are they used in?

Answer 13

Pneumococcal polysaccharide vaccines(PPV):
- Purified capsular polysaccharide from 23 capsular types of pneumococcus
- Used in >65s and in at-risk patients aged >2yrs

Pneumococcal conjugate vaccines (PCV):
- Contains capsular polysac types and is conjugated to proteins (PCV7, PCV10, PCV13) to improve immunogenicity
- PCV provides immunity in infants from 2 months old
- PCV13 given as a 2-dose regimen (12 wks and 1yr)

Question 14

Describe the vaccines for influenza- how are they prepared, who are they administered to?

Answer 14

• Prepared yearly in line w the strains
• Vaccination for all aged 2–17 years w intranasal Live Attenuated Influenza vaccine
• LAIV= high protection for children- efficacy of 83%
• Administered annually to high-risk groups and children from 2 years old

Question 15

Describe 4 features of the BCG vaccine

Answer 15

• Contains live attenuated organisms
• Intradermal injection usually in the left upper arm
• No further vaccinations should be given in the same limb for at least 3 months bc of lymphadenitis risk
• 1 BCG dose offered to those at increased risk/exposure to TB

Question 16

Describe the Hep A vaccine- how can it be given?
What else can be used to provide immunity against hep A?

Answer 16

• Hep A vaccine can be given to high-risk individuals as a monovalent vaccine (whole, inactivated virus) or combined with either typhoid or hep B vaccines
• Human normal Ig can be used to provide immediate but temporary immunity.