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MICBI Virology > L54 Vaccines > Flashcards

L54 Vaccines Flashcards

- New this year: COVID19 vaccines

1
Q

Vaccine is a type of active/passive immunisation.

Briefly describe the onset and prophylactic value.

A

Active

  • Ag given, stimulate Ab
  • rely on active immune response
  • Slow onset: few weeks to develop immunity
  • Pre-exposure prophylaxis
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2
Q

Pooled immunoglobulin e.g. IVIG / virus-specific Ig e.g. HBIG, VZIG, palivizumab (synthetic IgG against RSV) are examples of ______immunisation.

Briefly describe the onset and prophylactic value.

A
  • immediate but short duration (1-3 months)

- post-exposure prophylaxis

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3
Q

Basic principle of vaccination?

A

Use an artificial antigen to provoke adaptive immune response, so that the immune system is prepared and ready for a rapid and robust response when it encounters a real infection in the future

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4
Q

Give examples of vaccines that are live attenuated. (8)

A
  1. Viral
    - MMR (measles, mumps, rubella)
    - Rotavirus
    - Varicella (Chickenpox)
    - Vaccinia (Smallpox)
    - Yellow fever
    - Oral polio
  2. Bacterial
    - BCG
    - Oral typhoid
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5
Q

Inactivated vaccines can either be whole for fractional.

One type of fractional vaccine is protein-based subunit vaccine. Give examples (3).

A
  1. Influenza
  2. Hepatitis B
  3. Acellular pertussis
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6
Q

Other than subunit protein-based fractional vaccine, there is toxoid protein-based fractional vaccine. Give examples. (2)

A

Tetanus

Diphtheria

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7
Q

PPV23 (pneumococcal vaccine) is an example of which type of vaccine?

A

Polysaccharide-based pure fractional inactivated vaccine

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8
Q

Examples of inactivated vaccines in general? (4)

A
  1. Hepatitis A
  2. Flu (shot only)
  3. Polio (shot only)
  4. Rabies
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9
Q

Example of subunit vaccines (4)?

A
  1. Influenza
  2. Hepatitis B
  3. HPV (Human papillomavirus)
  4. Rotavirus
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10
Q

What is live attenuated vaccines?

Attenuation achieved by? (4)

A

Attenuated strain replicates to a small extent without causing diseases

  • Culture under alternative conditions e.g. reduced temperature
  • Delete mutants: delete genes that contribute to virulence
  • Site-directed mutagenesis: selective mutations of virulence-associated sites
  • Reassortment for segmented viruses (e.g. rotavirus)
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11
Q

What are the advantages of live attenuated vaccines? (3)

Disadvantages? (2)

A

Adv

  • single dose
  • long lasting
  • good cellular immune response

Disadv

  • Stability (cold temperature to retain viability)
  • Possible reversion to virulence
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12
Q

MMRV (measles, mumps, rubella, varicella) is a type of ___________ vaccine.

A

Live attenuated

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13
Q

What is an inactivated vaccine?

A

Whole virus killed by physical (heat) or chemical means (formaldehyde, beta-propriolactone)

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14
Q

What are the advantages (2) and disadvantages(1) of inactivated vaccine?

A

Adv

  • easy to prepare
  • no risk of reversion to virulence

Disadv
- less immunogenic > multiple primary doses, booster dose, adjuvant required

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15
Q

Hepatitis A vaccine is a type of __________ vaccine.

A

Inactivated

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16
Q

Poliomyelitis vaccine is a type of __________ vaccine.

A

Inactivated

17
Q

Hepatitis B vaccine is a type of __________ vaccine.

A

Subunit vaccine

18
Q

Influenza vaccine is a type of __________ vaccine.

A

Subunit vaccine

19
Q

What is a subunit vaccine?
Adv?
Disadvantages?

