Vaccination Flashcards

1
Q

Childhood Vaccination Schedule

A

2 Months - DTaP/IPV/HiB - Pneumococcal conjugate vaccine
3 Months - DTaP/IPV/HiB - Meningitis C
4 Months - DTaP/IPV/HiB - PCV - Mengitis C
12-13 Months - HiB/Men C - PCV - MMR
3 Years 4 Months - DTaP/IPV - MMR
13-18 Years - Td/IPV

Girls 12-13 Years - HPV

D - Diphtheria
T - Tetanus
aP - acellular Pertussis
IPV - Inactivated Polio
HiB - Haemophilus influenze type b
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2
Q

Vaccinations given to at risk groups?

A

Anthrax, Hep A/B, Men ACWY, Rabies, Varicella (if not immune)

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3
Q

Travel Vaccinations?

A

Cholera, Hep A/B, Jap Encheph, Tick-Bourne Encheph, Typhoid, Yellow Fever

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4
Q

Central Memory cells - where are they found?

A

Found in Lymph nodes and tonsils - roll along and extravasate in High Endothelial Venules (HEVs)

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5
Q

Central Memory Cells - what do they produce?

A

Produce IL-2 (to support other cells)

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6
Q

Central Memory Cells - in which population CD4/CD8 are they more prevalent in?

A

More central memory in CD4 population

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7
Q

Central Memory Cells - CCR7? CD62?

A

CCR7+ and CD62L+

Allow entry via HEVs to lymph nodes

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8
Q

Effector Memory Cells - Where are they found?

A

Liver and Lungs and Gut

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9
Q

Effector Memory Cells - CCR7? CD62?

A

CCR7-ve and CD62 low (therefore not found in lymph nodes

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10
Q

Effector Memory Cells - What do they produce?

A

Perforin and IFN- gamma

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11
Q

Effector Memory Cells - in which population CD4/CD8 are they more prevalent in?

A

More effector memory in CD8 population

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12
Q

How does CCR7 have its effects?

A

binds CCL19 and CCL21 present on the luminal surface of endothelial cells in lymph nodes which causes firm arrest and the initiation of extravasation

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13
Q

how does CD62L have its effects?

A

Interacts with a molecules on HEV, which mediates attachment and rolling

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14
Q

B cell Memory - what are they? what are their effects/ what do they produce?

A

Memory cells that can differentiate into plasma cells

Quicker response, more antibodies, higher affinity antibodies, more IgG and generally better antibodies

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15
Q

T helper cell response - Th1?

A

Cell mediated, involved cytokines IL-2, IFN-gamma, TNF

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16
Q

T helper cell response - Th2?

A

Humoral response, involves cytokines IL-4/5/6

17
Q

Live Vaccines - Advantages?

A

Life long immunity - no booster required

Immune response to several antigens and protection against cross reactive strains

18
Q

Live Vaccines - Disadvantages?

A

Careful in immunodeficent patients

Reversion to Virulence

Harder to store

19
Q

Live Vaccines - Examples?

A

Sabin polio (oral no longer used)

MMR

Chicken pox (varicella)

Yellow fever

BCG

Typhoid

20
Q

Inactive Vaccines - Advantages?

A

Easy Storage

Cheaper

Safe in ID patients

No Mutation/reversion

Can eliminate wild-type virus from community

21
Q

Inactive Vaccines - Disadvantages?

A

Poorer and shorter immunity

Repeated boosters, adjuvants to combat this

22
Q

Inactive Vaccines - Examples?

A

Inactivated - Salk (polio), Anthrax, Cholera, Bubonic Plague, Hep A, Rabies, Pertussis

Component - Hep B (HbS antigen), HPV (Capsid), Influenza (haemagglutinin, Neuraminidase)

Conjugate - Tetanus (exotoxin), HiB

Toxoids - Diphtheria, Tetanus

23
Q

What are Adjuvants in Vaccination?

A

Increase the immune respomnse without altering its specificity

24
Q

ALUM Adjuvant - how does it work?

A

Provides slow release antigen to help prime the immune response. Activates Gr1+ cells to produce IL-4 -> helps prime naive B cells.

Generally safe and mild, therefore commonly used

25
Q

CpG Adjuvant - how does it work?

A

Unmethylated motif with 2 Purines at 5’ end and 2 pyrimidines at 3’ end - acts as an immunostimulatory adjuvant. Activates TLRs on APCs stimulating expression of costimulatory molecules

26
Q

Complete Freund’s Adjuvant - how does it work?

A

Water-in-oil emulsion containing mycobacterial cell wall components. Mainly for animals, painful in humans

27
Q

Immune Stimulating Complex (ISCOMS) Adjuvant - How does it work?

A

Experimental, multimeric antigen with adjuvant built in

28
Q

How is the Mantoux test carried out?

A
  • Inject 0.1ml of 5 tuberculin units intradermally, examine arm after 48-72hrs
  • A positive result is indicated by redness and an iduration (swelling that can be felt) of at least 10mm in diameter. This implies previous exposure to tuberculin protein - thus it could represent previous BCG exposure
29
Q

Passive Vaccines - Giving Immunoglobulins - what diseases are they given for?

A
Hep A and Measles - HNIG
Hep B - HBIG
Rabies - HRIG
Varicella - VZIG
RSV - Paviluzimab