Immunology overview Flashcards
state of being protected from/ resistant to a particular disease due to the production of antibodies (involves the Ag-Ab response)
immunity
describe active immunity
antigenic stimulation of immune system
describe passive immunity
acquisition of preformed Abs
process of inducing or providing immunity by administering an agent
immunization
foreign agent is recognized in a specific manner and the immune system acquires memory of it
adaptive immune system
4 characteristics of the adaptive immune system
specific (to an antigen)
tolerance (differentiation between self and nonself)
memory
subsequent exposure results in rapid + strong immune response
adaptive immune system is divided into 2 parts
cell mediated immunity
humoral (antibody) immunity
primary immune response develops within ____ following first exposure to antigen and produces mainly the ___ antibody
within weeks
IgM
secondary immune response responds faster and more powerful + produces the ____ antibody
IgG
list 2 factors affecting usefulness of antibody levels
time since last exposure (testing after 1yr = low amts but still protected), type of exposure, individual response, vaccine type, variants and mutability of antigen (but also having antibodies ≠ protected)
describe cell mediated immunity
antigens displayed by infected cells, T cells, defend against infected cells, cancers, and transplant tissues
part of the immune system that protects the body without changing or adapting to the exposure (physical barriers, secretions, pH extremes)
passive immune system
Vaccine taken up by ___________ → activates________________to give memory cells → generates ____________cells to several epitopes → antigen persists to continue to recruit B memory cells and produce high affinity antibody → takes______ to establish adequate immunity following exposure to antigen
antigen presenting cells
both T and B cells
Th and Tc
~2wks
polysaccharide vaccines do not activate ____
T cells
what is variolation
exposing person to contents of a pustule from a pt suffering a mild form of smallpox
2 passive immunizing agents
Immunoglobulins. Antitoxins
live/ inactivated vaccines, toxoids, mRNAs are _______ immunizing agents
active
which component do all vaccines have
1. adjuvants
2. antigen
3. preservatives
4. stabilizers
2
substances added to vaccien to enhance the immune system’s response
adjuvants
adjuvants are never used in
1. inactivated vaccines
2. mRNA vaccines
3. live vaccines
4. toxoid vaccines
3
adjuvants function
enhance immune system response
may induce inflam factors to injection site (to stay at site)- may cause injection site reactions
preservatives are used in vaccines to prevent
bacterial or fungal contamination
preservatives are required in
1. all vaccines
2. single dose mRNA vaccine vials
3. all live vaccines
4. vaccines in a multidose vial
4
T or F: those that are allergic to egg should avoid flu shots
F- Egg proteins (used to be v common in flu shots- gotten very good at removing from vaccines, now are very safe in egg allergies)
what 3 antibiotics may be present in vaccines
neomycin, streptomycin, polymyxin B
the MMR vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
1
the varicella vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
1
the polio vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
2
hep A vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
2
3 pros of live attenuated vaccines
Single dose often sufficient to induce long lasting immunity
Strong immune response evoked
Local and systemic immunity produced
5 cons of live attenuated vaccines
Potential to revert to virulence
caution/ CI in immunosuppressed pts/ babies
Interference by passive antibody, potentially other live vaccines
Poor stability (sensitive to heat and light + must shake/ swirl gently until pellet completely dissolved (no bubbles)
Potential for contamination with adventitious viruses
reactions expected from inactivated/ killed vacciens typically within
48hrs
pros of inactivated vaccines
Stable
Constituents clearly defined (not growing things + getting contaminants)
Unable to cause infection
cons of inactivated vaccines
Needs several doses
Local rxns common
Adjuvant needed - keeps vaccine at injection site ,activates antigen presenting cells
Shorter lasting immunity
hep B vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
3
HPV vaccine type
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
3
influenza vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
3
shingrix vaccine is
1. live-attenuated
2. inactivated
3. subunit/ conjugate
4. mRNA
3
typically, AEs from subunit vaccines are _____ than inactivated
lower
which vaccine can cause a hard painless lump on the arm that will go away
Pneumococcal polysaccharide vaccine
polysaccharide subunit vaccine protects against _______________ through ____ independent immunogens
certain encapsulated bacteria
T cell independent
conjugated polysaccharide subunit vaccines are
Attaching (linking) the polysaccharide antigen to a protein carrier = creates an effective immunogen = elicits T cell immune response + B cell
protein subunuit vaccinse are
Purified, inactivated proteins from outer coating of viruses or bacteria
______ are often added as adjuvant for protein subunit vaccines to enhance immune response
aluminum salts
which 2 types of vaccines typically contain aluminum salts as adjuvants
toxoid and subunit
diphtheria vaccine type
1. subunit
2. live
3. inactivated
4. toxoid
4
toxoid vaccines typically require _______ dose(s) for immunity
1. single
2. multiple
2 - protection wanes over time
which of the following is least likely to require a booster shot
1. live attenuated
2. toxoid
3. subunit
4. mRNA
1
nucleic acids include
1. mRNA
2. DNA
3. sRNA
4. 1+2
4
2 general issues with nucleic acid vaccines
stability issues outside of cell, lack of public acceptance due to misinformation
nucleic acid vaccine MOA
Carries the genetic instructions from the host’s cells to make the antigen which more closely mimics a natural infxn- gets our cells to produce subunit of protein of interest
pros of mRNA vaccines
↓ cost and ease of prod (not grown in eggs/ cells)
No risk of preexisting immunity which can limit effectiveness (compared to viral vector vaccines)
Future: one vaccine to target multiple diseases
cons of mRNA vaccines
Must stabilize/ protect mRNA
Long term eff/ safety unknown (ex- v rare or long term SEs)
2 cons of combo vaccines
If have a rxn to a dose, you do not know what vaccine may have caused the rxn
May actually lower uptake or acceptance by some groups
list 3 intrinsic host factors determining vaccine response
Age, sex, genetics, comorbidities, circulating Abs (ex- maternal Abs), immunodeficiency, underlying disease
list 2 administration factors determining vaccine response
Vaccine schedule, site, route, needle size, time of day, coadmin vaccines/ drugs
what is primary vaccine failure
an individual fails to make an adequate immune response to the initial vaccination (ex- in ~10% of measles and mumps vaccine recipients)
describe secondary vaccine failure
individual makes an adequate immune response initially but then immunity wanes over time (a feature of most inactivated vaccines = need for boosters in some cases)
a reaction to a live vaccine usually occurs according to
the time it takes for the virus to replicate
ex- MMR = 7-12 days
when do reactions to inactivated vaccines typically occur
within 48hrs
which is preferable
1. shorter interval between vaccine doses
2. longer interval between vaccine doses
3. live vaccines administered at the same visit
4. live vaccines separated by at least 4 week
5. all but 1
5
live vaccines must be administered at _______ or _______
same visit or separated by at least 4 weeks
most routine childhood vaccines are
schedule 1
