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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
Q

Disadvantages of Live Attenuated Vaccines

4 Listed

A
  • 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
Q

Inactivated Whole Pathogen Vaccines Description

A

Preparations of normal, infectious pathogen that have been inactivated, usually by treatment with a clinical agent

27
Q

Advantages of Inactivated Vaccines

2 Listed

A
  • Reversion not an issue
  • Multiple Antigens are present
28
Q

Disadvantages of Inactivated Vaccines

6 Listed

A
  • 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
Q

Comparisons of immune responses to live and killed vaccine

A
30
Q

Subunit Vaccine Description

4 listed

A

Consists of purified components derived from the pathogen such as

31
Q

Subunit Purified Components Examples

3 Listed

A
  • Toxins (Tetanus, Diptheria, Pertussis)
  • Polysaccharide derived from bacterial capsule (pneumococcus, Meningococcus)
  • Viral Surface antigens (Hepatitis B Surface Antigen)
32
Q

Advantages of Subunit Vaccines

1 Listed

A
  • Can induce specific immune responses against molecules involved in virulence/pathogenesis
33
Q

Disadvantages of Subunit Vaccines

2 Listed

A
  • Often poorly immunogenic without adjuvants
  • Polysaccharide antigens elicit T-independent responses
34
Q

T-Cell-independent Immune Responses of Polysaccharide Vaccines

A
35
Q

Conjugate Vaccines Description

2 listed

A

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
Q

T-Cell-Dependent Immune Response to Protein or Protein-conjugate Vaccines

A
37
Q

Virus-like Particle Vaccines Description

2 Listed

A
  • 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
Q

Advantages of Virus-like Particle Vaccines

4 Listed

A
  • 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
Q

Disadvantages of Virus-like Particle Vaccines

3 Listed

A
  • May require multiple doses (recent data says maybe not)
  • Induces a limited immune response (to surface antigens)
  • Can be expensive to manufacture
40
Q

DNA Vaccines Description

3 Listed

A
  • 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
Q

Advantages of DNA Vaccines

3 Listed

A
  • Inexpensive to manufacture
  • Vaccines are often highly stable
  • quick development time
42
Q

Disadvantages of DNA Vaccines

4 Listed

A
  • 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
Q
A
44
Q

Barriers to vaccine development

4 Listed

A
  • 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
Q

Emerging Trends in Vaccines

4 Listed

A
  1. Novel Delivery Systems
  2. Novel Adjuvants
  3. Emerging Infectious Diseases
  4. Non-traditional Vaccine Targets
46
Q

Novel Delivery Systems Examples

4 Listed

A
  • Mucosal Delivery
  • Skin patches
  • Microneedles
  • Aerosol
47
Q

Novel Adjuvants Examples

3 Listed

A
  • Activators of innate immunity
  • Toll-like Receptors (CpG oligonucleotides, others)
  • Targeting of specific cell types (B cells, Mucosal cells)
48
Q

Trends in Vaccines: Emerging Infectious Diseases description

A

Rapid production of vaccines to face emerging threats

49
Q

Non-traditional Vaccine Targets Examples

3 listed

A
  • Self-molecules involved in disease processes
  • Allergens
  • Substances of abuse (Nicotine, Cocaine)
50
Q

Harmonized Schedules for Vaccination

4 Listed

A
  • 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
Q

Alleged or Disproved Vaccine Adverse Effects

4 Listed

A
  • 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
Q

Immediate Vaccine Reactions time frame

A

Within 24 hours

53
Q

Delayed Vaccine Reactions time frame

A

Within 14-28 days

54
Q

Generalized systemic reactions of Vaccines

5 Listed

A
  • Fever
  • Arthralgia
  • Headache
  • Fatigue
  • Generalized Rash
55
Q

Arthralgia AKA

A

Joint pain

56
Q

Local Reactions of Vaccines

3 Listed

A
  • Swelling
  • Pain
  • Erythema
57
Q

Allergic Vaccine Reactions

4 Listed

A
  • Anaphylaxis
  • Generalized urticaria (hives)
  • Dizziness
  • Syncope (fainting)
58
Q

Likelihood of Allergic Vaccine Reactions

A
  • Rare events & risk is minimized by screening (do you have an allergy to eggs)
59
Q

Transient Thrombocytopenia Description & Vaccine Reaction

2 listed

A
  • Thrombocytopenia is a condition characterized by abnormally low levels of thrombocytes, also known as platelets, in the blood
  • e.g. Measles; immune-mediated
60
Q

Rare Vaccine Reaction Associations

2 Listed

A
  • Guillain-Barre Syndrome
  • Post-vaccine encephalitis
61
Q

VAERS AKA

A

Vaccine Adverse Effects Reporting System (VAERS)

62
Q

Vaccine Preventable Diseases Examples

15 Listed

A

FMS (34 decks)

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