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Microbiology Midterm 2 > Vaccines > Flashcards

Vaccines Flashcards

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1
Q

what is immunization

A

this is the use of a specific immune response to prevent or lessen the severity of disease resulting from infection or the products of an infection (e.g., toxins)

taking advantage of the ability of the adaptive immunity to form specific ling-lasting responses

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2
Q

what are the objectives of immunization

A

individual protection from infection
- may be for the general population or specific risk groups

when a sufficient number of people are immune, infecting agents can not circulate in a population

elimination of infecting organism may be possible (very hard though)

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3
Q

what is herd immunity

A

protects those people who remain susceptible (society protection)

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4
Q

who is unable to be vaccinated sometimes

A

immunocompromised

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5
Q

How do antibodies work

A

may bind to an antigen and block its biological activity (“neutralizing antibody”)

coat the bacterium and make it more easily phagocytksed by an immune cell because its more identifiable

Bind to an organisms and activates complement to cause lysis and recruit immune cells to the area

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6
Q

what are neutralized antibodies

A

antibodies that stick to key antigens on a pathogen so they cant bind to certain receptors

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7
Q

What is opsonization

A

improves clearance of organisms when macrophages can find and chew they up makes phagocytosis easier

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8
Q

Antibodies are produced by ___ that are activated to become ____

A

B lymphocytes

plasma cells (go through the bloodstream)

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9
Q

Each ___ produces an ___ that is ____ for its target

A

plasma cell

antibody

specific

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10
Q

When stimulated by an infection or vaccine the ____ cell clone ___

A

specific B cell

multiplies

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11
Q

What do some of B cells become

A

memory cells and are long lived to allow a rapid response to subsequent exposure

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12
Q

What are T cells

A

specific T lymphocytes also survive as memory T cells and remain to regulate the immune response for cells that don’t look right or are cancerous

On re-exposure to the antigen they will multiply and shorten the time to a response

T lymphocytes regulate the immune response and cytotoxic T cells kill infected cells

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13
Q

What is passive immunization

A

The host receives antibody produced by another host (no memory component)

This protection is short lived (2-3 months) and no long term protection is generated

Ex. IVIG (polyclonal, random antibodies in here not directed at a specific antigen), Hepatitis B Ig (HBIG), Varicella Zoster Ig (VZIG), Rabies Ig, RSV

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14
Q

How does passive immunization work

A

naturally occurring

therapeutic

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15
Q

what is naturally occurring passive immunization

A

the neonate receives antibody transplacentally from the mother, or in colostrum (breast milk) this is based on what the mother is exposed to

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16
Q

What is therapeutic passive immunization

A

antibody (immunoglobulin or Ig) is given

to provide rapid protection after a potential exposure to an agent. e.g., after a needle stick

to lessen the severity of ongoing disease, e.g., antibody given in necrotizing fasciitis

for individuals unable to produce antibody

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17
Q

wheat is active immunization

A

the generation of immunity by administering an antigen to elicit an immune response in the host

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18
Q

What are the types of active immunization

A

live attenuated (MMRV)

virus vectors, replicating/non-replicating

inactivated whole cell, subunit, virus like particles

DNA, RNA (COVID-19 mRNA vaccine

Toxoid

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19
Q

How do live live attenuated immunizations work

A

these use organisms which are limited in their ability to cause disease but share antigenicity with the virulent forms

eg., against TB in infants

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20
Q

how are live attenuated immunizations made

A

attenuated (whimsy version of the organism) are those that have been repeatedly cultured in the lab until they have lost their virulence properties

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21
Q

How are live attenuated immunizations administered

A

need not be by injection, and may mimic the natural route of infection

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22
Q

what is the advantage of live attenuated immunizations

A

that they mimic a natural infection and give stronger and long term immunity, and may not need booster doses

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23
Q

what are the disadvantages of live attenuated immunizations

A

they may be virulent for immunosuppressed people or in pregnancy

They may revert to the virulent form during the infection in the host

they must be handled properly to maintain viability until they are used (need refrigeration) harder to transport and store, need to be kept at -80 degrees Celsius

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24
Q

what type of immunization is BCG

A

vaccine used for tuberculosis

a live attenuated

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25
Q

what type of immunization is used for MMRV

A

= measles/mumps/rubella/varicella

is routinely in childhood and has been very successful in largely eradicating these diseases in the immunized

