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FMS > FMS Week 10: Vaccines > Flashcards

FMS Week 10: Vaccines Flashcards

1
Q

Adaptive immunity and the primary infection

A
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2
Q

What are vaccines?

A

Vaccines are harmless agents that elicit adaptive immune responses

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3
Q

Consequences of immunization

4 listed

A
  • circulating Antibody in serum (ideally high-affinity IgG)
  • Increased frequency of pathogen-specific B and T cells (memory cells)
  • Rapid response to infection
  • these immune responses prevent or modify disease
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4
Q

Most Vaccines do not prevent infection but…

A

some do!

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5
Q

Herd Immunity

A

Pathogens are unable to spread if they cannot infect people

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6
Q

The first vaccine was

A

Smallpox

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7
Q

Critical issues in Vaccine Development

3 Listed

A
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8
Q

Most modern vaccines against bacteria target …

A

Capsular Polysaccharides

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9
Q

Typical Extracellular Bacteria Vaccine targets

3 Listed

A
  • Capsular Polysaccharides
  • Bacterial toxins
  • induce neutralizing antibodies
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10
Q

Appropriate targets of Intracellular Bacteria

2 Listed

A
  • CTL responses are probably the most important (antibodies may also have value)
  • There are no particularly effective vaccines against intracellular bacteria that are currently clinically approved
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11
Q

Effector mechanism likely for Tuberculosis?

A

T cell Vaccines

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12
Q

Factors that influence the immune response as it pertains to vaccines

5 Listed

A
  • Type of Antigen (structure, protein vs carbohydrate)
  • Dose, route of administration (e.g. intramuscular, subcutaneous, Mucosal, etc.)
  • Age (newborns, infants/children, adolescents/adults, elderly)
  • Adjuvants
  • State of the host: e.g. underlying immune deficiency (e.g. splenectomy, HIV infection, congenital immune deficiency, chemotherapy)
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13
Q

Adjuvant definition

A

Adjuvants are agents that enhance the immunity induced by vaccines

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14
Q

Adjuvant functions

3 Listed

A
  • can enhance translocation of antigens to lymphoid tissues
  • Provide physical protection to antigens, allowing a more prolonged exposure to the immune system
  • Often provoke local immune reactions at the site of immunization, usually through interactions with innate immune receptors such as TLRs
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15
Q

Common Adjuvants

4 Listed

A
  • Alum
  • Mineral Oil
  • Squalene
  • TLR agonists (MPL & CpG)
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16
Q

Main Classes of Vaccines

6 Listed

A
  1. Live Attenuated
  2. Inactivated
  3. Subunit
  4. Conjugate
  5. Virus-like particles
  6. DNA
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17
Q

Classical Vaccine Strategy classes of vaccines

3 listed

A
  1. Live Attenuated
  2. Inactivated
  3. Subunit
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18
Q

Classes of Vaccines: Recombinant DNA Technology

4 Listed

A
  1. Subunit
  2. Conjugate
  3. Virus-Like Particles
  4. DNA
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19
Q

Safety of the various vaccine types

A

Most Safe

  • DNA
  • Recombinant proteins and VLPs
  • Isolated pathogen components
  • Inactivated
  • Live Attenuated

Least Safe

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20
Q

Immunogenicity of the various vaccine types

A

Most Immunogenic

  • Live attenuated
  • Inactivated and VLPs
  • Isolated pathogen components
  • Recombinant proteins
  • DNA

Least Immunogenic

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21
Q

Live Attenuated Vaccines definition

A

Live pathogens that replicate in the host but do not cause disease because the pathogen has been mutated to a non-pathogenic form

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22
Q

Live Attenuated Vaccines: Methods of Attenuation

6 listed

A
  • Repeated passage in a different species
  • Repeated passage in cell lines
  • Repeated passage in cold
  • Genetic reassortment with attenuated genes
  • Deletion or mutation of genetic sequences
  • Use of a naturally occurring non-pathogenic relative
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23
Q

Consequences of Attenuation

4 Listed

A
  • Tropism
  • Gene expression
  • Immunogenicity
  • Ability to replicate
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24
Q

