Vaccines and Immunisation

Question 1

Phases of adaptive immunity

Answer 1

1. Antigen recognition
2. Lymphocyte activation
3. Antigen elimination
4. Contraction (homeostasis)
5. Memory

Question 2

Live vaccines

Answer 2

Virus weakened, often by repeatedly passing virus through a tissue culture in which it replicates poorly
+ activates killer T cells
+ 1/2 doses req for lifelong immunity
- may be reactivated,less safe for people with weakened immune system
- storage, must be refrigerated

eg MMR, varicella, rotavirus

Question 3

Inactivated vaccines

Answer 3

Pathogen treated with heat or chemicals to kill it before introduction into the body
\+ low risk of causing infection
\+ easy to store and transport
- req several doses and boosters
- elicit weaker immunological response

eg polio, hepA, rabies

Question 4

Subunit vaccines

Answer 4

One or more parts of the pathogen such as protein is isolated and introduced to evoke immune response
+ low risk of adr
+ can be used in pt with weakened immune system
- difficult to manufacture
- may req boosters

eg. hepB, influenza, pertussis Pneumococcus

Question 5

Toxoid vaccines

Answer 5

Toxins produced by pathogen is deactivated and introduced into the body
+ stable, easy to distribute
+ unable to cause disease or spread
- may req boosters to maintain immunity

eg diphtheria, tetanus

Question 6

Recombinant vaccines

Answer 6

Produced using genetic engineering, may contain no actual virus or may contain modified strain of virus

eg hepB, HPV

Question 7

Herd immunity

Answer 7

Enough of the population (depending on how contagious the disease is) is immunised to contain the spread of the disease and most community members are protected, including the unimmunised indiv

Question 8

Vaccines for respiratory (airborne or droplet) transmitted infection (9)

Answer 8

influenze, pneumococcus, meningococcus, diphtheria, pertussis, hemophilus influenzae (bacteria), mmr, chicken pox, bsg

Question 9

Vaccines for contact transmitted infection (3)

Answer 9

tetanus, rabies, shingles

Question 10

General considerations in vaccine use

Answer 10

Effectiveness, AE, CI and precautions, simultaneous adm

Question 11

Vaccines for food and water transmitted infection

Answer 11

hepA, typhoid, cholera, rotavirus

Question 12

Vaccines for vector borne transmitted infection

Answer 12

yellow fever, japanese encephalitis dengue, malaria

Question 13

Effective of vaccines consideration

Answer 13

Varies by vaccine eg hepB 95% effective, var 90%

Other factors:
Site given (hepA/B in deltoid and not gluteus)
Pt age and immune status (inf less effective in 80 vs 60)
cold chain problems (not kept at recommended temp)

Question 14

AE of vaccines

Answer 14

General:

• mild and common: pain at injection site, headache, myalgia
• uncommon: fever, hematoma
• severe but rare: anaphylaxis, hypersensitivity

Question 15

CI/precautions of vaccines

Answer 15

• Fever, may not be able to mount immune response
• pregnancy
• immunocompromised
• allergy to vaccines or components
• bleeding risk (on anti-coagulaiton or low platelet counts) - precaution

Question 16

Only exception of simultaneous adm?

Answer 16

PCV and meningococcal conjugate vaccine in pt with functional or anatomical asplenia (nonfunctional spleen)
- 4 week interval to avoid interference

Question 17

Can live vaccines adm via intramuscular or SC be adm together?

Answer 17

No, 28 days apart

Question 18

Hematoma

Answer 18

A collection of blood outside of blood vessels

Question 19

CI/precautions of vaccines

Answer 19

• (Moderate/severe illness) Fever, may not be able to mount immune response
• pregnancy
• immunocompromised
• allergy to vaccines or components
• bleeding risk (on anti-coagulaiton or low platelet counts) - precaution

Question 20

Vaccine preservative eg.

Answer 20

Thiomersal

Question 21

Vaccine stabilisers

Answer 21

Inorganic Mg salt such as Mg sulfate, Mg chloride, mixtures of lactose, sorbitol and gelatin, monosodium glutamate and glycine

Question 22

Vaccine trace components eg

Answer 22

Formaldehyde, used to deactivate viruses and detoxify bacteria

Question 23

Vaccine precaution!

Answer 23

Bleeding risk (on anti-coagulation or low platelet count)

Question 24

Vaccine preservative (prevent contamination) eg.

Answer 24

Thiomersal