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26
Q

what is the Sabin polio vaccine

A

this agent was used to eradicate polio in the Western Hemisphere, it was cheap and gave IgA immunity in the git

oral version

it reverted to the virulent form and so as wild type polio disappeared, the vaccine became more dangerous than the risk of acquiring the disease, and so it was replaced by the killed (Salk) polio vaccine. some places use a combination series of the two types

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27
Q

What are replicating virus vectors

A

viruses that don’t cause human disease are engineered to express (or cause the expression) of target virus protein

this allows an immune response to the target virus without infection by it

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28
Q

How do replicating virus vectors work

A

genes for the the relevant protein are inserted into the virus vector

mimics a real infection to give a strong immune response

ex. ebola vaccine

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29
Q

What is a non replicating viral vector

A

a carrier virus (for example an adenovirus) is treated so it can not replicate or cause disease

30
Q

How do non replicating viral vectors work

A

a gene from the target virus is added to the carrier virus so that it expresses the target virus protein

gives a better immune response than a protein subunit vaccine

more easily transported and stored than vaccines needing replicating virus

31
Q

What are types of inactivated vaccines

A

whole cell, subunit and virus like particles vaccines

32
Q

What are inactivated vaccines given with

A

often given with a substance that increases their immunogenicity

given with an “adjuvant” that helps boost the response, e.g., alum to increase antibody levels

conjugation of polysaccharides to protein improves response

boosters maintain effectiveness

33
Q

What are examples of inactivated vaccines

A

influenza vaccine, hepatitis A vaccine

34
Q

How are inactive vaccines administered

A

given by injection and there they do not give a local IgA response (mucosal immunity)

require multiple doses at specific intervals

immunity wanes over time so that reimmunization be required

they give an antibody response but not cell mediated immunity

35
Q

What are subunit vaccines made from

A

purified antigens derived from the pathogen and which are found to produce an effective immune response (little pieces of antigens, want body to recognize and neutralize)

these vaccines are less prone to side effects than whole cell and are often very effective but are expensive (as specific proteins desiring them)

36
Q

What are examples of subunit vaccines

A

hepatitis B vaccine where the outer coating (surface antigen) is used

haemophilia influenzae typ B, pneumococcal, and meningococcal vaccines (menigitis types!!) are prepared from bacterial polysasccharde capsular material. As this material is not very immunogenic it is now often bound to a protein conjugated to increase its immunogenicity

Pertussis (whooping cough) vaccine

37
Q

How do viruses like particles work

A

from viral proteins that self assembly to form particles

just shell, with antigen on the outside of the virus will not infect and replicate

As there is no nucleic acid the particles look like viruses but are incapable of causing disease

38
Q

What are examples of viruses like particles

A

HPV vaccine and Hepatitis B vaccine

39
Q

How do RNA vaccines work

A

made of mRNA that instructs our cells to produce a viral protein from the target virus

the protein causes an immune response

RNA is unstable so need to be in a lipid envelop and kept at very low temperatures

hard to transport and store

40
Q

How do DNA viruses work

A

similar to RNA vaccine but more stable

plasmid is injected which included a gene for a target virus protein

cells make the protein and elicit an immune response

more easily stored and transported

has to get into cell nucleus to work

potential for incorporation into genome (with possible oncogenicity)

41
Q

What are toxoids

A

they are inactivated toxins

immunization protects from the action of the toxin

multiple doses are given with an adjuvant to increase immunogenicity

these have been very effective vaccines

42
Q

what are examples of toxoids

A

tetanus and diphtheria toxoid vaccines

43
Q

Who makes the federal recommendations for childhood immunization

A

National Advisory Committee in Immunizations (NACI and MOHs

44
Q

What are the effects of age in immunizations

A

maternal antibody may affect response in babies

as immature immune system decreases response: polysaccharide vaccines are not effective in <2 year olds

some vaccines have short lived responses in young

poor response to vaccines in the very old

45
Q

Why do vaccine programs fail

A

many programs so not reach the target of 85%

missed opportunities to immunize by health-care workers and care-givers

improper vaccine storage results in ineffective immunization

vaccine hesitancy (umbrella term, somewhat interested but issues with the amount of vaccines)

46
Q

why may vaccines not be in routine use

A

incidence too low, vaccine too expensive

we haven’t had small-pox vaccine in awhile because the indecency is low

47
Q

Why may there be outbreaks of vaccines in preventable diseases

A

vaccine may not be in routine use

may occur in the unvaccinated/under vaccinated

48
Q

what is the anti-vaccine fringe

A

will not get usually its the other two options

press coverage causing fear or
vaccine hesidamcy with the amount of boosters and doses