Advantages of Live Attenuated Vaccines

4 Listed

A
  • Highly immunogenic and stimulates a broad immune response (innate and adaptive)
  • All antigens are expressed (multiple targets)
  • Usually effective with a single dose
  • Often inexpensive to manufacture
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25
Disadvantages of Live Attenuated Vaccines 4 Listed
* Can revert back to pathogenic form * Requires a system to grow the virus * Potential for contamination * Can be dangerous in immunodeficient or pregnant individuals
26
Inactivated Whole Pathogen Vaccines Description
Preparations of normal, infectious pathogen that have been inactivated, usually by treatment with a clinical agent
27
Advantages of Inactivated Vaccines 2 Listed
* Reversion not an issue * Multiple Antigens are present
28
Disadvantages of Inactivated Vaccines 6 Listed
* Risk of incomplete inactivation * Requires a system to grow the virus * Manufacture requires handling of large volumes of virulent pathogen * Manufacture often expensive * Inactivation may alter immunogenicity * Requires Boosting
29
Comparisons of immune responses to live and killed vaccine
30
Subunit Vaccine Description 4 listed
Consists of purified components derived from the pathogen such as
31
Subunit Purified Components Examples 3 Listed
* Toxins (Tetanus, Diptheria, Pertussis) * Polysaccharide derived from bacterial capsule (pneumococcus, Meningococcus) * Viral Surface antigens (Hepatitis B Surface Antigen)
32
Advantages of Subunit Vaccines 1 Listed
* Can induce specific immune responses against molecules involved in virulence/pathogenesis
33
Disadvantages of Subunit Vaccines 2 Listed
* Often poorly immunogenic without adjuvants * Polysaccharide antigens elicit T-independent responses
34
T-Cell-independent Immune Responses of Polysaccharide Vaccines
35
Conjugate Vaccines Description 2 listed
Consist of purified component(s) of a pathogen linked to a highly immunogenic carrier (such as inactivated bacterial toxins) & Allows for a T-dependent antibody response
36
T-Cell-Dependent Immune Response to Protein or Protein-conjugate Vaccines
37
Virus-like Particle Vaccines Description 2 Listed
* Consist of the viral structural proteins that when overexpressed, spontaneously self-assemble into particles that are indistinguishable from infectious virus * VLPs do not contain viral nucleic acid and are therefore, non-infectious
38
Advantages of Virus-like Particle Vaccines 4 Listed
* Excellent safety profile * Does not rely on the ability to grow pathogen * Highly immunogenic due to the repetitive structure * Inside of particle can be modified with adjuvants
39
Disadvantages of Virus-like Particle Vaccines 3 Listed
* May require multiple doses (recent data says maybe not) * Induces a limited immune response (to surface antigens) * Can be expensive to manufacture
40
DNA Vaccines Description 3 Listed
* Injection of DNA coding for the target molecule. The gene can be introduced using a viral vector or can be injected as naked DNA. Once the DNA enters the cell, the target antigen is expressed at high levels * Secreted antigens can elicit antibodies * Antigens delivered to APCs can elicit T cell responses
41
Advantages of DNA Vaccines 3 Listed
* Inexpensive to manufacture * Vaccines are often highly stable * quick development time
42
Disadvantages of DNA Vaccines 4 Listed
* Effectiveness is unclear * It May be more effective in generated cell-mediated immune responses (for therapeutic vaccines) * Safety unclear * Likely require multiple doses and multiple delivery platforms
43
44
Barriers to vaccine development 4 Listed
* Target Identification * Immunogenicity (magnitude of Response) * Safety issues (especially with new technologies) * Antigenic Variation (RNA viruses (such as HIV, Influenza, Hepatitis C Virus) Certain bacteria and protozoa)
45
Emerging Trends in Vaccines 4 Listed
1. Novel Delivery Systems 2. Novel Adjuvants 3. Emerging Infectious Diseases 4. Non-traditional Vaccine Targets
46
Novel Delivery Systems Examples 4 Listed
* Mucosal Delivery * Skin patches * Microneedles * Aerosol
47
Novel Adjuvants Examples 3 Listed
* Activators of innate immunity * Toll-like Receptors (CpG oligonucleotides, others) * Targeting of specific cell types (B cells, Mucosal cells)
48
Trends in Vaccines: Emerging Infectious Diseases description
Rapid production of vaccines to face emerging threats
49
Non-traditional Vaccine Targets Examples 3 listed
* Self-molecules involved in disease processes * Allergens * Substances of abuse (Nicotine, Cocaine)
50
Harmonized Schedules for Vaccination 4 Listed
* Provided by the American Committee on Immunization Practice (ACIP) under the National Immunization Program (CDC) * Schedules of primary series and booster injections for children and adults * ACIP general recommendations and harmonized schedules define acceptable variation in dosing, vaccine intervals, and age of immunization * Updated every year
51
Alleged or Disproved Vaccine Adverse Effects 4 Listed
* Causation or relapse of Multiple Sclerosis; Hep B Vaccines * Causation of juvenile diabetes; Haemophilus Vaccines * Causation of convulsive disorders or chronic encephalopathy; whole cell DPT * Causation of autism; Measles Vaccine; Thimerosal (Ethyl mercury)
52
Immediate Vaccine Reactions time frame
Within 24 hours
53
Delayed Vaccine Reactions time frame
Within 14-28 days
54
Generalized systemic reactions of Vaccines 5 Listed
* Fever * Arthralgia * Headache * Fatigue * Generalized Rash
55
Arthralgia AKA
Joint pain
56
Local Reactions of Vaccines 3 Listed
* Swelling * Pain * Erythema
57
Allergic Vaccine Reactions 4 Listed
* Anaphylaxis * Generalized urticaria (hives) * Dizziness * Syncope (fainting)
58
Likelihood of Allergic Vaccine Reactions
* Rare events & risk is minimized by screening (do you have an allergy to eggs)
59
Transient Thrombocytopenia Description & Vaccine Reaction 2 listed
* Thrombocytopenia is a condition characterized by abnormally low levels of thrombocytes, also known as platelets, in the blood * e.g. Measles; immune-mediated
60
Rare Vaccine Reaction Associations 2 Listed
* Guillain-Barre Syndrome * Post-vaccine encephalitis
61
VAERS AKA
Vaccine Adverse Effects Reporting System (VAERS)
62
Vaccine Preventable Diseases Examples 15 Listed

FMS (34 decks)

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