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MLSCI 475 > Vaccination > Flashcards

Vaccination Flashcards

1
Q

What is the purpose of vaccination?

A

disease prevention = for individual and community

prevention of common diseases or prevent spread of outbreaks

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2
Q

passive prevention of disease

A

maternal antibodies (placental transfer, breastmilk), antitoxins (tetanus fo ex), IVIg (specific and broad)

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3
Q

active prevention of disease

A

natural infection
vaccines
toxoids

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4
Q

T or F. Passive immunity can be artificial or natural

A

T

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5
Q

characteristics of a good vaccine

A
  • effective = elicit correct response for the organism
  • safe = minimal side effects; no disease
  • inexpensive
  • long term protection
  • manufactured quickly
  • easy to administer (1 dose, no refrigeration)
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6
Q

immune response required for viruses

A

cell-mediated
- cytotoxic T cells
- Th1, IL-2, IFNy, TNF

antibody
- can aid in prevention and spread of virus
- neutralization (bind surface to prevent attachment)
- complement activation

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7
Q

describe the antibody-mediated response to extracell bacteria

A
  1. toxin neutralization
  2. complement-mediated lysis
  3. opsonization and phagocytosis (Ig + Comp)
  4. anaphylatoxin = mast cell degranulation
  5. chemotaxis
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8
Q

define efficacy

A

ability of vaccine to elicit a response

measured in the individual (Ab level)

clinical trials

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9
Q

define effectiveness

A

ability of vaccine to reduce disease in the community

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10
Q

IMPACT

A
  • Immunization monitoring program ACTive)
  • across Canada
  • pediatric hospital-based surveillance network
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11
Q

CAEFISS

A

Canadian adverse events following immunization surveillance system

  • national monitoring (PHAC)
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12
Q

vaccine complications

A
  • adverse rxns
  • vaccine additives - allergens
    > egg protein, latex, gelatin
    > neomycin, streptomycin, gentamycin, polymyxin
    > thimerosal
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13
Q

inactivated vaccine

A
  • killed by heat, chemical, irradiation
  • stable
  • humoral response
  • side effects
  • requires boosters (need to see Ag over and over to get plasma cells to produce memory B cells)
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14
Q

whole organism vaccines

A

bacteria or viral particles

inactivated

live attenuated

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15
Q

live attenuated

A
  • same parent organism, just not pathogenic (avirulent strain)
  • good efficacy (one repeat)
  • poor stability (needs refrigeration)
  • humoral and cell-mediated response
  • few side effects
  • may revert to virulent form
  • immunosuppressed/immunocompromised
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16
Q

subunit vaccine

A
  • component of organism used (purified macromolecule)
  • fewer side effects
  • polysaccharide requires conjugate
  • many capsular polysaccharide strains
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17
Q

types of subunit vaccine

A

inactivated exotoxin (toxoid)
polysaccharide
recombinant microbial antigen

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18
Q

this outlines policy and regulations regarding publicly funded immunizations

A

Alberta Immunization Policy
- Alberta Ministry of Health
- Provincial Legislation (Public Health)

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19
Q

these governing bodies ensure access, safety, education, training, reporting, research, and evaluation

A

CMOH with government and AHS

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20
Q

DTaP-IPV-Hib-HB

A

DIPHTHERIA, TETANUS, ACELLULAR PERTUSSIS

INACTIVATED POLIO VIRUS

HAEMOPHILUS INFLUENZAE TYPE B

HEP B

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21
Q

how often do you get a tetanus shot as an adult?

A

every ten years

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22
Q

HiB

A

Haemophilus influenzae type B
- encapsulated = phagocytosis and complement resistant
- bacteremia, pneumonia, epiglottitis, meningitis
- most common cause of bacterial meningitis in children under 5 prior to vaccine
- conjugate vaccine

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23
Q

T or F. HiB vaccine is a polysaccharide vaccine

A

T!

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24
Q

Disadvantages of HiB polysaccharide vaccine

A
  • no memory
  • IgM response only
  • T-independent
  • does not work in children under 2 y/o
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25
Q

pneumococcal disease

A
  • S. pneumoniae
  • pneumonia, sepsis, meningitis
  • multiple strains/serotypes
  • polysaccharide
  • vaccine must be conjugated and include serotypes causing disease
  • polysaccharide vaccines ineffective in children under 2
  • PNEU-C13
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26
Q

rotavirus route of admission

A

fecal-oral route
risk group: 3 months - 3 yrs

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27
Q

symptoms of rotavirus

A

fever, vomiting, severe diarrhea

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28
Q

this can cause severe dehydration/hospitalization

A

rotavirus

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29
Q

T or F. Rotorix is available for risk groups only

A

F! Available for everyone in AB; oral vaccine

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30
Q

what type of vaccine is Rotorix?

A

live attenuated virus
- lots of side effects = GI upset
- leads parents not to get second dose

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31
Q

MMR-Var

A
  • live attenuated
  • 95% effective at one dose; 2 doses = 100%
  • less effective before 6 mos of age
  • 12-18 mos - 4 yrs if only one dose
32
Q

side effects of MMR-Var

A

mild fever, rash that can look like disease

33
Q

rare but serious side effects of measles

A

encephalitis

34
Q

rare but serious side effects of mumps

A

sterility, deafness, encephalitis

35
Q

rare but serious side effects of rubella in pregnancy

A

miscarriage, deafness

36
Q

complications of chickenpox

A

CELLULITIS, GROUP A STREP, PNEUMONIA, ENCEPHALITIS

37
Q

Shingles

A

reactivation of virus as an adult
= painful, time off work, $

38
Q

N. meningitidis

A

meningococcal disease
- septicemia, meningitis
- risk groups: children <2, 15-24 elderly
- conjugate vaccine (MenCC); 4-24 mos
> protection vs type C
- gr 9 = ACYW-135 = teens, young adults = close contact, dorms, etc.