49
Q

Describe the Diphtheria/Tetanus/Pertussis vaccine

A

Diphtheria and tetanus use toxoids and pertussis uses an acellular vaccine called (DTaP)

Primary immunization is at 2,4,6 months, with boosters at 18 months and 4-6 years

Often combined in a pentavalent form (contains 5 vaccines in one) with poliovirus and Haemophilus influenzae type B vaccines

Diphtheria toxin and tetanus Td booster is given at 14-16 years of age with boosters every 10 years

Less diphtheria toxoid to decrease adverse reactions

50
Q

What type of vaccine is the polio vaccine

A

available as inactivated (IPV, Slak) or live as oral administration (OPV, Sabin)

OPV induced a natural immunity with advantages of secretory-IgA production, but shedding through GI tract offered opportunity for vaccines-associated infections by mutated virus (secondary immunizing people)

Primary immunization at 2,4,6 mo. with boosters at 18 mo and 4-6 yrs

51
Q

What is the future for the polio vaccine

A

may no longer be necessary in future decades if poliovirus infection is eradicated

Oral polio vaccine is no longer used in North America due to growing immunosuppressed population and vaccine-asscoicated paralytic polio

52
Q

______ was the most common cause of bacterial meningitis and epiglottis in Canada prior to 1995

A

Haemophilus Type B Vaccine (Hib)

53
Q

What does the Haemophilus Type B Vaccine consist of

A

polysaccharide conjugated to a protein ( 4 preparations exist)

Conjugated to a protein activates T-cell dependent immunity (immunogenic in infants and improved memory)

54
Q

What are the adverse reactions of the Hib vaccine

A

fever, local redness, and swelling in <5%

55
Q

What vaccines can Hib vaccine be given in conjunction with

A

DTaP and polio

56
Q

What type of vaccine is the Measles/Mumps/Rubella vaccine

A

live-attenuated vaccine

57
Q

When is the Measles/Mumps/Rubella vaccine administered

A

primary immunization at age 12-15 months (needs a robust enough immune system)

second dose recommend at 18 mo. or 4-6 years

58
Q

what are the adverse reactions of Measles/Mumps/Rubella vaccine

A

rash and fever 5-10%

59
Q

What is the contraindication/when the vaccine should not be used in the Measles/Mumps/Rubella vaccine

A

severe acute illness or immunosuppression ]

60
Q

What type of vaccine is the influenza vaccine

A

inactive whole or split0virus vaccine (arms)

or attenuated live vaccine is avaliable (in nose)

61
Q

What does the influenza vaccine contain

A

two influenza A strains (H2N3-like, H1N1-like) and 2 influenza B strains

62
Q

When is the influenza administered

A

recommended yearly to high-risk individuals and those capable of transmitting influenza to those at high risk (i.e., Heath care workers usually only 60-70% receive)

63
Q

Who are the high risk groups that should receive the influenza vaccine

A

chronic cardiac or pulmonary disorders

residents if nursing homes and chronic care facilities

age > 65 yrs

Chronic conditions such as; diabetes mellitus, cancer, immunosuppression, renal disease, anemia, hemoglobinopathy, HIV

Children and adolescents requiring long-term aspirin

64
Q

What is the Hepatitis B vaccine

A

Purified HBsAg (recombination)

65
Q

Why should someone get a Hepatitis B vaccine

A

individuals infected at an earlier age have greater risk of liver failure, cirrhosis, and carcinoma

increasing cases in Canada throughout the 80s

66
Q

When is the Hepatitis vaccine administered

A

3 doses at 0.1, and 6 months

no booster

67
Q

What are the pneumococcal vaccines

A

polysaccharide vaccine (23 valent) which will induce immunity against 90% of pneumonia strains of S. pneumonia

pneumoncococcal conjugate vaccine with 13 valents, conjugated to diphtheria toxoid

68
Q

Who is the polysaccharide pneumoncococcal vaccine reccomended for

A

age over 65 yrs

no spleen, splenetic dysfunction or sickle cell disease

cerebrospinal fluid leaks

all “high-risk” operons who require influenza vaccine

69
Q

What is the efficacy of the polysaccharide pneumoncococcal vaccine and how often should you get vaccinated

A

80% in healthy adults

recommended to repave vaccinations very 5 years

70
Q

When is the pneumoncoccal conjugate vaccine given

A

2,4,6, 12-15 months

71
Q

____ vaccine provides better immunity in small children

A

pneumococcal conjugate vaccine

72
Q

____ vaccine improves memory via cell mediated immunity

A

Microbiology Midterm 2 (15 decks)

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