PHRM 825: Immunizations Flashcards
Which type of immunity provides nonspecific, generalized defense against a wide variety of pathogens?
Innate
Which type of immunity is considered the first line of defense against invading pathogens?
Innate
Which type of immunity generates immunological memory which provides protection against the specific pathogen upon subsequent exposure?
Acquired immunity
Which type of immunity includes physical barriers, physiologic factors, processes, and immune cells?
Innate immunity
Which type of immunity has humoral and cell-mediated immunity?
Acquired
It is considered ____ immunity when a patient receives antibodies against a pathogen
Passive
It is considered ____ immunity when a patient is exposed to an antigen
Active
____ immunity provides immediate protection
Passive
____ immunity triggers the immune system to produce disease-specific antibodies
Active
Antibodies transmitted from mother to newborn during last trimester of gestation is an example of ___ immunity
Passive
Patient receives an antibody-containing product (IVIG, HBIG) is an example of ____ immunity
Passive
____ immunity takes weeks to produce protective level of antibody but lasts years
Active
What is humoral immunity?
When the adaptive immune system is activated by the innate immune system and triggers specific B-cells to develop into plasma cells
What type of immunity secretes large amounts of antibodies?
Humoral
What do antibodies secreted during humoral immunity do?
- Bind to antigens and mark the pathogen for destruction by phagocytes
- Bind to antigens and activate the complement
- Bind to antigens so that the antigen can no longer recognize host cells
What is cell-mediated immunity?
Adaptive immune response that is primarily mediated by thymus-derived small lymphocytes, which are known as T-cells
What do T helper cells do during cell-mediated immunity?
Stimulate B-cells to secrete antibodies, activate phagocytes, activate T-killer cells, and enhance the activity of NK cells
What do T killer cells do during cell-mediated immunity?
Recognize and destroy cells infected by viruses
The secondary immune response is ___ and ___ than the primary immune response
Faster and larger
What is heard immunity also known as?
Community immunity
What is heard immunity?
When immunized individuals protect those who are not immunized
How is a live attenuated vaccine made?
“Wild” virus or bacteria are modified in a laboratory
What type of vaccine still has the ability to replicate and cause disease, but is weakened?
Live attenuated
How is an inactivated vaccine made?
Produced by growing virus or bacteria in a laboratory and inactivating with heat or chemicals
What type of vaccine cannot replicate and cannot cause disease?
Inactivated
What 7 vaccines are live attenuated vaccines?
- MMR
- Rotavirus
- Typhoid
- Vaccinia (smallpox)
- Varicela
- Yellow fever
- Zoster (Zostavax)
What 10 vaccines are inactivated vaccines?
- Anthrax
- Haemophilus influenzae type B
- Hepatitis A and B
- Human papillomavirus
- Influenza (injectable)
- Meningococcal
- Pneumococcal
- Poliovirus (IPV)
- Zoster (Shingrix)
- Tetanus combinations (DTaP, Tdap, Td, etc)
When are toxoids used
When a bacterial toxin is the main cause of an infection
How are toxoids made?
Inactivation of toxin by heat or chemical treatment into a toxoid
How does the immune system fight against toxins after a toxoid vaccine is given?
Immune system produces antibodies that lock onto and block the toxin from being released
Which vaccine includes only the antigens that best stimulate the immune system?
Subunit vaccines
Which type of vaccine is associated with fewer adverse effects than whole vaccines?
Subunit
How many antigens can a subunit vaccine contain in one vaccine?
1-20+
What is an example of a toxoid vaccine
Diptheria and tetanus toxoid in DTaP
How does a polysaccharide vaccine work?
The polysaccharide outer sugar coat disguises a bacterium’s antigen
Immature immune systems (<2 years old) cannot recognize and respond to which vaccine?
Polysaccharide
What do conjugated vaccines contain?
An antigen or toxoid-linked polysaccharide
How is hepatitis B spread?
Via blood or body fluids
What disease can cause liver damage and failure
Hepatitis B
Hepatitis B has ___ incubation and contagious time
Long
What does HBV mean?