39
Q

T or F. HPV self-resolves

A

T

40
Q

cancers caused by HPV

A

cervical, anal, vaginal, penile, head, and neck

41
Q

when is the HPV vaccine administered?

A

grade 6 = males and females

42
Q

strains of HPV

A

9
HPV-9

43
Q

non-routine vaccines purpose

A

travel
occupation
high risk group = lifestyle, health
group living facility

must pay/not free

44
Q

Hep A vaccine

A

Havrix = 1 dose = inactivated virus

Twinrix = 3 doses HAV inact/HBV recomb

45
Q

Hep A route of admission

A

fecal/oral
non-endemic to Canada

46
Q

high-risk for Hep A

A

travel to endemic areas
military
occupational workers
liver disease
high risk sexual behaviour

47
Q

Hepatitis B DNA

A

positive for virus and infectious

48
Q

Hepatitis B HBs Ag

A

positive for virus - early stage

49
Q

Hepatitis B Anti-HBs

A

end-stage of infection and immunity

50
Q

Anti-HBc

A

previous or chronic infection

  • Anti-HBc IgM/Total (see if really chronic or right afer infection)
51
Q

HBe (enveloped) Ag and anti-HBe

A

chronic infection

52
Q

HBV vaccine - we are positive for this

A

HBs Ag

53
Q

what kind of vaccine is HBV vaccine

A

recombinant subuit

54
Q

this titre for anti-HBs is considred protective

A

> /= 10 IU/L

55
Q

Dukoral

A

V. cholerae
- inactivated Vibrio strains (heat/formalin)
- recombinant cholera B toxin subunit
- oral = IgA production
= also provides protection to TEC

56
Q

T or F. Labile toxin for Vibrio and ETEC are similar

A

T, antibody response will neutralize

57
Q

T or F. Dukoral is self-administered

A

T

58
Q

how many doses for Dukoral

A

2 doses 1 wk apart prior to travel

59
Q

limitations of Dukoral

A
  • traveller’s diarrhea can be caused by other organisms
  • side effects = 50% ab pain, diarrhea
  • requires boosters
60
Q

at risk populations that require vaccines

A

transplantation workup
splenectomy pt
pregnancy
senior in long term care

61
Q

why are live attenuated vaccines not recommended for children under 12 mos

A

less effective de to passive maternal immunity

62
Q

why are live attenuated viruses not recommended for immunosuppressed individuals?

A

virus might be strong enough to cause disease

63
Q

this vaccine leads to long lasting, effective immunity (cellular, humoral) with often 1 dose

A

live attenuated virus
two doses almost 100% protection

64
Q

this vaccine requires refrigeration

A

live attenuated
- short expiry to ensure viability

65
Q

T or F. Live attenuated virus vaccines may have more pronounced side effects such as fever, rash, respiratory due to live virus

A

T

66
Q

inactivated virus vaccines characteristics

A

safe, effective, minimal side effects

produce humoral response rather than cellular response

may require multiple doses

67
Q

conjugate, subunit recomb, toxoid vaccines characteristic(s)

A
  • strong humoral responses to specific aspects of pathogen (cell wall, protein, etc.)
  • requires multiple doses and booster shots
  • toxoid provides protection against toxin, and not the organism itself
68
Q

AstraZeneca vs J&J DNA COVID vaccine

A
  • modified non-replicating chimp adenovirus
  • E1 gene replaced with Covid19 spike gene (J&J Ad26.COV2)
  • similar = only human adenovirus vs. chimp)
69
Q

side effects of AstraZeneca vaccines

A
  • rare but serious
  • vaccine-induced immune thrombotic thrombocytopenia (VITT)
  • antibodies produced against PF4
  • incidence 0.000019
70
Q

COVID mRNA vaccines

A

Pfizer and Moderna

71
Q

how do mRNA vaccines work?

A
  • mRNA encapsulated in lipid nanoparticle fuse with cells
  • mRNA produces spike protein
  • MHC I presentation
  • secreted antigen taken up by macs = MHC II presentation
  • TLR 3 = RNA
72
Q

safety and effectiveness of Pfizer and Moderna

A

95% EFFICACY AFTER TWO DOSES = PHASE 3 TRIALS

73
Q

side effects of Pfizer

A
  • pain, swelling, fatigue (mild-moderate)
  • 1-3 day duration
  • rare myocarditis in males 12-17 y/o
74
Q

T or F. Polysaccharide vaccines are not effective in children under 2 years of age

A

T! unless conjugated

75
Q

pure polysaccharide vaccines - why are they not recommended?

A

only T indenpdent immunity = no memory, lss specific, IgM only
short-lived (~2 yrs)
targets specific strains only

76
Q

pros of DNA vaccibues

A
  • induces cell mediated immunity
  • prolongs expression, enhances memory
77
Q

AstraZeneca vaccine

A
  • non-replicating virus enters cell
  • cDNA into nucleus => mRNA
  • spike proteins produced
  • MHC I display
  • secreted antigen taken up by macs (MHC II)
  • cellular and humoral
  • TLR 9

MLSCI 475 (22 decks)

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