MICRO: Vaccines Flashcards

1
Q

Define variolation.

A

Deliberate infection with smallpox in the hope that a mild infection would follow and subsequent protection

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2
Q

Define R0.

A

The number of people that one sick person will infect on average / i.e. the basic reproductive rate

  • Higher in a totally susceptible population
  • If below 1 then transmission of disease is halted
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3
Q

Which of these viruses is most contagious?

HIV/ SARS.Measles/Hep C/Ebola

A

Measles

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4
Q

Define herd immunity. What is HIT?

A
  • HI = a form of immunity that occurs when vaccination of a significant proportion of the population provides a measure of protection for individuals that are not immune
  • HIT = Herd Immunity Threshold = percentage of fully immune individuals required to stop spread
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5
Q

HIT equation?

A

1 - 1/R0 = HIT

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6
Q

Which immune response is important in attenuated virus vaccines?

A
  • If an attenuated virus vaccine is used, the T cell response is very important in destroying infected cells
  • At the end of these processes, the main goal is to produce memory cells to the vaccine antigen
    • Memory B cells
    • Memory killer T cells
    • Memory T helper cells
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7
Q

What are the benefits of antibodies?

A
  • Antibodies (produced by plasma cells) lead to:
    • Neutralisation of infectivity
    • Antibody-dependent cellular cytotoxicity
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8
Q

Should live vaccines be avoided if…

A

1 and 2

But premature babies can also have a premature immune system.

Igs = may not produce immune response

High dose steroids = immunosuppressed

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9
Q

What are the advantages and disadvantages of inactivated vaccines? Give some examples.

A
  • Inactivatede.g. Influenza, Polio (OPV = live attenuated; IPV = inactivated), Cholera
    • Whole microorganism is destroyed by heat, chemicals, radiation or antibiotics –> no risk of causing infection
    • Advantages: :
      • Stable
      • Constituents clearly defined
      • Unable to cause infection
    • Disadvantages
      • Local reactions common
      • Adjuvant needed
      • Need several doses (shorter lasting immunity)
      • Shorter lasting
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10
Q

What are some examples of live attenuated vaccines? What are the advatages/disadvantages?

A
  • Live Attenuatede.g. MMR, yellow fever
    • Live organisms are modified to be less virulent (there is, however, a risk of virulence)
    • It is avoided in pregnant women and immunocompromised patients

A:

  • Multiple antigens
  • Long lasting immunity
  • Sttrong immune response

D:

  • Not for immunosuppressed
  • Can directly cause the illness
  • Potential for contamination
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11
Q

Give examples of toxoid vaccines.

A
  • Toxoid Vaccines – e.g. Diphtheria, Tetanus
    • Inactivated toxin components
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12
Q

What is an important consideration of subunit vaccines? Give some examples.

A
  • Subunit – e.g. HBV, HPV
    • Protein components of the microorganism or synthetic virus-like particles are used - MUST CHOOSE CORRECT COMPONENT
    • They lack viral genetic material and are unable to replicate
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13
Q

Give examples of conjugate vaccines. Describe them.

A
  • Conjugate – e.g. NHS bacteria vaccines, flu vaccines (?)
    • Poorly immunogenic antigens are paired with a protein that is highly immunogenic (adjuvant)
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14
Q

What is an example of heterotypic vaccines?

A
  • Heterotypic – e.g. BCG (bovine strain)
    • Using pathogens that infect other animals but do NOT cause disease in humans or causes mild disease
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15
Q

Give an example of viral vectored vaccines.

A
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16
Q

Give examples of nucelic acid vaccines.

A

Directly encapsulated in lipid particles.

Quite unstable so can degrade in light/heat.

No DNA vaccines exist yet - worry about integration into human genome

17
Q

Describe monovalent vs multivalent.

A
  • Monovalent = targeting one strain
  • Multivalent = targets several strains
18
Q

What is the risk of components in vaccines?

A

Anaphylaxis

19
Q

What are the determinants of primary vaccine immune response?

A
20
Q

What are the detrminants of duration of vaccine response?

A

Learn main column

21
Q

What are the common components of vaccines?

A
  • Stabilisers are substances added to keep it chemically stable for transport from the site of production to the site of use
  • Aluminium hydroxide is a commonly used adjuvant
  • Preservatives are particularly important for multi-use vaccines where you don’t want the vials to be contaminated
  • Antibiotics are used to prevent contamination
  • Some trace components are left from the vaccine manufacture process
22
Q

What are the contraindications/precautions for all vaccines/DTP/ influenza/ live vaccines?

A
23
Q

What are some vaccination programme considerations?

A
  • Vaccination should be administered before the peak-age-incidence of the disease
  • Vaccination programmes either targeted towards high risk groups or widely disseminated to everyone
  • Effective R0 needs to be <1
  • Catch up campaigns to pick up anyone that missed vaccinations should be considered
24
Q

What are the barriers to vaccination?

A

Access e.g. need good healthcare system, fridges etc

Anti-vaccination

25
Q

What are the prerequisites for successful disease eradication?

A
  • No animal reservoir
  • Antigenically stable pathogen with only one/few strains
  • No latent reservoir of infection and no integration of pathogen genetic material into the host genome (e.g. can’t eradicate HSV)
  • Vaccine must induce a lasting immune response
  • High coverage required for very contagious pathogens (e.g. measles)