Hepatitis B Virus
What does HBIG mean?
Hepatitis B Immune Globulin
Infants born to HBV-infected mothers should receive which 2 vaccines withing 12 hours of birth?
HepB and HBIG
How is haemophilus influenzae type B spread?
Direct contact and respiratory droplets
What is the incubation time for haemophilus influenzae type B?
~3 days
What are the clinical manifestations for haemophilus influenzae type B?
- Pneumonia
- Bacteremia
- Meningitis
What type of vaccine is the haemophilus influenzae type B vaccine?
Encapsulated aerobic gram-negative cocobacillus
Haemophilus influenzae type B is rarely seen in what population?
Children older than 5 years old
What are some examples of haemophilus influenzae type B?
ActHIB, PedvaxHIB, MenHiberix, Pentacel, PedvaxHib, COMVAX
What does the tetanus toxin do to the body?
Blocks the release of neurotransmitters preventing muscle relaxation and causing severe muscle spasms
What does the diptheria toxin do to the body?
Can attack any mucous membrane and cause tissue destruction, can also cause myocarditis and neuritis
How is pertussis transmitted and what does it cause?
Through respiratory droplets and causes whooping cough
How is tetanus transmitted?
Direct contact through broken skin
How is Diptheria transmitted?
Respiratory droplets or direct contact
What is the incubation period for diphteria?
2-5 days
What is the incubation period for tetanus?
3-21 days
What is the incubation period for pertussis?
5-21 days
How is diptheria treated?
Antibiotics
How is tetanus treated?
Immunoglobulin or antitoxin
How is pertussis treated?
Antiobiotics
What does the DTaP vaccine contain?
Diptheria and tetanus toxoids, and acellular pertussis absorbed
What most commonly occurs in later doses of DTaP?
Localized skin reactions
What is poliomyelitis caused by?
An enterovirus
How does the poliomyelitis enterovirus infect the body?
It enters through the mouth and destroys the spinal cord cells leading to flaccid paralysis of muscles while the sensory function is still intact
When was Polio eradicated?
1994
How is streptococcus pneumoniae spread?
Airborne respiratory droplets or direct contact with respiratory secretions
What are the clinical manifestations of streptococcus pneumoniae?
- Pneumonia
- Bacteremia
- Meningitis
- Acute otitis media
What is the incubation period of streeptococcus pneumoniae?
1-3 days
What is the pneumococcal PCV13 vaccine for and what does it target?
13-valent Pneumococcal conjugate vaccine (Prevnar 13) that targets 13 serotypes and is indiccated for prevention of serotypes that cause otitis media
Who is PCV13 recommended for?
- Infants and young children
- One dose for immunicompromised adults > or = 19 years
- All adults > or = 65 years
What is rotavirus caused by?
Gastroenteritis
How is rotavirus transmitted?
Fecal-oral route
What are the different types of influenza?
A, B, and C
How are influenza A viruses categorized?
2 major surface antigens
How does the influenza virus change?
It changes it’s 2 major surface antigens to evade the immune system (antigenic drift and antigenic shift)
What are the 2 major surface antigens on the influenza virus and what do they do?
- Hemagglutinin (H): helps the virus attach to cells
- Neuraminidase (N): helps the virus leave cells and spread to other cells
How is influenza spread?
- Aerosolized respiratory droplets from cough or sneeze
- Direct contact with saliva or nasal drainage
What is the incubation period for influenza?
1-4 days
What are the symptoms of influenza
High fever, nonproductive cough, fatigue, sore throat, muscle aches, headache, runny nose
How long does it take uncomplicated influenza to go away?
5-7 days
What are the risk factors for influenza?
- Age (<5 or >65)
- Pregnant women
- Residents of long-term facilities
- Chronic medical conditions
What is the inactivated influenza vaccine (IIV) indication, contraindication and when should you give the high dose?
Indicated: >6months old
High dose for >65 years old
Contraindicated: Severe egg allergy
What does MMR stand for?
Measles, Mumps, Rubella
How is MMR spread?
