Principles of immunisation

Question 1

What are the 2 types of immunity?

Answer 1

Adaptive and innate

Question 2

What gives people active adaptive immunity?

Answer 2

Immunisation vaccines

Infection or exposure

Question 3

How do people get passive adaptive immunity?

Answer 3

Placental transfer of IgG
Colostral transfer of IgA

Antibody therapy
Immune cell administration

Question 4

What are the similarities and differences between active and passive immunity?

Answer 4

Both are specific (adaptive)

Passive does not give rise to memory cells ∴ the patient is not immune

Question 5

Serum sickness is a problem associated with passive immunity. What is it and what can it lead to?

Answer 5

Administered antibodies recognised as foreign by the recipient

Results in anaphylaxis

Question 6

If active immunity gives long term memory to an antigen, why is passive immunity still used in treatment?

Answer 6

Passive immunity has a much faster effect

Question 7

What is the MMRV vaccine against?

Answer 7

Measles
Mumps
Rubella
Varicella - chickenpox

Question 8

What are the 4 types of common vaccine?

Answer 8

LAV - live attenuated

Inactivated - killed antigen

Subunit - purified antigen

Toxoid - inactivated toxins

Question 9

Vaccinations against viruses are commonly what type of vaccine?

Answer 9

LAV

Question 10

In what situations would it not be suitable to give a patient a vaccine?

(Contradictions of vaccination)

Answer 10

Febrile illness (fuck knows what that is)

Pregnancy - cannot give LAV to a pregnant woman

Allergies

Immunocomprimised patients - susceptible to LAV

Question 11

What is antigenic drift?

Answer 11

Mechanism for alteration of the structure of the antigen of the pathogen

Co-infection of hosts (for example, human and avian) allows genetic re-assortments of different strains of a virus via POINT MUTATIONS

This creates a slightly different virus that has different antigens

∴ previous vaccine will not grant immunity to this new virus

Question 12

What does the cold chain network ensure?

Answer 12

Maintains quality of vaccines through their transport process, by ensuring the vaccines are transported in the correct temperature ranges

Question 13

Who are neonates?

Answer 13

Newborn infants

most vulnerable to infection at ages up to 18-24 months

Question 14

What is a subunit vaccine?

Answer 14

Presents the antigen

But does not introduce the actual viral particle

Question 15

Although subunit vaccines are generally very safe and easy to standardise, they are not very immunogenic.

What does this mean, and what must be given in the vaccine to help this?

Answer 15

They are not very good at triggering an immune response

Adjuvants are given with the vaccine - these are substances that enhance a body’s immune response to an antigen

Question 16

What is a potential problem with toxoid vaccines?

Answer 16

They only induce immunity to the toxin

Do not produce immunity to the organism that produced the toxin

Question 17

Give 2 examples of diseases vaccinated against with toxoid vaccinations.

Answer 17

Tetanus

Diptheria

Question 18

Give 2 examples of subunit vaccinations.

Answer 18

Hep B surface antigen (HBsAg)

Human papilloma virus (HPV) proteins

Acellular pertussis (aP) vaccine

Haemophilus influenzae type B (Hib)

Pneumococcal (PCV-7, PCV-10, PCV-13)

Question 19

Describe the attenuation mechanism

how LAV’s are made and why this makes them safe

Answer 19

Virus cultured in human cells

Transferred and grown in monkey cell culture

Virus acquires mutations that allow it to grow well in monkey cells

Virus no longer grows well in human cells (is attenuated) so can be used in vaccine

Question 20

Which vaccine type usually requires booster shots?

Answer 20

Killed whole organism / inactivated

Question 21

Which vaccine type usually requires refrigeration?

Answer 21

Live attenuated

Question 22

What is the difference between antigenic drift and antigen shift?

Answer 22

Drift = mutations causing changes in the presented antigens

Shift = recombination of different strains to make a new strain that presents antigens from the original strains

Question 23

What is a conjugate vaccine?

Answer 23

One in which a poor (usually carbohydrate) antigen is bonded to a stronger protein antigen

So it causes a greater immune response

Question 24

Conjugate vaccines are mainly used against what type of pathogen?

Answer 24

Bacteria

Question 25

What type of cancer is caused by human papilloma virus?

Answer 25

Cervical cancer

Question 26

What do checkpoint inhibitor antibodies do?

Answer 26

Block proteins on tumour cells or the receptors for them on T cells

Cancer would normally evade immune system attack by binding to the receptor

So the immune system attacks the tumour cells

Question 27

Immunotherapy basically aims to…

Answer 27

Improve or restore immune system function, so that it fights cancers in the body

Question 28

Give a examples of a Live attenuated vaccine (LAV) in clinical usage

Answer 28

Tuberculosis (BCG)

Oral polio vaccine (OPV)

Measles

Yellow fever

Rotavirus

Question 29

What diseases are vaccinated against using inactivated (killed) vaccines?

Answer 29

Whole cell pertussis - wP

Inactivated polio virus (IPV) - against polio

Question 30

Hypogammaglobulinaemia is a condition in which serum antibody levels become dangerously low

How is it treated?

Answer 30

primary or secondary
Infusion of γ-globulins to reduce infection

This is an example of artificial passive immunity

Question 31

Give an example of natural passive immunity?

Answer 31

Maternal transfer of immunoglobulins to a developing foetus

Question 32

Give 3 examples of natural sources of passive immunity

Answer 32

Snake/spider bites and scorpion/fish stings - antibodies specified against the toxin are administered

Infusion of γ-globulins to treat Hypogammaglobulinaemia

Prophylactic treatment of rabies - antibodies against the virus are injected post exposure