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USMLE Immunology > Vaccine Immunology > Flashcards

Vaccine Immunology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is vaccination?

A

Providing protection by utilizing pre existing components of the immune response or by inducing the generation of antigen specific memory cells

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2
Q

What are the types of immunization?

A

Active and passive. Active is the most common

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3
Q

Discuss active immunization

A

This is the injection of an antigen, often requiring additional components, immune response is generated in vivo, takes time to develop but provides long term protection due to generation of memory T cells and B cells. Potential to develop cell mediated and humoral response.

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4
Q

Discuss passive immunization

A

It is injection of pre formed antibodies, immediate protection but short term, only provides humoral immunity- pathogen needs to be susceptible to antibody mediated destruction. There’s a risk of adventitious pathogen transfer.

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5
Q

What is horse antisera (passive immunization) used against?

A

Snake venom, botulism toxin, diphtheria toxin

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6
Q

What is pooled human Ig used against? What is humanized monoclonal used against? (Passive immunization)

A

Hepatitis A or B, measles, rabies, tetanus, varicella zoster

Respiratory syncytial virus (RSV)

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7
Q

Dimeric secretory IgA is particularly effective at?

A

Preventing bacterial colonization

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8
Q

What are the general requirements for a successful vaccine?

A

Appropriate adaptive immune response, effective, stable, safe, inexpensive

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9
Q

Which infectious agents were declared eradicated following global vaccination programs?

A

Smallpox in humans in 1979

Rinderpest in cattle in 2011

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10
Q

What are the components needed in a vaccine?

A
  1. Antigen: whole organism(live attenuated or killed), subunit
  2. Carrier: provides helper T cell epitopes
  3. Adjuvant: non specifically stimulates a specific immune response; depot + DC activator causing up regulation of co stimulatory molecules CD80, CD86
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11
Q

Give examples of adjuvants

A

Aluminum salts, AS03, AS04, MF59, virosomes

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12
Q

Give an example of a vaccine aimed at preventing infection

A

Polio (OPV)

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13
Q

Give an example of a vaccine aimed at controlling existing infection

A

Zoster

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14
Q

Give an example of a vaccine aimed at preventing disease development post exposure

A

Rabies

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15
Q

Give an example of a vaccine aimed at preventing fetal infection

A

Rubella

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16
Q

Give an example of a vaccine aimed at preventing or controlling cancer

A

HPV/HBV

17
Q

What is the function of an adjuvant in a vaccine?

A

Stimulates antigen uptake and stimulates an immune response

18
Q

What are the advantages of live attenuated vaccines?

A
  1. Mimic natural infection thus providing appropriate responses
  2. Stimulate both humoral and cell mediated immunity
  3. Typically generate long term immunity with reduced need for booster immunization
19
Q

What are the disadvantages of live attenuated vaccines?

A
  1. There’s a slight potential to revert back to virulent form
  2. Often require refrigeration
  3. Potential for spread from vaccinee
  4. Contraindicated in immunocompromised due to risk of significant pathology
20
Q

Give examples of live attenuated vaccines

A 
Viruses 
Intranasal influenza
Measles mumps rubella 
OPV 
Rotavirus 
Varicella zoster virus 
Yellow fever

Bacterial
Oral typhoid vaccine Ty21a
Bacilli Calmette Guerin

21
Q

What are the advantages of inactivated vaccines

A
  1. Relatively easy to manufacture
  2. No possibility of reversion to virulent pathogen
  3. Safe for use in the immunocompromised
22
Q

What are the disadvantages of inactivated vaccines?

A
  1. Adjuvants required
  2. Typically requires initial 2-3 immunizations and then relatively frequent boosts
  3. Immunity can be short lived and predominantly humoral with poor cell mediated immunity
23
Q

Give examples of inactivated vaccines

A 
Hepatitis A virus 
Influenza virus 
Japanese enecephalitis virus 
Poliovirus 
Rabies 
Tick borne encephalitis
24
Q

Give examples of subunit vaccines

A

Viruses
Hepatitis B
Human papillomavirus

Bacteria
DTaP
Meningococcal serogroup B vaccines

25
Q

What is the Gardasil-9 vaccine given to females 9-26 years old for?

A

Prevention of cervical, vulvar, vaginal, anal cancer and genital warts

26
Q

What is the Gardasil-9 vaccine given to males 9-26 years old for?

A

Prevention of anal cancer and genital warts

27
Q

What are toxoid vaccines?

A

Chemically inactivated bacterial exotoxins, protect from disease but not infection. Examples are tetanus toxoid San diphtheria toxoid.

28
Q

What do conjugate vaccines do?

A

They comprise polysaccharides coupled to protein. Tetanus or diphtheria is usually the protein. Converts T independent response to T dependent response.

29
Q

What are examples of conjugate vaccines?

A

Hib
Meningococcal conjugate vaccines
Pneumococcal conjugate vaccine

30
Q

Pertactin is an example of?

A

Bacterial outer membrane protein (OMP)

31
Q

What are the two types of genetic change the influenza virus can undergo?

A

Antigenic drift and antigenic shift

Antigenic drift refers to point mutation
Antigenic shift refers to exchange of genetic material

32
Q

Which antigens in the influenza virus can undergo point mutations?

A

The neuraminidase and hemaglutinin antigens

33
Q

Give an example of antigenic shift

A

An exchange between human influenza virus and avian influenza virus. Creates a new strain of human influenza virus.

34
Q

What is the BCG vaccine?

A

Attenuated live Bacille Calmette Guerin strain of Mycobacterium bovis for TB, used in countries with high prevalence of TBto prevent childhood tuberculosis meningitis and miliary disease. Considered only for health care workers for exposure and children with negative TB skin test and at high risk

35
Q

What does success of a HIV vaccine require?

A

Requires identification of immunogens and immunization strategy that induces broad and long lasting CTL immunity together with broadly neutralizing antibodies

USMLE Immunology (13 decks)

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