Therapeutics - Vaccines Flashcards
3 ways that vaccine efficacy can be measured
-prevention from getting disease
-mortality (decreases mortality - ie - influenza)
-does the pt develop antibodies (hep b)
true or false
influenza vaccine is not effective in preventing young adults from getting the disease
false- it is 90% effective
2 types of immunity and differentiate
passive and active
passive - administering antibodies to a patient. immediate but short term immunity (dont reproduce)
active - administer antigen to induce an immune response
example of when we would give a “passive immunization” to a patient
to prevent contagious disease in someone recently exposed and they haven’t been vaccinated for it
ie - someone bit by rabid animal but dont have rabies vaccine - give passive immunization
2 ways in which we could give passive immunizations
administering either immunoglobulins (antibodies derived from humans) OR antitoxins (antibodies derived from animals)
human derived better tolerated
true or false
active immunizations tend to give long term immunity
true
stimulating own immune system and own memory cells
2 ways active immunizations can be administered
vaccines (derived from pathogen)
toxoids (derived from bacterial toxins)
2 categories of vaccines
live attenuated (weakened)
killed inactivated
live vaccines
weakened microorganism,
they MULTIPLY in the body and spread throughout for around 2 weeks. in this time, antigen is being processed and antibodies formed (MORE than killed AND they last longer)
true or false
inactivated vaccines do not replicate
true
thus, need more frequent boosters
which type of vaccines typically have adjuvants?
inactivated/killed - gives boost to the immune response
true or false
when giving a live vaccine, it is possible that the patient may get a mild form of the disease
TRUE
ie - chicken pox vaccine - may get very small version of a chicken pox rash
why can live vaccines not be administered to immunosuppressed patients
the organism may mutate and become pathogenic again – can get the full blown disease
true or false
ALL live vaccines should be administered in immunosuppressed patients, including pregnant patients
true
the live vaccine can cross the placenta!! CONTRAINDICATED
**which product should not be given to pregnant patient
ANY LIVE VACCINE (coming l8er
true or false
inactivated vaccines do not replicate
true
cannot cause disease
any adverse effects will be LOCAL - pain, swelling, etc
*name the 6 live vaccines
MMR
varicella
rotavirus
intranasal influenza
yellow fever
oral typhoid capsules
EVERYTHING ELSE IS INACTIVATED
name 3 bacteria that have a polysaccharide coating, and thus also have vaccines that are derived from this capsule?
step pneumoniae (pneumovax)
meningococcal vaccine
h. influenzae type b
in which population are polysaccharide vaccines not very effective?
what is another issue with polysacchraide vaccines
children less than 2. they dont boost the immune system enough
also, the titers and antibodies produced are very low
what was done in attempt to make polysacchradie vaccines more effective
conjugated polysaccharide vaccines were made. the polysaccharide is conjugated to a protein (covalently linked)
tremendously increases the effectiveness in young children
higher antibody levels and longer lasting
3 examples of conjugated polysaccharide vaccines
pneumococcal conjugate
meningococcal conjugate (MCV4)
Hib (haemophilius influenza type B)
how often are the CDC immunization schedules updated
once a year
note to self
you can always given vaccines later than scheduled, even the 2nd in a 2 dose series - you’re just delaying the effects
however, if you give 2nd dose EARLIER than recommended, it doesnt count and doesnt work
can you give 2 or more live vaccines at the same time
YES - but has to be same day OR separated by 4 weeks
1 vaccine preventable disease that causes fatalities
influenza
anyonw ___ and older gets the flu shot
6 months and older
true or false
a young person and older person get the influenza vaccine. they work equally as well in both patients at preventing the disease
FALSE - prevention is much better in younger people (~90% effective), but effectiveness decreases as you get older
every year, new influenza vaccine formulation comes out. this contains ____ type A strains and ____ type B strains
2 type A
1 type B
*general recommendation on when to immunize for flu
start at september, aim to have everyone immunized by end of october
name 3 influenza products that are preferred for patients 65 and older
Fluzone High-Dose
Fluad
Flublok
differentiate between Fluzone High dose vs fluad vs floblok
all are preferred for ages 65 and older
fluzone high dose is 4x the standard dose (4x the antigen) and thus has more side effects
fluad contains an adjuvant to boost the immune response
flublok is recombinant DNA and has 3x the standard dose (antigen)
true or false
we can give any influenza vaccine to a patient 65 and older
TRUE
fluzone high dose, fluad, and floblok are preferred, but not required
ONLY live influenza vaccine
flumist - intranasal
true or false
flumist produces much less antibodies than the other influenza vaccines
TRUE - even tho it’s the only live one, its given intranasal — can only replicate in the sinus
who is flumist indicated for
2-49 years old – only HEALTHY patients
differentiate between prevnar vs PPSV23
PPSV23 is a polysacchardie vaccine that produces a low amount of antibodies and is not very effective
prevnar13/20 are CONJUGATED polysaccharide vaccines and are much more effective and produce a better immune response in both children and adults
differentiate between prevnar 13 and prevnar 20
prevnar 20 has 7 more strains than prevnar 13 and is much more effective
how is polio spread
fecal-oral contamination
ppl got from contaminated water a lot in the past
what does polio cause
muscle paralysis
if works way to diaphragm, people stop breathing
explain how the live polio vaccine is better than inactivated
live vaccine will replicate in the GI tract. you will now have antibodies against polio lining the GI tract
polio is transmitted via fecal oral route. if you ingest contaminated water, it will NEVER get absorbed into the blood stream because antibodies are lining the GI
also, person is shedding the virus over 2 weeks and giving immunity to others in their household
OPV vs IPV
OPV - oral poliovirus vaccine (live)
IPV = inactivated poliovirus vaccine
is OPV used in the US
no - it’s a live vaccine, immunosuppressed can get polio still. it’s completely eradicated in the US - not worth the risk
everyone gets inactivated now
diptheria
complications from diphtheria toxin
can cause myocarditis, neuritis, and death
Tdap in pregnancy
EVERY pregnancy
only hepatitis that causes acute infection
hep A only around 30 days
how is hep A transmitted
fecal oral