Respiratory transmission
What is the incubation period for measles?
7-21 days
What is the incubation period for mumps?
12-25 days
What is the incubation period for rubella?
12-23 days
Clinical manifestation of measles
Fever, malaise, cough, coryza, conjuctivitis, rash
Clinical manifestation of mumps
Pain, tenderness, parotid salivary gland swelling (in neck)
Clinical manifestation of rubella
Rash spreading from face, low fever
What is the varicella zoster virus for?
Chicken pox
How is VZV spread?
Respiratory droplet and/or direct contact with lesions
What does VZV stand for?
Varicella Zoster Virus
What is the incubation period for VZV?
10-21 days
What is the clinical manifestation of VZV?
Itchy rash, malaise, fever
How long does it take for the chicken pox to resolve?
Days to weeks
How is hepatitis A spread?
Fecal-oral or contaminated food/water
Where does hepatitis A replicate and what does it cause?
Replicates in the liver but does NOT cause chronic infection or chronic liver disease
What virus accounts for ~99% of cervical cancers?
HPV
What does HPV stand for?
Human papillomavirus
How is HPV spread
Unknowingly through sex
What are the 3 types of HPV vaccines?
HPV4, HPV2, and HPV9
How is nisseria meningitidis spread?
Respiratory transmission
What does nisseria meningitidis cause?
Meningitis
What is the incubation period for nisseria meningitidis?
3-7 days
What is the clinical manifestation for nisseria meningitidis?
Fever, headache, stiff neck, nausea, vomiting, light sensitivity, altered mental status
Meningococcal is what type of bacteria?
Encapsulated aerobic gram-negative
Pneumococcal PPSV23 vaccine is not effective in what population?
Children <2 years old
PPSV23 is recommended for who?
- Adults >65
- Children >2 years old and at high risk
- Adults 19-64 who smoke cigarettes or who have asthma
What does the Herpes zoster virus cause?
Shingles
How is shingles spread?
Direct contact with lesions
What is the incubation period for the herpes zoster virus?
Virus remains dormant from initial infection
What is the clinical manifestation of shingles?
Itchy, rash, pain
How long does it take for shingles to resolve?
Days to weeks
4 rare vaccines
- Rabies immune globulin
- Yellow fever
- Typhoid fever
- Japanese encephalitis
Rabies immune globulin
- Rabies is caused by rhabdovirus, transmitted by bite of infected animal
- Vaccinate for pre-exposure prevention or post-exposure prophylaxis with rabies immune globulin
Yellow fever
- Transmitted by infected mosquito
- Live attenuated virus
Typhoid fever
- Food and water borne illness
- Oral live attenuated vaccine or IM injection
Japanese Encephalitis
- Mosquito-born viral illness in Asia
- IM injection if spending >1 month during transmission season
Smallpox has a sudden onset of __–> ___–> ___
High fever, rash, lesions
When is smallpox contagious?
When lesions develop
How was the smallpox vaccine developed?
Developed from cowpox and tested in 7 year old boy
What can anthrax cause?
Cutaneous, gastrointestinal, meningitis, shock
Where does bacillus anthracis live and what does it cause?
In soil and can infect animals; anthrax
Palivizumab (Synagis) is what kind of infection?
Respiratory syncytial virus (RSV) infection
What can RSV cause?
Cold-like illness, pneumonia, and bronchiolitis
What viral infection infects most infants by 1 year and almost everyone by 2?
Respiratory syncytial virus (RSV)
The Palivizumab vaccine for RSV contains what kind of antibody and provides what kind of immunity
Monoclonal antibody and passive immunity
Where are adverse effects related to vaccines reported ?
Vaccine Adverse Event Reporting System (VAERS)
What is VAERS?
National vaccine safety surveillance program that monitors for reported adverse events requiring further investigation
What type of vaccine should pregnant women not receive?
Live attenuated
Who can provide vaccines in the pharmacy profession?
Pharmacists and pharmacy interns
What is CHIRP
Vaccine registry for indiana residents