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Vaccinology - Bacterial vaccines Flashcards

1
Q

What are the goals of bacterial vaccines? (5)

A
  1. Disease prevention
  2. Eradication & control of disease
  3. Protection of vulnerable populations through heard immunity
  4. Global health equity
  5. Prevention of antimicrobial resistance
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2
Q

What are possible bacterial vaccine target antigens? (5)

A
  1. Bacterial DNA
  2. Flagella
  3. Lipopolysaccharides (LPS)
  4. Exotoxins
  5. Outer membrane proteins
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3
Q

What type of bacterial vaccine types are available? (5)

A
  1. Toxoid
  2. Live attenuated
  3. Subunit
  4. Conjugate
  5. Inactivated
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4
Q

For which bacterial diseases are toxoid vaccines used? (2)

A
  1. Diphtheria
  2. Tetanus
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5
Q

What is the causative agent of diphtheria?

A

Corynebacterium diphtheriae

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6
Q

How is diphtheria transmitted?

A

Respiratory illness, spreading via droplets

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7
Q

What are the symptoms of diphtheria? (3)

A
  1. Pharyngitis
  2. Fever
  3. Swelling of the neck
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8
Q

How does diphtheria cause severe respiratory disease?

A

Bacterial toxins kill respiratory tissue

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9
Q

What is the untreated vs. treated mortality of diphtheria?

A

Untreated: 50%
Treated: 10%

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10
Q

What is the causative agent of tetanus?

A

Clostridium tetani

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11
Q

How is is tetanus transmitted?

A

From bacterial spores in the evironment

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12
Q

What kind of toxin is tetanus toxin? What are its effects?

A

Neurotoxin, causing tightening of the muscles & brain damage

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13
Q

There [is/isn’t] an antitoxin for tetanus

A

There is no antitoxin for tetanus

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14
Q

What is the mortality of tetanus?

A

11%

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15
Q

What is the mechanism of action of toxoid vaccines?

A

Combat the disease by generating antibodies to the toxins causing symptoms

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16
Q

What is a toxoid?

A

Chemically-/heat-inactivated toxin

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17
Q

What are the advantages of toxoid vaccines? (2)

A
  1. Highly effective
  2. Well-tolerated & safe
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18
Q

What is the disadvantage of toxoid vaccines?

A

Slow manufacturing process -> requires bacterial culture & toxoid inactivation

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19
Q

For which bacterial diseases are inactivated vaccines used? (4)

A
  1. Whooping cough
  2. Typhoid fever
  3. Cholera
  4. Plague
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20
Q

What is the causative agent of whooping cough?

A

Bordetella pertussis

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21
Q

What is the causative agent of typhoid fever?

A

Salmonella typhi

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22
Q

What is the causative agent of cholera?

A

Vibrio cholerae

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23
Q

What is the causative agent of plague?

A

Yersinia pestis

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24
Q

Which two types of vaccine are available for Bordetella pertussis? Which one is used in the RVP?

A
  1. Whole cell vacine = inactivated vaccine
  2. Acellular vaccine = subunit vaccine -> used in RVP
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25
Q

Against which bacterial components is the immune response generated in inactivated vaccines?

A

All pathogen antigens

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26
Q

What are the advantages of inactivated bacterial vaccines? (4)

A
  1. Stable
  2. Cannot revert to virulent form
  3. Safely adminstered to immunocompromised
  4. Relatively inexpensive, can be mass-produced
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27
Q

What are the disadvantages of inactivated bacterial vaccines? (2)

A
  1. Genreate less robust immune resposne -> may require boosters
  2. Slow manufacturing process -> requires bacterial culture & inactivation
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28
Q

Which types of subunits can be used for subunit vaccines? (3)

A
  1. Proteins
  2. Peptides
  3. Polysaccharides
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29
Q

Which bacterial subunits are included in the Bordetella pertussis acellular (=subunit) vaccine? (4)

A
  1. Peractin
  2. Pertussis toxoid
  3. Fimbriae
  4. Filamentous haemagglutinin
30
Q

What are the advantages of bacterial subunit vaccines? (2)

A
  1. Generally seen as the safest vaccine
  2. No risk of recombination
31
Q

What are the disadvantages of bacterial subunit vaccines? (4)

A
  1. Lower immunogenicity
  2. Usually requires adjuvants -> higher risk of side effects
  3. Complex to develop
  4. Polysaccharides are thymus-independent antigens
32
Q

Why are subunit vaccins relatively complex to develop?

A

Requires discovery & production of target antigens

33
Q

Why is it disadvantageous that polysaccharides are thymus independent antigens? (2)

A

They cause T-cell independent B-cell activation, leading to:
1. No immunity to polysaccharides in children
2. Poor memory induction

34
Q

Why do children not develop immunity when vaccinated with polysaccharides?

