immunisation Flashcards

lecture 11

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1
Q

What are the characteristics of passive immunity?

A

Short-lived (half-life of IgG about 3 weeks)

Hypogammaglobulinaemia in infants as maternal IgG declines

IVIgG every 2-4 weeks for immunodeficiency to maintain protective levels

Tetanus antitoxin

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2
Q

What are the characteristics of active immunity?

A

Exploits “immunological memory”

Secondary vs. primary response:

-Faster to develop

-Greater in magnitude

-May be qualitatively better (e.g., higher affinity antibody)

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3
Q

How does herd immunity work to protect both the individual and the population?

A

Individual Protection: Immunisation protects the individual from infection.

Population Protection: If a majority of the population is immune, the spread of the disease declines, leading to protection of the community (herd immunity).

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4
Q

What are some important facts about measles?

A

A highly contagious viral disease, patients develop a rash and a fever

In 2022, 136,000 people died

Serious complications can occur:

Ear infection, which can lead to hearing loss

Pneumonia, especially in young children

Sub-acute sclerosing panencephalitis (SSPE), a rare but fatal complication involving the CNS

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5
Q

What are the historical milestones and requirements for herd immunity against measles?

A

1st vaccine in 1963

MMR vaccine in 1988

Need 83-94% of the population immune to prevent outbreaks

1998 paper from Wakefield and colleagues linked MMR vaccine to autism

The paper was retracted but resulted in a decline in vaccine uptake and outbreaks

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6
Q

What are the requirements for an effective vaccine?

A

Safe

High level of protection

Long-lasting protection

Right type of response (local or systemic, antibody or cell-mediated immunity)

Low cost

Stable

Easy to administer

Minimal side effects

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7
Q

What are the different types of vaccines?

A

**Inactivated **(dead) organisms (e.g., Salk polio vaccine)

**Attenuated **(live but virulence disabled) organisms (e.g., Yellow fever, MMR)

**BCG **vaccine containing Mycobacterium bovis strain

Subunit vaccines - protein fragments (e.g., Hepatitis B)

**Toxoid **- bacterial toxin (e.g., Tetanus)

**Conjugate vaccines **(e.g., Streptococcus pneumoniae + diphtheria)

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8
Q

What are the key facts about polio?

A

Caused by an enterovirus, spread through the fecal-oral route

Mainly affects children under 5

1/200 cases result in paralysis

Member of the Picornaviridae family:** positive-sense RNA**, translated into a large polypeptide cleaved post-translation

Most infections are subclinical; a small number have flu-like symptoms

3 strains causing symptoms

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9
Q

What are subunit vaccines and toxoid vaccines?

A

Subunit vaccines use isolated antigens (e.g., Hepatitis B)

Tetanus toxoid: inactivated form of a protein exotoxin

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10
Q

What are conjugate vaccines and their benefits?

A

Conjugate vaccines allow T cell help for polysaccharide conjugated to protein

Converts** thymus-independent polysaccharide antigen to a thymus-dependent form**

Young children can respond

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11
Q

What is reverse vaccinology?

A

Whole genome screening to identify proteins for vaccines

Used to develop a vaccine against Neisseria meningitidis group B

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12
Q

: What are adjuvants and how do they enhance immune responses?

A

A substance administered with an antigen to promote immune response

Provide a depot

Immunostimulatory properties

Examples: Alum, MF59, AS03, AS04

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13
Q

What are some recent additions to the vaccination schedule?

A

MenB (Sept 2015 for babies)

MenACWY (2015 for teenagers)

Influenza (2003 nasal spray for children)

Shingles (2006 for over 70s)

RSV (2024 for late pregnancy and 75-79 year olds)

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14
Q

What changes occur in antibodies during successive immune responses?

A

Faster development

Greater magnitude

Higher affinity

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15
Q

What is the classification and transmission route of the polio virus?

A

Caused by an enterovirus

Spread through the fecal-oral route

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16
Q

What is a subunit vaccine and give an example?

A

Uses isolated antigens

Example: Hepatitis B surface antigen

17
Q

How do conjugate vaccines enhance the immune response in young children?

A

Converts thymus-independent polysaccharide antigen to a thymus-dependent form

Young children can respond due to T cell help

18
Q

What is reverse vaccinology and how was it used for Neisseria meningitidis group B?

A

Whole genome screening to identify vaccine proteins

Developed a 4-component vaccine through gene prediction and immunisation trials

19
Q

What is the role of adjuvants in vaccines?

A

Substances administered with antigens to enhance the immune response

Examples include Alum, MF59, AS03, and AS04

20
Q

What are some newer adjuvants used in clinical vaccines and their specifics?

A

MF59: Squalene-based, used in flu vaccines since 1997

AS03: Includes squalene and vitamin E, used in H1N1 flu vaccine

AS04: Alum plus monophosphoryl lipid A, used in HBV and HPV vaccines

21
Q

What are inactivated (dead) vaccines and give an example?

A

Uses killed organisms to induce immunity

Example: Salk polio vaccine

22
Q

What are attenuated (live) vaccines and give an example?

A

Uses live organisms with disabled virulence to induce immunity

Examples: MMR (measles, mumps, and rubella), Sabin polio vaccine

23
Q

What does the BCG vaccine contain and what does it target?

A

Contains** Mycobacterium bovis strain**

Used to protect against tuberculosis (TB)

24
Q

What are subunit vaccines and give an example?

A

**Uses protein fragments from the pathogen to induce immunity

Example: Hepatitis B vaccine

25
Q

What are toxoid vaccines and give an example?

A

Uses** inactivated bacterial toxins **to induce immunity

Example: Tetanus toxoid vaccine

26
Q

What are conjugate vaccines and give an example?

A

Combines a polysaccharide antigen with a protein to enhance the immune response

Example: Pneumococcal conjugate vaccine (Prevar 14)

27
Q

What are important characteristics and considerations for inactivated vaccines?

A

Important antigens must survive the killing process

May have side effects

Often being replaced by newer vaccines

28
Q

What are important characteristics and considerations for attenuated vaccines?

A

Live organisms that can replicate without causing disease

Often induce stronger and longer-lasting immunity

29
Q

Give an example of an attenuated vaccine and its method of administration.

A

Sabin polio vaccine

Administered as drops on the tongue

30
Q

What are important considerations for subunit vaccines?

A

Antigen is crucial for inducing immunity

May have non-responders who do not develop immunity