Lec36 Viral Vaccines Part 2 Flashcards

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1
Q

How efficacious are viral MMR and polio vaccines?

A

> 99% reduction in yearly morbidity

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2
Q

Antiv

A

antiviral –> humoral immunity

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3
Q

What are two principal mech of specific antiviral immunity?

A
  1. humoral: neutralize by specific antibodies made by B cells with help from CD4 against viral proteins [prevents or limits infection of host cells]
  2. cell mediated: target virus-infected host cells by cytotoxic T cells [CD8] specific for immunogenic viral peptide [eliminates infected host cells, resolves infection]
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4
Q

Which types of vaccines initiate cell mediated [CD8] immune response?

A
  • live only
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5
Q

Which type of vaccines initiate humoral [CD4/antibody] immune response?

A
  • live
  • killed
  • protein subunit
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6
Q

What type of vaccine is Hep B vaccine?

A

protein subunit vaccine [recombinant]

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7
Q

What type of vaccine is hep A vaccine?

A

inactivated whole virus

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8
Q

What type of vaccine is polio? How is it administered?

A
  • in US: inactivated whole virus [IM]

- in developing countries/some of europe its live attenuated [oral]

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9
Q

What type of vaccine is rotavirus? How is it administered

A

oral virus
either:
1. live pentavalent human-bovine reassortment rotavirus
2. live human attenuated

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10
Q

What type of vaccine is MMR? how is it administered?

A
  • all live attenuated

- give IM

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11
Q

What type of vaccine is influenza?

A

two types

  • inactivated whole virus [IM}
  • live attenuated/cold adapted [intranasal]
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12
Q

What type of vaccine is HPV?

A
  • reassembled virus-like particles [look like whole virus but don’t contain nucleic acid or genome DNA, made of combined protein subunits]
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13
Q

What is benefit of live polio vaccine [OPV] vs inactivated PV?

A
  • provides intestinal immunity [prevent shedding of polio in stool and other secretions]
  • prevents secondary spread of vaccine to unprotected contacts
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14
Q

What is influenza vaccine composed of?

A
  • 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
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15
Q

What are properties of measles vaccine? Who should get it?

A
  • 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]
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16
Q

What are properties of rubella vaccine?

A
  • live vaccine

- don’t give during pregnancy due to concern for congenital rubella

17
Q

What are properties of mumps vaccine? How effective?

A
  • live vaccine
  • highly effective
  • recent cases have occurred in vaccinees
18
Q

What are the properties of varicella vaccine? side effect?

A
  • live vaccine
  • may produce mild vaccine-associated disease
  • give higher dose to vaccinate against zoster for > 60 y.o.
19
Q

Who should not get live vaccines?

A
  • patients with defective CMI because may cause illness
20
Q

What are properties of HPV vaccine?

A
  • composed of reassembled virus-like particle

- 2 versions

21
Q

What types of HPV does HPV4 cover? HPV2?

A

HPV4 covers types 6, 1, 16, 18

HPV2 covers 16,18 only

22
Q

What diseases associate with types 6 and 11 HPV?

A
  • papillomatosis [genital warts] including respiratory papillomatosis in infants
23
Q

What types of HPV cause genital warts?

A

types 6 and 11

24
Q

What diseases associated with types 16 and 18 HPV?

A

cervical cancer

25
Q

What types of HPV most associated with cervical cancer?

A

types 16 and 18

26
Q

How is HPV transmitted?

A

direct [usually sexual] contact

27
Q

When do you give HPV vaccine?

A

ideally before onset of sexual activity [11-12 yo]

28
Q

What are examples of passive immunizations? 5 known diseases that get prevented with it?

A

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

29
Q

What is palivizumab [synagis]?

A

Ig for RSV give to premature babies to keep them from getting RSV = passive immunity

30
Q

What are common adverse events to vaccines?

A
  • commonly mild to moderate: fever, injection site rxn
31
Q

What is potential rare complication of live oral polio vaccine?

A

paralytic polio

32
Q

What is potential rare complication of tetanus vaccine?

A

guilain-barre

33
Q

What is potential rare complication of varicella vaccine?

A

acute cerebellar ataxia

34
Q

What is contraindication to getting DTaP vaccine?

A

encephalopathy within 7 days of prior dose

35
Q

What is contraindication to getting influenza vaccine

A

severe allergic rxn to eggs

36
Q

What are contraindications to getting MMR[V] vaccine?

A
  • pregnancy
  • deficient CMI
  • prior anaphylaxis to neomycin or gelatin