Immunology - Vaccination (Adjuvants)

Question 1

traditional vaccines

Answer 1

derived from live-attenuated- or inactivated whole organisms or toxins, effective in inducing predominantly antibody-based immunity, highly reactogenic, developments to produce safer less reactogenic vaccines also capable of inducing cell-mediated
immunity have resulted in compromised vaccine efficacy

Question 2

adjuvants - general

Answer 2

designed to improve poorly immunogenic vaccines, substances used in combination with a specific antigen
that produced a more robust immune response than the antigen alone

Question 3

adjuvants’ effect on immune response

Answer 3

• increase the immunogenicity of weak antigens
• enhance speed and duration of immune response
• stimulate and modulate humoral responses, including antibody isotype
• stimulate cell-mediated immunity
• improve induction of mucosal immunity
• enhance immune responses in immunologically immature patients particularly infants
• decrease the dose of antigen required; reducing costs and eliminating inconvenient
requirements for booster shots

Question 4

molecules considered

Answer 4

mineral compounds (e.g.
Alum), water-in-oil or oil-in-water emulsions (e.g. Freund’s adjuvant), natural and
synthetic toxins derived from bacteria (e.g. cholera toxin, CT and lymphotoxin, LT)

Question 5

categorization

Answer 5

based on their

mechanism of action, 2 broad groups

Question 6

particulate

vaccine-delivery systems

Answer 6

target antigen to antigen presenting cells (APCs)

Question 7

immunostimulatory adjuvants

Answer 7

directly activate antigen presenting cells (APCs) through specific receptors e.g.
toll-like receptors (TLRs) resulting in inflammatory responses that amplify the innate immune
response

Question 8

ultimate aim

Answer 8

activate the innate immune system to respond more rapidly to

infection and for the adaptive immune response to become more specific

Question 9

Aluminium-based
mineral salts (Alum)

Answer 9

ie Aluminium phosphate + Calcium phosphate + Aluminium hydroxide, ie Anthrax (BioThrax®, Emergent Biosolutions) + Hepatitis A (Vaqta®, Merck) + DTP (Triple AntigenTM, CSL limited)

Question 10

MF59

Answer 10

Submicron oil-in-water

emulsion, Influenza (FLUAD®, Novartis)

Question 11

Monophosphoryl lipid

A (MPL)

Answer 11

Bacteria-derived

immunostimulant, Hepatitis B (Fendrix®, GlaxoSmithKline)

Question 12

Virosomes

Answer 12

Spherical vesicles containing
viral membrane proteins in
the lipid membrane, Hepatitis A (Epaxal®, Berna Biotech) + Influenza (Inflexal®, Berna Biotech)