A

Contain only the antigenic fraction of virus

Adv: less reactogenic (less adverse reactions)

Disadv:
- Less immunogenic (than live attenuated and inactivated), requires adjuvant

20
Q

Diphtheria and tetanus (of DTaP) are a type of _______ vaccine. Briefly describe.

It usually requires booster dose.

A

Toxoid vaccine is a chemically modified toxin which no longer toxic but still antigenic and can be used as a vaccine.
(Does not contain the pathogen)

21
Q

List all possible adverse reactions of vaccines. (5)

A
  1. Mild, self-limiting
    - pain, localised swelling,
    - fever, malaise
  2. Severe, immediate
    - anaphylaxis, resuscitation should be in place
  3. Rare
    - Guillain-Barre syndrome (<1 per million)
    - reversion to virulence (live attenuated)
22
Q

Contraindicated/Precaution/Vaccine only if indicated?

Allergy in

a) Live attenuated vaccine
b) Inactivated vaccine

A

Both contraindicated

23
Q

Contraindicated/Precaution/Vaccine only if indicated?

Pregnancy:

a) Live attenuated vaccine
b) Inactivated vaccine

A

a) Contraindicated

b) Vaccine if indicated

24
Q

Contraindicated/Precaution/Vaccine only if indicated?

Immunosuppression:

a) Live attenuated vaccine
b) Inactivated vaccine

A

a) Contraindicated

b) Vaccine if indicated

25
Q

Contradicated/Precaustion/Vaccine only if indicated?

Severe illness:

a) Live attenuated vaccine
b) Inactivated vaccine

A

Both precaution

26
Q

Contradicated/Precaustion/Vaccine only if indicated?

Recent blood product:

a) Live attenuated vaccine
b) Inactivated vaccine

A

a) Precaution

b) Vaccine if indicated

27
Q

Adjuvant are commonly used in inactivated/ subunit vaccines.

It augments immune response to the target antigen by? (4)

A
  1. Retain and release antigens slowly
  2. Recruit additional signalling pathway (e.g. TLR)
  3. Activate innate immune response (e.g. complement, cytokines)
  4. Activated APCs
28
Q

Alum (aluminium hydroxide)
MPL (monophosphoryl lipid )
MF59 (oil-in-water) are examples of?

A

Adjuvants

29
Q

What are the potential side effects of adjuvants
A. Local inflammation
B. Anaphylaxis
C. Influenza-like illness
D. Cross reaction with human antigens e.g. GMB
E. Possibly carcinogenic and teratogenic

A

All of the above

30
Q

What are the 3 aims of vaccination programme? Describe.

A
  1. Eradication
    - complete extinction of pathogen e.g. chickenpox
  2. Elimination
    - eliminate disease in a region, although organism remains circulating somewhere
    - e.g. Poliovirus
  3. Containment: maintain low level of disease
    e. g. rubella
31
Q

Which of the follow matches regarding the available vaccines for COVID19 in 2021?

A. CoronaVac by Sinovac Biotech - inactivated vaccine

B. Toxinamera by Pfizer- BioNTech - mRNA (genetic vaccines)

C. ChAdOx1 mCoV-19 by Oxford - Non-replicating adenovirus vector (viral vector vaccines)

D. Protein-based subunit vaccines - Glycoprotein by Novavax

A

All of the above

A-C in HK

32
Q

Clinical trials from phase 0 to?

A

Phase IV (4)

33
Q

How mRNA vaccines work?

A

mRNA sequence is generated that codes for virus spike protein
> cells read it and produce millions copies of spike protein
> protein fragments spur the immune system to produce antibodies

34
Q

Adv and disadv of mRNA vaccines?

A

Adv

  • no significant safety concerns
  • 2 doses
  • simpler than proteins

disadv

  • Protecton duration?
  • Slow immune response
  • mRNA unstable
35
Q

HPV vaccine?

A

Subunit vaccine

9-valent vaccine now

MICBI Virology (9 decks)

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