Basic Principles of Vaccination Flashcards

1
Q

Transfer of antibody produced by one human or an animal to another human

Temporary protection that wanes or disappears with time (usually within a few weeks or months)

A

Passive immunity

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2
Q

Passive immunity

sources of antibody

A

Transplacental transfer of maternal antibodies to infants

Blood products used for transfusion ((WB, RBC, Platelet, Convalescent Plasma)

Immune globulins derived from plasma of human donors or produced in animals (horse or equine-derived antibodies)

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3
Q

Natural passive immunity

A

Maternal antibody

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4
Q

Protection produced by stimulation of the person’s own immune system

Usually permanent -> lasts for many years or lifetime

A

Active immunity

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5
Q

Sources of active immunity

A

Natural infection with the disease-causing form of organism

Artificial sources: vaccination

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6
Q

Natural active immunity

A

Follows infection

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7
Q

Natural passive immunity

A

Transfer of antibodies across placenta

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8
Q

Artificial passive immunity

A

Injection of antibodies

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9
Q

Artificial active immunity

A

Exposure to antigen

Vaccination

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10
Q

Live attenuated vaccines from

A

Viral

Bacterial

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11
Q

Inactivated vaccines

A

Whole (virus or bacteria)

Fractional (protein based, polysaccharide)

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12
Q

Live microbe weakene by growth conditions in lab or less virulent relative

A

Live attenuated

Ex
MMR
BCG

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13
Q

BCG is made up of

A

M bovis

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14
Q

Microbe killed or inactivated by chemicals, heat or radiation

A

Inactivated (killed)

Ex
Influenza, IPV, rabies, inactivated Hep A

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15
Q

1-20 parts of microbe that best stimulate immune response

A

Subunit

Ex
Hep B, HPV, Influenza, acellular pertussis

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16
Q

Principles of Vaccination #1

The more similar a vaccine is to the disease-causing form of organism, the better the immune response to vaccine

Immune response and memory produced very similar to natural infection

Usually produce immunity with ONE DOSE
(except vaccine given orally rotavirus)

Applies to

A

Live attenuated

MMR, VZV, Rotavirus, Oral polio and JE vaccine

Bacterial: BCG, oral cholera

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17
Q

Live attenuated vaccines advantages

A

Mimic natural infection
Highly immunogenic
Provide long-lasting protection
Single dose often sufficient

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18
Q

Live attenuated vaccines disadvantages

A

Severe reactions possible - if they revert to virulence

Interference from circulating antibody

Fragile - must be stored and handled carefully (exposure to heat or light result in poor response)

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19
Q

Live attenuated vaccines in RHUs

A

BCG
OPV
MMR

Rota
JE
Varicella

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20
Q

Composed of killed microorganisms of inactivated components

Cannot replicate

Less interference from circulating antibody than live vaccine

Always require multiple doses (booster)

Immune response mostly HUMORAL

Antibody titer diminishes with time

May require periodic supplemental doses to “boost” antibody titers

A

Inactivated vaccines

21
Q

Inactivated Whole Cell Vaccine

A

Viral: polio (IPV), hepatitis A, rabies, influenza

Bacterial: pertussis, typhoid, cholera

22
Q

Inactivated Fractional Vaccine (protein based)

A

Subunit: hep B, influenza, acellular pertussis, HPV

Toxoid: diptheria, tetanus

23
Q

Unique type of inactivated subunit vaccine composed of long chains of sugar molecules that make up the surface capsule of certain bacteria

A

Polysaccharide vaccines

24
Q

Not immunogenic in children <2 years of age
No booster response
Antibody has less functional activity (mostly IgM)
Immunogenecity improved by

A

Pure polysaccharide vaccines

Conjugation

25
Vaccine is chemically combined with protein molecule
Conjugation
26
Antibody response of short duration, no memory and no affinity maturation No response in young infants (<18 months)
Free polysaccharide vaccine
27
Antibody response of long duration, memory and affinity maturation Protective response in young infants (>2 months) Able to produce T cell response
Conjugated Polysaccharide vaccine
28
Inactivated fractional | Pure Polysaccharide Vaccines
Pneumococcal PPSV23 Meninggococcal Samonella typhi (Vi)
29
Inactivated Fractional | Conjugated Polysaccharide Vaccines
Hib Pneumococcal Meningococcal
30
Inactivated vaccines advantages
Less reactogenic No risk for causing disease Less interference from circulating antibody Often more stable to heat
31
Inactivated vaccine disadvantages
Often less effecfive than live-attenuated Generally require 3-5 doses for long term protection Antibody titer diminishes with time
32
Inactivated vaccines in RHUs
Hep 5 Pentavalent vaccine IPV Pneumococcal conjugate vaccine
33
Principle #2 All vaccines can be administered simultaneously at same visit but at different sites following the minimum age requirement. EXCEPT
PCV 13 and MCV4-D (Menactra) | PCV13 and PPSV23
34
PCV13 and MCV4-D (Menactra) should be given separately by
4 weeks
35
PCV 13 and PPSV23 Polysaccharide should be given separately by
8 weeks
36
Simultaneous administration of vaccines:
Increases the probability that a child will be fully immunized at the appropriate age If possible, use licensed combination vaccines to reduce the number of injections Use separate syringes and separate sites
37
What is the best timing for non-simultaneous administration of different vaccines? Principle #3 For two or more, live parenteral vaccines the minimum interval between doses is
4 weeks
38
All other vaccine combinations non-live parenteral could be given
simultaneously or at any interval between doses
39
Live oral vaccines like | OPV, Rota, Ty21a typhoid vaccine can be administered
simultaneously or at any interval before or after inactivated or live parenteral vaccine
40
What is the interval between antibody containing blood products and vaccines? Principle #4 Inactivated vaccines generally are not affected by circulating antibody to the antigen Inactivated vaccines can be administered
Before, after or at the same time as the antibody Simultaneous administration of antibody (immune gobulin) and vaccine recommendation for postexposure prophylaxis of certain diseases eg Hep B, rabies, tetanus
41
May be affected by circulating antibody to the antigen
Live parenteral vaccines - they may replicate
42
Interval between antibody and measles and varicella containing vaccines If live vaccine given first
Wait 2 weeks before giving antibody
43
In measles and VZV vaccines, if antibody is given first
Wait 3 months or longer before giving the vaccine
44
Washed RBC interval
0 months
45
Hepatitis A IG interval
3 months
46
Measles prophylaxis IG | (Immunocompetent recipient) interval
6 months
47
Plasma/platelet product interval
7 months
48
Intravenous immune globulin IVIG interval
7-11 months