A

T-cell independent antigen -> completely dependent on B-cells, which have not fully matured in young children

35
Q

For which bacterial diseases are conjugate vaccines used? (3)

A
  1. Haemophilus influenzae type B (Hib)
  2. Pneumococcal disease
  3. Meningococcal disease
36
Q

What is the causative agent of pneumococcal disease?

A

Streptococcus pneumoniae

37
Q

What is the causative agent of meningococcal disease?

A

Neisseria meningitidis

38
Q

How many serotypes of Haemophilus influenzae are there?

39
Q

What differentiates different Haemophilus influenzae-subtypes from one another?

A

Their capsular polysaccharides

40
Q

Which of the Haemophilus influenzae-subtypes is considered most cangerous? Why?

A

Type b (Hib) -> can cause meningitis & sepsis

41
Q

What is the case-fatality rate of Hib?

42
Q

What are frequent long-term consequences of Hib-infection? (2)

A
  1. Neurologic sequelae: 10-15%
  2. Deafness: 15-20%
43
Q

How many pneumococcal serotypes are known?

44
Q

True or false: all pneumococcal serotypes can cause major infections

A

False; while most can cause disease, only a few can cause major infections

45
Q

Which diseases can S. pneumoniae cause? (5)

A
  1. Pneumonia
  2. Bacteriaemia
  3. Meningitis
  4. Acute otitis media
  5. Sinusitis
46
Q

What is the case fatality rate of pneumonia caused by S. pneumoniae?

47
Q

What is the case fatality rate of bacteriaemia caused by S. pneumoniae in childeren vs. elderly?

A

20% in childeren, up to 60% in elderly

48
Q

What is the case fatality rate of meningitis caused by S. pneumoniae in childeren vs. elderly?

A

8% in childeren, up to 22% in adults

49
Q

Why are elderly vaccinated with a different pneumococcal vaccine than children?

A

Children = conjugated vaccine
Elderly = polysaccharide vaccine -> children’s immune system poorly respond to polysaccharide vaccines

50
Q

Which pneumococcal vaccine is used for children?

A

Synflorix = 10-valent conjugate vaccine

51
Q

Which pneumococcal vaccine is used for elderly/immunocompromised?

A

Pneumovax 23-valent polysaccharide vaccine

52
Q

How many serogroups of N. meningitidis are there? Which is considered most dangerou?

A

12 serogroups, group B is considered most dangerous

53
Q

Which diseases can N. meniningitidis cause? (2)

A
  1. Meningitis
  2. Sepsis
54
Q

What is the case fatality rate of meningitis caused by N. meningitidis?

A

5-10% (with good treatment)

55
Q

What is the case fatality rate of sepsis caused by N. meningitidis?

A

20-50% within 24 hours

56
Q

Which serogroups are included in the meningococcal vaccine?

A

A, C, W, Y

57
Q

What kind of vaccine is the pneumococcal vaccine?

A

Conjugate vaccine

58
Q

To which conjugate are meningococcal antigens conjugated in the conjugate vaccine?

A

TTetanus toxoid

59
Q

What is a bacterial polysaccharide? (definition)

A

Long polymer composed of repeating units of simple structures

60
Q

Where are polysaccharides found?

A

On the outside of Gram+ and Gram- bacteria

61
Q

What is the advantage of conjugation of polysaccharides to protein antigens?

A

Leads to T-cell activation, which in turn stimulates proper B-cell activation

62
Q

What are the results of T-cell stimulation of B-cells in conjugate vaccines? (4)

A
  1. B-cells properly activated -> antibody production
  2. Limited memory formation
  3. Hyporesponsiveness to subsequent vaccination
  4. Still somewhat poor response in young children
63
Q

What are the advantages of conjugate vaccines? (3) (compared to polysaccharide)

A
  1. Enhanced immunogenicity
  2. Protection of young infants
  3. More effective immune response
64
Q

What are the disadvantages of conjugate vaccines? (3)

A
  1. Expensive
  2. Resource-intensive
  3. Limited strain coverage
65
Q

For which bacterial diseases are live attenuated vaccines used? (2)

A
  1. Oral typhoid vaccine
  2. Tuberculosis
66
Q

Are live attenuated vaccines currently in routine use in the RVP?

67
Q

What are the two attenuation methods to create live attenuated bacterial vaccines?

A
  1. Random/targeted mutations in virulence-related genes to weaken the bacterium
  2. Use of less pathogenic strains/serotypes that are still similar to the disease-causing agent
68
Q

What is the tuberculosis vaccine?

A

BCG vaccine

69
Q

Which bacterial strain is used in the BCG vaccine?

A

Mycobacterium bovis -> provides cross-protection for severe tuberculosis disease

70
Q

What are the advantages of bacterial live attenuated vaccines? (2)

A
  1. More potent than inactivated vaccines
  2. Immune response lasts longer
71
Q

What are the disadvantages of bacterial live attenuated vaccines? (3)

A
  1. Risk of reversion to disease-causing agent
  2. Dangerous for immunocompromised
  3. May require careful storage & transportation

I&I WC2 (25 decks)

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