Vaccines Flashcards
Stimulation with antigen to develop immunologic defenses against a future exposure
Active immunization
Induction of provision of immunity by any mean, active or passive
Immunization
Administration of preformed antibodies
Passive immunization
Occurs during infection
Natural active
Injecting or taking antigens by mouth
Artificial active
Mother to child placenta or milk
Natural passive
Injection of antitoxins given
Artificial passive
Results in the rapid appearance of low IgG antibody titers
Extrafollicular response
IgG titers peak after how many weeks?
4 weeks
2 weeks-4 weeks
Reactivates immune memory and results in a rapid <7 days increase of IgG antibody titer
Booster
Prevent or reduce infections by extra and intracellular agents and clear extracellular pathogens
Antibodies
Reduce control and clear (not prevent) intracellular pathogens
CD8+ cells
Reduce control and clear (do not prevent) extra and intra cellular pathogens
CD4+ cells
Antibody mechanisms
Binding to enzymatic and active sites of toxins
Opsonization
Complement activation
Preventing viral binding and entry
Antigens in vaccines
Weakened pathogens
Killed pathogens
Protein parts of pathogens
When a critical portion of the community is immunized against a contagious disease most members of the community are protected against the disease because there is little opportunity for an outbreak.
Community herd immunity
Critical portion
At least 80% immunized
Immune globulins
IVIg Hep B immune globulin Rabies immune globulin Tetanus immune globulin CMV immune globulin Anti-D immune globulin (Rh)
Live attenuated vaccines
Viral mmr, varicella/zoster, yellow fever, rotavirus, intranasal influenza, vaccinia, oral polio
Bacterial BCG, oral typhoid
Weakened form of wild virus or bacteria, produces mild symptoms
Live attenuated
Cannot replicate, not as effective as live vaccines
Inactivated vaccines
Generally require 3-5 doses
Inactivated vaccines
Inactivated vaccine immune response
Mainly humoral
Boosters needed, titer may diminish with time
Inactivated
More durable immune response, which type of vaccine?
Live attenuated
Whole cell inactivated vaccines viral
Polio, hep a, rabies, influenza
Whole cell inactivated bacterial
Pertussis, typhoid, cholera, plague
Fractional inactivated
Subunit
Toxoid
Fragment of microbe, may be surface proteins or viral genes
Subunit
Examples of subunit vaccines
Hep B Influenza Acellular pertussis Hpv Anthrax
Toxin rendered not harmful
Toxoid
Toxoid examples
Diptheria
Tetanus
Polysaccharide vaccines types
Pure polysaccharide
Conjugate polysaccharide
Not consistently immunogenic in children <2 years
Pure Polysaccharide vaccines
No booster response, antibody with less functional activity, immunogenicity improved by conjugation
Pure polysaccharide vaccines
Examples pure polysaccharide
Pneumococcal
Meningococcal
For children <2 years, linked to proteins
Conjugate polysaccharide
Examples conjugate polysaccharide
H. influenzae type b
Pneumococcal
Meningococcal
Bcg
Live attenuated
Diptheria
Toxoid
Tetanus
Toxoid
Pertusis whole cell
Killed
Pertussis acellular
Protein
Polio Salk
Killed
Polio Sabin
Live attenuated
Rabies
Killed
Hep A
Killed
Hep B
Protein
HPV
Fractional subunit, VLPs
HiB
Polysaccharide
HiB conjugate
Polysaccharide conjugate
Pneumococcal
Polysaccharide
Conjugate
Varicella
Live attenuated
MMR
Live attenuated
Typhoid
Live attenuated oral
Polysaccharide
Influenza
Killed trivalent
Live attenuated intranasal
Rotavirus
Live attenuated
Meningococcal
Polysaccharide
Conjugate
Yellow fever
Live attenuated
WHO expanded program vaccines
BCG DPT OPV/Sabin HepB Measles (not MMR)
Principles of vaccination
Correct
Age
Interval
No. of doses
Adverse reactions
Local pain swelling redness
Systemic fever malaise headache
Specific
Allergic
Local adverse reaction common in
Inactivated vaccines, tetanus hpv
Systemic effects in
Live vaccines, dpt
Intussuception
Rotavirus vaccine
Permanent contraindications to vaccination
Severe allergic reaction to prior dose
Encephalopathy within 7 days of pertussis vaccination not due to other causes
Allergy to component, live and inactivated
Contraindicated
Encephalopathy, inactivated
Contraindicated
Pregnancy, live
Contraindicated
Pregnancy, inactivated
Vaccinate if indicated
Immunosuppresion, live
Contraindicated
Immunosuppression, inactivated
Vaccinate if indicated
Severe illness, live and inactivated
Precaution
Recent blood product, live
Precaution, mmr and varicella only 2 containing
Recent blood product, inactivated
Vaccinate if indicated
Routine adult immunization
Tetanus, diptheria, acellular pertussis HepB Varicella MMR Pneumococcal Influenza
Additional vaccines for health care workers
Typhoid
Rabies
DPT
Inactivated
Intramuscular
HepB
Inactivated
IM
Varicella
Live attenuated
SubQ
MMR
Live attenuated
SubQ
Pneumococcal
Inactivated
IM
Influenza
Inactivated
IM
Typhoid
IM capsular polysaccharide
Rabies
IM/ ID