Vaccines Flashcards

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1
Q

Define immunisation

A

Immunisation – Process whereby person or animal is made immune or resistant to infectious disease

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2
Q

What is R0?

A

Basic reproductive rate

The number of people that one sick persn will infect, on average, is called R0

If R0 is reduced <1 then transmission is halted

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3
Q

What is herd immunity?

A
  • Form of immunity that occurs when vaccination of a significant proportion of a population provides a measure of protection for individuals that are not immune.
  • Herd Immunity Threshold

HIT = 1 -1/R0

Percentage of fully immune individuals required to stop the spread of disease

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4
Q

Describe the different types of immunity

A
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5
Q

Describe how the immune respone acts when in contact with a vaccine

A
  • Vaccine is delivered and Antigen presenting cells (such as macrophages, dendritic cells) take up the antigen part of the infecting cells from the cell surface
  • The Innate system responsible for detecting PAMPs (Pathogen Associated Molecular Patterns) and DAMPs (Damage Associated Molecular Patterns) and presenting them through Pattern Recognition Receptors(PRR) to APC
  • APCs the present antigens from the infecting cells to naive T cells specific for that antigen, which recognises it as foreign and is activated. - This normally takes place in lymph nodes
  • B cells become activated, with the help of T helper cells, and undergo cell division. Some develop into plasma cells, and others memory B cells
  • Antibodies are released from developed plasma cells
  • Antibodies:
    • Neutralization of infectivity owing to binding of viral surface antigens
    • Destruction of infected cells – antibody dependent cellular cytotoxicity. Macrophages and NK cells carrying Fc receptors bind to the antibodies.
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6
Q

For which type of vaccine is the T cell response important for?

A

If attenuated virus vaccine, then T cell response important in destroying infected cells

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7
Q

What is the goal of vaccination?

A

Goal of vaccination is to produce memory cells to the vaccine antigen

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8
Q

What happens post-vaccination if someone is exposed to the infection they have been vaccinated against? (in the immune response)

A
  • Entry of pathogen activated memory T cells which encourage immune response
  • Memory B cells become active plasma cells (more antibodies produced at a faster rate)
  • Memory killer T cell response may be reactivated
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9
Q

What are protective antigens?

A

Protective antigens – one that can stimulate an immune response and prevent/alleviate the clinically important consequences of infection.

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10
Q

What are adjuvants?

A

Adjuvants – substances of various kinds that enhance immune response

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11
Q
  1. What are the two groups of vaccines?
  2. Name some of both
A

Non replicative (+/- adjuvant)

  • Whole virion
  • Split
  • Subunit
  • Pure antigen

Replicative

  • Live attenuated
  • Vectorised (gene of protective antigen introduced in a vector)
  • DNA based
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12
Q

Describe an inactivated vaccine, pros, cons and some examples

A
  • Inactivated vaccines are made of whole microorganism destroyed by heat, chemicals, radiation or antibiotics
  • Examples = Influenza, cholera, polio
  • Advantages
    • Stable
    • Constituents clearly defined
    • Unable to cause the infection
  • Disadvantages
    • Need several doses
    • Local reactions common
    • Adjuvant needed
      • keeps vaccine at injection site
      • activates antigen presenting cells
    • Shorter lasting immunity
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13
Q

Describe attenuated vaccines, pros, cons and examples

A
  • Live organisms modified to be less virulent
  • Examples: measles, mumps, rubella, yellow fever
  • A number of methods used to achieve attenuation
    • Naturally occurring (e.g. Poliovirus strain with lack of virulence for brain and spinal cord in monkeys.
    • Adenovirus vaccine (types 4 and 7) given orally was restricted to replication in the GIT.
    • Derived from wild type through serial passage in cell cultures prepared from an unnatural host. -> mutants partially restricted in humans at portal of entry and/or target organs.
  • Advantages
    • Single dose often sufficient to induce long-lasting immunity
    • May stimulate response to multiple protective antigens
    • Strong immune response evoked
    • Local and systemic immunity produced – particularly important for infections where CMI plays an important role. Activation of all components of immune system
  • Disadvantages
    • Potential to revert to virulence
    • Can cause illness directly
    • Contraindicated in immunosuppressed patients
    • Interference by viruses or vaccines and passive antibody
    • Poor stability
    • Potential for contamination
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14
Q

What are toxoid vaccines and some examples?

A
  • Vaccine made of inactivated toxic components
  • Examples: tetanus and diptheria
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15
Q

What are subunit vaccines and some examples?

A
  • Protein component of the microorganisms or synthetic virus like particles.
  • Lacking viral genetic material and unable to replicate.
  • Examples:
  • Hepatitis B, HPV
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16
Q

What are conjugate vaccines and some examples?

A
  • Poorly immunogenic antigens paired with a protein that is highly immunogenic (adjuvant)
  • Examples:
  • Haemophilus influenzae type B
17
Q

What are heterotypic vaccines and some examples?

A
  • Pathogens that infect other animals but do not cause disease or cause mild disease in humans
  • Examples:
  • BCG
18
Q

What are some common components of vaccines?

A
  1. Active Component/Antigens
  2. Stabilizers
  • Help maintain effectiveness during storage
  • Factors affecting stability – Temperature, pH

3.Adjuvants

•Highly heterogeneous group of compounds with the ability to enhance immune response

4.Preservatives

  • Particularly in multidose vaccines to prevent bacterial and fungal growth
  • E.g. Thiomersal

5.Antibiotics

  • (In trace amounts) Used during manufacturing phase to prevent bacterial and fungal growth
  • E.g. MMR <25micrograms of neomycin

6.Trace components

  • Formaldehyde – used to inactivate viruses and detoxify bacterial toxins
  • A purification process during production removes almost all formaldehyde
19
Q

Describe the contraindications and precautions of the following vaccines

  • All
  • DTP
  • Influenza
  • Live vaccines
A
20
Q

What are some serious reactions that the following vaccines can cause?

A
21
Q

What is needed for successful disease eradication?

A
  • No animal reservoir
  • Antigenically stable pathogen with only one (or small number of) strains
  • No latent reservoir of infection and no integration of pathogen genetic material into host genome
  • Vaccine must induce a lasting and effective immune response
  • High coverage required for very contagious pathogens