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Microbiology > Defence and vaccination against bacteria > Flashcards

Defence and vaccination against bacteria Flashcards

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1
Q

Which type of acquired immunity is important for preventing septicaemia?

A

Humoral immunity

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2
Q

Which type of acquired immunity is important for preventing intracellular infections?

A

Cell mediated immunity

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3
Q

3 roles of antibodies

A

Toxin neutralisation
Focus complement binding
Opsonin

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4
Q

Why is cell-mediated immunity important?

A

For eliminating intracellular bacteria

Interaction between T lymphocytes and macrophage is key to clearance

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5
Q

Name 7 properties of a good vaccine

A 
Stimulates effective immune response
Safe
No adverse reactions
Inexpensive
Stable
Easy administration
Simple to control
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6
Q

2 methods of vaccine protection

A

Direct

Indirect (Herd)

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7
Q

Direct protection

A

Give individual immunity

Stops colonisation that leads to infection

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8
Q

Herd immunity

A

Transmission cycle broken
Prevents spread
Indirectly protects those who are still susceptible (not immune)

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9
Q

Clinical trials

A

Phase 1: Safety/ immunogenicity, small no of adults
Phase 2: Assesses immune response/ expands safety database, includes all groups likely to use
Phase 3: Protection studies- placebo controlled double blind, need good disease surveillance, vaccine efficacy determined

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10
Q

Vaccine efficacy equation

A

1 - (Attack rate in vaccinated / Attack rate in unvaccinated)

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11
Q

Herd effect is a relationship between

A

Basic reproduction number R0,
vaccine effectiveness,
coverage needed to reduce or eliminate disease

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12
Q

When can herd effect be calculated

A

Post vaccine introduction

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13
Q

Herd effect equation

A

1 - (attack rate unvaccinated post-introduction / attack rate unvaccinated pre-introduction)

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14
Q

Vaccine coverage needed equation

A

( 1 - 1/R0) / Effectiveness

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15
Q

3 components of a vaccine

A

Antigen: stimulate immune response to target disease
Adjuvant: enhance and modulate immune response
Excipients: maintain pH/ stability, preservative

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16
Q

Types of vaccine antigen

A 
Live attenuated organisms
Killed whole organisms
Purified component vaccines
Toxoids
Polysaccharide conjugates
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17
Q

Childhood immunisation programme UK

A

Pre-primary: DTaP-IPV booster, MMR booster
Live attenuated influenza
Girls 12-13: HPV
Secondary ed: dTaP-IPV booster, MenACYW

18
Q

What antigens are in the paediatric combined vaccine DTaP-Hib-IPV?

A 
Tetanus toxoid 
Diphtheria toxoid
Pertussis components
Haemophilus influenza type b
Inactivated polio types. 1,2 and 3
19
Q

What is the adjuvant in DTaP-Hib-IPV?

A

Aluminium phosphate

20
Q

Examples of DTaP-Hib-IPV

A

Pediacel (Sanofi)

Infanrix (GSK)

21
Q

Polysaccharides as antigens

A

T cell independent
Large and linear
Not readily degraded
Highly repetitive

22
Q

Immune response to polysaccharides

A

Predominantly IgM
Poor memory effect
Low avidity antibody

23
Q

Conjugate vaccines

A

Polysaccharide chemically linked to immunogenic protein e.g. Tetanus toxoid

24
Q

Why are conjugate vaccines expensive?

A

Sophisticated technology is required to produce

25
Q

Why do conjugate vaccines have highly purified components?

A

purified saccharide and carrier proteins such as tetanus toxoid
Makes them safe and simple for licensure and control

26
Q

When are conjugate vaccines very effective?

A

When humoral immunity is required
Long-lived, boost-able immunity
Reduce carriage i.e. offer herd immunity

27
Q

T cell dependent antigens

A

Naive T cells primed by interaction with APCs, requires antigenic stimulation via MHCII-TCR pathway
T cells interact with B cells: Saccharide specific B cells take up conjugate and present the carrier peptides to T cells via MHCII
Activated B cells differentiate into antibody secreting plasma cells and memory B cells

28
Q

Mode of action of T cell dependent antigens

A

Stimulates T cells so when vacinee encounters organism again, B cells that are stimulated get T cell help
where they wouldn’t have got T cell help if the polysaccharide hadn’t been conjugated

29
Q

List 3 licensed conjugate vaccines

A

Hib
Pneumococcal
MenC

30
Q

What is the problem with MenC?

A

Need a booster later on (MenACYW)

31
Q

What is the problem with using 13 serotypes in a pneumococcal vaccine?

A

Potentially 100 infection causing serotypes

Concerns about serotype replacement: replacement disease being caused by serotypes not in vaccine

32
Q

Meningococcal Outer Membrane Vesicle Vaccines

A

OMVs from gram negative bacteria released by meningococci in vivo and culture
Contain all protein antigens associated with OM
Vaccine produced by detergent extraction to make them less reactogenic

33
Q

What is the Reverse vaccinology approach?

A

genome sequence data used to identify candidate antigens
Produce recombinant antigens
Test in mice to see if good immune response
Develop into vaccine for clinical trials and use in people

34
Q

Describe Tuberculosis BCG vaccine

A

Attenuated strain of Mycobacterium bovis

Efficacy uncertain as instituted at time of social, economic and public health improvements

35
Q

Types of typhoid vaccine

A

Vivotif live attenuated vaccine

Vi polysaccharide- capsule from typhoid, not suitable in very young

36
Q

2 types of Cholera vaccine

A

Killed whole cell parenteral vaccine

Killed whole cell oral vaccine

37
Q

What are the 2 ways in which adjuvants potentiate the immune response?

A

Delivery systems

Immune potentiators

38
Q

How do adjuvants work as delivery systems?

A

Usually a depot of antigen which is slowly released.
Way of getting antigen to where you want in the body
e.g. mineral salts, surface active agents, liposomes

39
Q

How do adjuvants work as immune potentiators?

A

molecules that alter immune response to make it different/ better
e.g. Toxins, lipids, Nucleic acids (CpG), Peptidoglycan

40
Q

How do adjuvants relate to PAMPs?

A

they stimulate an innate immune response

41
Q

Risk benefit analysis of vaccinating the immunocompromised

A

Need to protect vulnerable patient
Public health perspective (herd immunity)
Protect patient by immunising close contacts
Live vaccines need particular consideration
Decision on whether to vaccinate depends on the nature of immunodeficiency and the vaccine

Microbiology (9 decks)

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