M11: Prophylactic Immunisation

Question 1

What is natural active immunity?

Answer 1

Follows clinical or subclinical infection

Question 2

What is artificial active immunity?

Answer 2

Induced by vaccination

Question 3

What is natural passive immunity?

Answer 3

Due to trans-placental maternal IgG antibody which protects child for first few months of life

Question 4

What is artificial passive immunity?

Answer 4

By injection of pre-formed antibody derived from serum of man or animals

Question 5

What are horse antitoxins used to treat?

Answer 5

Treatment in suspected cases of diphtheria and botulism

Question 6

What is HNIG?

Answer 6

• Human normal immunoglobulin

- Protective levels of antibody to a range of diseases present in pooled normal human serum

Question 7

What are the properties of an ideal vaccine? (6)

Answer 7

• Promotes effective immunity
• Confers lifelong protection
• Safe (no side effects)
• Stable
• Cheap
• Seen to be good and effective

Question 8

What is a toxoid vaccine?

Answer 8

• Use of inactivated toxin

- Useful for conditions where symptoms of a disease can be attributed essentially to the effects of a single toxin

Question 9

Give 2 examples of toxoid vaccines

Answer 9

• Tetanus vaccine

- Diphtheria vaccine

Question 10

What is an inactivated vaccine?

Answer 10

Use of killed organisms to stimulate production of antibodies

Question 11

Give 2 examples of inactivated vaccines

Answer 11

• Typhoid vaccine

- Influenza vaccine

Question 12

What is an attenuated live vaccine?

Answer 12

• Use of living organisms with reduced virulence (attenuated) but still immunogenic
• Multiply in the body and mimic natural infection with antibody production but without symptoms

Question 13

Give 2 examples of attenuated live vaccines

Answer 13

• MMR vaccine

- Yellow fever vaccine

Question 14

What are some safety problems that may arise when preparing a vaccine? (4)

Answer 14

• Contamination
• Inadequate inactivation of killed vaccine.
• Reversion to virulence of attenuated vaccine
• Residual toxicity of toxoids

Question 15

Which antibody is predominately produced from the 1st injection of an inactivated or toxoid vaccine?

(Primary response)

Answer 15

IgM antibody

Question 16

Which antibody production increases during a secondary response?

Answer 16

IgG antibody

Question 17

Some toxoids & inactivated vaccines contain adjuvants, what are these?

Answer 17

Substances which enhance the antibody response

Question 18

Give 2 examples of adjuvants

Answer 18

• Aluminium phosphate

- Aluminium hydroxide

Question 19

Vaccine uptake rate must exceed what % for herd immunity to operate well

Answer 19

90%

Question 20

What are 2 main problems associated with immunisation in first few months of life?

Answer 20

• Infant immune system is not fully developed at birth and capacity to make antibody is limited
• Trans placental maternal antibody may prevent a response to live virus vaccines and reduce that to some killed vaccines.

Question 21

What may be a benefit of combined vaccines?

Answer 21

May enhance antibody production

Question 22

What is the time frame between administering two separate live vaccines?

Answer 22

3 weeks apart

Question 23

Which vaccine uses the mouth as a route of administration?

How does this work?

Answer 23

• Oral polio vaccine (OPV)

- Enables virus to colonise gut and promote both local and humoral antibodies

Question 24

Majority of vaccines are administered how?

What are the preferred sites?

Answer 24

• Subcutaneous and intramuscular injection
• Anterolateral aspect of thigh
• Upper arm

Question 25

What is the route of administration of the BCG vaccine?

Answer 25

Intradermal injection

Question 26

What may be some side effects of some vaccines?

Answer 26

• Pain
• Erythema (reddening)
• Fever
• Malaise

Question 27

What is a rare side effect of a vaccine?

Answer 27

Anaphylactic reactions

Question 28

When may you not administer a vaccine to someone? (5)

Answer 28

• If previous severe reaction to that vaccine
• If patient has acute illness
• No live vaccine to immunocompromised patients
• No live vaccine to pregnant women
• No BCG vaccine to HIV +ve or AIDS