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1.3 POM Immunology > Vaccines > Flashcards

Vaccines Flashcards

1
Q

What is a vaccine?

A

Something that stimulates the immune system, without causing serious harm or side effects

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2
Q

How can vaccines be administered?

A
  1. Injection
  2. Nasal spray
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3
Q

What are the 7 considerations made when making a vaccine?

A
  1. Safety
  2. Easy to administer
  3. Cheap
  4. Stable
  5. Active against all variants
  6. Provides life-long protection
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4
Q

How do vaccines work?

A

Trains immune system to recognise and remember an infection without actually infecting the patient

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5
Q

Are vaccines effective?

A

Yes - very —> eradicated smallpox

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6
Q

What are the ways vaccines can stimulate a better secondary immune response?

A
  1. Stimulate prevention of entry
    - Antibodies and macrophages
  2. Stimulate kill of infected cells
    - CD8 T cells
  3. Boost overall immune response
    - B cells and CD4 T cells
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7
Q

What is the overall aim of vaccines?

A

Reduce community spread of an infection

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8
Q

What is R0?

A

Basic reproductive number
- Number of cases one case generates on average

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9
Q

What do vaccines aim to do to R0?

A

R0<1
—-> Over time, number of cases decrease

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10
Q

What is herd immunity?

A

Indirect community immunity when most are immune

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11
Q

How do vaccines achieve herd immunity?

A

Decrease chance infected person interacting with susceptible (unvaccinated) host and transmitting infection

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12
Q

What are the 5 components of a vaccine serum?

A
  1. Water
  2. Active ingredient
  3. Adjuvants
  4. Residual traces
  5. Preservatives and stabilisers
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13
Q

What is the function of water in vaccines?

A

Main ingredient containing all other components

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14
Q

What is the function of the active ingredient in vaccines?

A

Specific pathogen that will stimulate primary immune response

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15
Q

What is the function of adjuvants in vaccines?

A

Boost immune system

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16
Q

What is the function of preservatives and stabilisers in vaccines?

A

Maintain vaccine quality and safety (prevent contamination)

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17
Q

Why do you get residual traces in a vaccine?

A

Part of vaccine manufacturing process

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18
Q

What are the 4 types of vaccines?

A
  1. Inactivated toxoid
  2. Conjugate
  3. Dead pathogen
  4. Live attenuated
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19
Q

What are inactivated toxoid vaccines?

A

Vaccines containing chemically inactivated form of pathogen toxin

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20
Q

What is an example of an inactivated toxoid vaccine?

A

Tetanus toxoid
- Stimulates antibody production —> blocks toxin binding nerves

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21
Q

What are the pros and cons of inactivated toxoid vaccines?

A

Pros:
- Cheaper
- Safe
- Been used for decades —> lots of research

Cons:
- Only works for pathogens encoding toxins
- Need good understanding of infection biology

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22
Q

What are recombinant protein vaccines?

A

vaccine containing recombinant protein from pathogen (eg. surface antigen)

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23
Q

What is an example of a recombinant protein vaccine and how does it work?

A

HbSAg (HeP B surface antigen)
- Stimulates neutralising antibody production

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24
Q

What are the pros and cons of recombinant protein vaccines?

A

Pros:
- Pure
- Safe

Cons:
- Expensive
- Not very immunogenic (ability to stimulate immune response)
- Doesn’t work against capsulated bacteria

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25
Q

What type of pathogen do recombinant protein vaccines not work on and why?

A

Capsulated bacteria
- Polysaccharide capsule hides antigens

26
Q

What are conjugate vaccines?

A

Vaccine containing a combination of a weak antigen with a strong antigen as a carrier

27
Q

What is an example of a conjugate vaccine and how does it work?

A

S. pneumoniae
- Polysaccharide coat component conjugated to immunogenic carrier protein
- Stimulates Th cells to activate B cells against polysaccharide

28
Q

What are the pros and cons of conjugate vaccines?

A

Pros:
- Improves vaccine immunogenicity
- Highly effective against bacteria

Cons:
- Expensive
- Susceptible to carrier protein interference
- Very strain specific

29
Q

How do conjugate vaccines make T-independant B cells T-dependant?

A
  1. BCRs bind to polysaccharide part
    TCR binds to carrier protein part
  2. Stimulates cognate T cell/B cell interaction
  3. Enhances production of anti-polysaccharide antibodies
30
Q

What are dead pathogen vaccines?

A

Vaccines containing a chemically pathogen

31
Q

What is an example of a dead pathogen vaccine and how does it work?

A

Influenza split vaccine

32
Q

What are the pros and cons of dead pathogen vaccines?

A

Pros:
- Immunogenic
- Cheap
- Quick

Cons:
- Killing of bacteria alter chemical structure of antigen
- Need to grow pathogen
- Risk vaccine-induced pathogenicity
- Risk contamination with live pathogen

33
Q

What are live attenuated vaccines?

A

Vaccine containing live but weakened pathogen

34
Q

What are 3 examples of a live attenuated vaccine and how does it work?

