Microbiology 8- Defence and vaccination against bacteria Flashcards

1
Q

Properties of a Good Vaccine

A

Stimulates an effective immune response

Safe and does not cause adverse reactions

Inexpensive

Stable

Easy to administer

Simple for both manufacturer and regulatory authorities to control

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2
Q

Describe direct protection

A

Stopping the disease affecting you if you get the disease

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3
Q

Describe indirect protection

A

Stop transmissions

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4
Q

How do we determine vaccine Safety and Efficacy

A

Phase 1 trials
Primarily for safety but are often also used to assess immunogenicity

Usually small numbers of adults

Phase 2 trials
Primarily for assessing immune response but also used to expand safety database

Typically includes all groups that are likely to use the vaccine

Phase 3 trials
Protection studies, usually placebo controlled double blind trials
provide statistically conclusive data for licensure

Require good disease surveillance
case ascertainment
definition of endpoint

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5
Q

What is the definition of vaccine efficacy and what is the formula

A

The reduction in the incidence of disease among people who have received a vaccine compared to the incidence in unvaccinated people.

1-
Attack rate in vaccinated group /Attack rate in unvaccinated group

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6
Q

What is the definition of herd immunity and what is the formula

A

Form of immunity that occurs when the vaccination of a significant portion of the population provides a measure of protection for individuals who have not yet developed immunity.

1-
Attack rate unvaccinated post-introduction
Attack rate unvaccinated pre-introduction

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7
Q

What three elements do vaccines consist of?

A

Antigen
To stimulate immune response to the target disease

Adjuvant
To enhance and modulate the immune response

Excipients
Buffer, salts, saccharides and proteins to maintain the pH, osmolarity and stability of the vaccine
Preservative

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8
Q

Typical vaccine antigens

A

Live attenuated organisms

Killed whole organisms

Purified component vaccines

Toxoids

Polysaccharide conjugates

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9
Q

What does DTaP-Hib-IPV protect against

A

Tetanus and Diptheria Toxoids

Bordatella pertussis - whooping cough

Haemophilus influenzae type b

Inactivated polio virus types 1,2 and 3

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10
Q

How does DT vaccine work

A

chemical inactivation of bacterial exotoxin

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11
Q

What is whooping cough caused by

A

Bordetella pertussis which infects ciliated epithelium and releases toxin

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12
Q

What were some side effect of the whooping cough vaccine

A

anaphylaxis
prolonged crying
febrile siezures

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13
Q

What does hib cause and why is the vaccine effective

A

H. influenzae type b causes meningitis and septicaemia in the young.

Bacterial surface covered by a polyribosyl-ribitol phosphate capsule.

Polysaccharides are poorly immunogenic

The Hib component is a conjugate vaccine

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14
Q

What is a conjugate vaccines

A

Carbohydrate chemically linked to immunogenic protein.

T cell recognition of protein carriers enhances B cell activation

Promotes efficient antibody response to polysaccharide capsule

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15
Q

How do conjugate vaccine work

A

some bacteria have polysaccharide antigens and injecting them wouldn’t really stimulate a strong enough response because they’re not taken up by antigen presenting cells and presented because they’re not peptides so you dont get t cell immunity

if u inject the polysaccharide with a conjugate protein then it’ll be presented on APC and you get T cell immunity not just antibodies (and you’d only get IgM and IgD antibodies without T cell help anyway)

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16
Q

How do vaccines for group B meningococcal disease work

A

They target outer membrane vesicles which have all the same antigens as the bacteria

17
Q

What are adjuvants?

A

They potentiate the immune response (humoral, cellular or both).

18
Q

What are the two types of adjuvants

A

Delivery systems

Immune potentiators

19
Q

4 strategies Pathogenic bacteria have to avoid host defences

A

Resist Complement
Having thick cell wall - Mycobacterium tuberculosis
Capsule - Neisseria meningitidis

Resist Antibodies
Antibody protease - Streptococcus pneumoniae
Antigenic variation - Neisseria gonorrhoeae

Resist Phagocytosis
Polysaccharide capsule - Neisseria meningitidis
Debilitate phagocytes - Yersinia pestis
Hide inside other cells - Chlamydia

Inhibit Intracellular Killing
Escape from phagosome - Listeria monocytogenes
Block phagosome maturation - Mycobacterium tuberculosis