Immunizations

Question 1

Define passive immunity

Answer 1

transfer of immunity from one individual to another

Question 2

Give an example of natural passive immunity

Answer 2

Maternal IgG transferred to fetus in utero, IgA transferred in breast milk

Question 3

Give an example of a medical use of passive immunity

Answer 3

IVIG
maintenance of humoral immunity in patients with antibody deficiencies
prevent a specific disease pre or post exposure

Question 4

List four sources of immunoglobulins

Answer 4

horse Ig- ex snake bite antivenom
pooled human plasma- not selected to concentrate a single antibody
specific high titer human Ig- donors are immunized then Ig is harvested
monoclonal antibody- produced in lab cell culture, ex against RSV

Question 5

What are the advantages of passive immunity?

Answer 5

rapid onset, not dependent on intact immune system, very effective

Question 6

What are some disadvantages of passive immunity?

Answer 6

expense, possible adverse events esp with horse Ig, short duration of protection (weeks to months)

Question 7

List two features of the adaptive immune response

Answer 7

is protective- prevents further episodes of the disease

induces immunological memory

Question 8

In immunization, production of antibody alone is not enough- the antibody must be able to______ the inciting agent.

Answer 8

neutralize

Question 9

Describe some key features of live vaccines

Answer 9

retain capacity to reproduce in the host leading to prolonged immune exposure and excellent immune response- both cellular and humoral
may not require a booster
rarely cause disease in the human host or revert to virulent form
shedding of vaccine–> inadvertent but sometimes helpful transmission to others

Question 10

Live attenuated vaccines may cause a full case of the disease in ________ patients and ________ women

Answer 10

immunocompromised

pregnant women

Question 11

List examples of attenuated vaccines

Answer 11

varicella
MMR
smallpox
TB (BCG)
intranasal influenza vaccine
rotavirus
oral polio vaccine

Question 12

Inactivated vaccines produce primarily a ______ immune response and usually require boosters

Answer 12

humoral

Question 13

Give examples of inactivated vaccines

Answer 13

inactivated polio vaccine
whole cell pertussis
some variants of influenza vaccine

Question 14

Differentiate between inactivated and purified subunit vaccines

Answer 14

Same characteristics but inactivated vaccines have lower adverse event rates because they contain fewer antigens

killed vaccines contain the whole organism

Question 15

Give an example of a purified subunit vaccine

Answer 15

tetanus toxoid

may not prevent infection with the organism but help the host immune system neutralize the toxin - prevents disease manifestation

Question 16

List three organisms for which polysaccharide vaccines are important

Answer 16

Hib
Strep pneumoniae
Neisseria meningitidis

Question 17

Why are polysaccharide vaccines not used in children?

Answer 17

polysaccharides are poorly immunogenic for children under 2- they cannot develop antibody responses to polysaccharide antigens

Question 18

What type of vaccines can be used to protect young children from encapsulated organisms

Answer 18

conjugate vaccines- polysaccharide capsule linked to a protein

examples- pneumococcal, Hib, meningococcal

Question 19

List examples of surface antigen vaccines

Answer 19

HBV, some pertussis, some influenza

Question 20

Why is neomycin added to some vaccines?

Answer 20

Preservative, prevent contamination of the batch

Question 21

List three goals of vaccination

Answer 21

prevent disease in individual
prevent disease in population
eradicate disease

Question 22

_________ is the ability of a vaccine to produce a measurable immune response in a population

Answer 22

Immunogenicity

measure by concentration of antibody in serum
ex: 95% of people who get two doses of polio vaccine develop antibody production

Question 23

______ is the ability of a vaccine to actually prevent disease in a population

Answer 23

Efficacy

ex: pertussis vaccine is 85% efficacious in Italy

Question 24

List five strategies to improve immunization rates

Answer 24

immunize early, often, at every opportunity
get it out of the clinic
school/ day care passport laws
public education/ advocacy
combined vaccines to decrease number of shots and visits