A
  1. BCG
  2. LAIV
  3. OPV
    - Attenuate pathogen via serial passage —> lose virulence factors
    - Pathogens still replicate —> triggers innate immune response
35
Q

What are the pros and cons of live attenuated vaccines?

A

Pros:
- Strong immune response
- Response may be localised (LAIV)

Cons:
- Pathogens can revert to being active
- Vaccine may infect immunocompromised
- Other infection may outcompete pathogen from virus

36
Q

What are adjuvants?

A

Substances added to vaccines to produce a more robust immune response

37
Q

How do adjuvants boost the immune system?

A

Induce signals that activate dendritic cells to present antigen to T cells in lymph nodes

38
Q

What are 2 examples of adjuvants?

A
  1. AS03 —> chicken pox, malaria (+ potentially Tb, COVID-19)
  2. MF59 —> influenza
39
Q

What are the 5 reasons for new vaccine production?

A
  1. Demographics changing - aging in UK
  2. Environments changing - global warming —> pathogens found in new locations
  3. New diseases - eg. COVID-19
  4. Old diseases without vaccines present - eg. HIV/TB
  5. Antibiotic resistance - new approach to bacterial infection control
40
Q

What are the 5 barriers to vaccine production?

A
  1. Scientific challenges
  2. Injection safety
  3. Logistics of cold chain (transporting, storing, and managing)
  4. Development time and cost
  5. Public expectation - want risk-free vaccines
41
Q

How long to vaccines take to produce?

A

15 years

42
Q

What are 3 examples of viruses that need vaccines targeting multiple strains?

A
  1. HIV
  2. Influenza
  3. Rhinovirus
43
Q

Which … infections are attenuated vaccines used against?

A

Bacterial:
1. Chicken pox
2. Cholera
3. Anthrax
4. Typhoid
5. TB (BCG)

Viral:
1. Rabies
2. Yellow fever
3. Influenza
4. Polio
5. Measles
6. Mumps

44
Q

Which 4 infections are inactivated toxoid vaccines used against?

A

Bacterial:
1. Diptehria
2. Tetanus
3. Typhus
4. Whooping cough

45
Q

Which 2 infections are conjugation vaccines used against?

A

Bacterial:
- Pneumococcus —> pneumonia
- Meningococcus —> meningitis

46
Q

Which 3 pathogens are recombination vaccines used against?

A

Viral:
1. Hep A
2. Hep B
3. HPV

47
Q

Which 3 infections are vaccines being developed for?

A
  1. COVID-19
  2. Malaria
  3. Dengue
48
Q

What are the 8 options for SAR-CoV-2 vaccine active ingredients?

A
  1. Live attenuated virus particles
  2. Live recombinant viral vector
  3. VLPs
  4. Inactivated virus particles
  5. Proteins
  6. mRNA
  7. saRNA
  8. DNA
49
Q

What are the 6 phases of vaccine approval?

A
  1. Pre-clinical tests
  2. Phase 1 —> 20-80 humans
  3. Phase 2 —> 100-300
  4. Phase 3 —> 1,000-3,000
  5. FDA review
  6. Phase 4 —> 1,000 participants
50
Q

When are drugs approved for testing in humans?

A

After pre-clinical testing

51
Q

When are drugs approved for use?

A

After FDA review

52
Q

When are drugs submitted for FDA approval?

A

After Phase 3

53
Q

How did SAR-CoV-2 vaccines get released so quickly?

A

Large-scale production started in phase 2 and 3

54
Q

Which 6 organisations need to approve vaccines in the UK?

A
  1. MHRA —> licensing
  2. JCVI —> recommendations
  3. DH —> decide vaccine policies
  4. Pharmaceutical company —> sells vaccine to DH
  5. NIBSC —> control vaccine distribution and use
  6. UKHSA —> post-licensure assessment
55
Q

What are the 8 considerations when making a vaccine schedule?

A
  1. Aim
  2. Need for vaccine (prevalence of infection)
  3. Scheduling with other vaccines
  4. Availability
  5. Cost
  6. Accessibility by population
  7. Cultural attitudes and practises towards vaccines
  8. Delivery facilities
56
Q

What are the 4 age stages of the baby vaccination schedule?

A
  1. 8 weeks old
  2. 12 weeks old
  3. 16 weeks old
  4. 1 year old
57
Q

Which 3 vaccines are given at 8 weeks?

A
  1. DTaP/IPV/HiB/HepB (Infanrix hexa)
  2. MenB
  3. Rotavirus
58
Q

Which 3 vaccines are given at 12 weeks?

A
  1. DTaP/IPV/HiB/HepB (Infanrix hexa)
  2. PCV
  3. Rotavirus
59
Q

Which 2 vaccines are given at 16 weeks?

A
  1. DTaP/IPV/HiB/HepB (Infanrix hexa)
  2. MenB
60
Q

Which 4 vaccines are given at 1-year?

A
  1. Hib/MenC
  2. PCV booster
  3. MMR
  4. MenB booster

1.3 POM Immunology (13 decks)

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