Lec36 Viral Vaccines Part 2 Flashcards
How efficacious are viral MMR and polio vaccines?
> 99% reduction in yearly morbidity
Antiv
antiviral –> humoral immunity
What are two principal mech of specific antiviral immunity?
- humoral: neutralize by specific antibodies made by B cells with help from CD4 against viral proteins [prevents or limits infection of host cells]
- cell mediated: target virus-infected host cells by cytotoxic T cells [CD8] specific for immunogenic viral peptide [eliminates infected host cells, resolves infection]
Which types of vaccines initiate cell mediated [CD8] immune response?
- live only
Which type of vaccines initiate humoral [CD4/antibody] immune response?
- live
- killed
- protein subunit
What type of vaccine is Hep B vaccine?
protein subunit vaccine [recombinant]
What type of vaccine is hep A vaccine?
inactivated whole virus
What type of vaccine is polio? How is it administered?
- in US: inactivated whole virus [IM]
- in developing countries/some of europe its live attenuated [oral]
What type of vaccine is rotavirus? How is it administered
oral virus
either:
1. live pentavalent human-bovine reassortment rotavirus
2. live human attenuated
What type of vaccine is MMR? how is it administered?
- all live attenuated
- give IM
What type of vaccine is influenza?
two types
- inactivated whole virus [IM}
- live attenuated/cold adapted [intranasal]
What type of vaccine is HPV?
- reassembled virus-like particles [look like whole virus but don’t contain nucleic acid or genome DNA, made of combined protein subunits]
What is benefit of live polio vaccine [OPV] vs inactivated PV?
- provides intestinal immunity [prevent shedding of polio in stool and other secretions]
- prevents secondary spread of vaccine to unprotected contacts
What is influenza vaccine composed of?
- inrfluenza undergoes antigenic drift and sometimes shift –> yearly repeat doses required for optimal immunity
- composed of 2 prevalent strains of influenza A [one H1N1 and one H3N2] and the single most prevalent strain of influenza B isolated during the previous year
What are properties of measles vaccine? Who should get it?
- vaccinate at 1 yr then booster at 4-6 yrs
- live vaccine that temporarily suppresses CMI [cell mediated immunity] –> so don’t test someone for tuberculin reactivity within 6 wks of vaccine
- pre-existing antibody interferes with immune response to vaccine [ie maternal antibodies in infants, intravenous Ig]
What are properties of rubella vaccine?
- live vaccine
- don’t give during pregnancy due to concern for congenital rubella
What are properties of mumps vaccine? How effective?
- live vaccine
- highly effective
- recent cases have occurred in vaccinees
What are the properties of varicella vaccine? side effect?
- live vaccine
- may produce mild vaccine-associated disease
- give higher dose to vaccinate against zoster for > 60 y.o.
Who should not get live vaccines?
- patients with defective CMI because may cause illness
What are properties of HPV vaccine?
- composed of reassembled virus-like particle
- 2 versions
What types of HPV does HPV4 cover? HPV2?
HPV4 covers types 6, 1, 16, 18
HPV2 covers 16,18 only
What diseases associate with types 6 and 11 HPV?
- papillomatosis [genital warts] including respiratory papillomatosis in infants
What types of HPV cause genital warts?
types 6 and 11
What diseases associated with types 16 and 18 HPV?
cervical cancer
What types of HPV most associated with cervical cancer?
types 16 and 18
How is HPV transmitted?
direct [usually sexual] contact
When do you give HPV vaccine?
ideally before onset of sexual activity [11-12 yo]
What are examples of passive immunizations? 5 known diseases that get prevented with it?
passive immunization = prep immune globulin or monoclonal antibodies to prevent infection
hep A – standard human immune globulin
hep B – hep B IG
rabies – rabies IG
RSV – [palivizumab, Synagis]
Intravenous Immune globulin [for pt with humoral immunodeficiency]
varicella immune globulin
maternal antibodies across placenta or via breast feeding
What is palivizumab [synagis]?
Ig for RSV give to premature babies to keep them from getting RSV = passive immunity
What are common adverse events to vaccines?
- commonly mild to moderate: fever, injection site rxn
What is potential rare complication of live oral polio vaccine?
paralytic polio
What is potential rare complication of tetanus vaccine?
guilain-barre
What is potential rare complication of varicella vaccine?
acute cerebellar ataxia
What is contraindication to getting DTaP vaccine?
encephalopathy within 7 days of prior dose
What is contraindication to getting influenza vaccine
severe allergic rxn to eggs
What are contraindications to getting MMR[V] vaccine?
- pregnancy
- deficient CMI
- prior anaphylaxis to neomycin or gelatin
