Viral Pathogens: Hepatitis Flashcards
1
Q
Hepatitis B Virus
A
Belongs to the virus family Hepadnaviridae and DNA
- unusual partially double-stranded circular small DNA genome
- abdominal tenderness (pain or discomfort when an affected area is touched)
2
Q
Abdominal guarding
A
tensing of abdominal wall muscles to guard inflamed organs within the abdomen from the pain of pressure upon them
3
Q
Hepatitis B Virus Structure
A
4 Open Reading Frames (ORFs)
4
Q
ORF C
A
encodes the core antigen (HBcAg) which forms a protective Nucleocapsid around the genome
5
Q
ORF S
A
encodes the surface antigen (HBsAg)
-composed of large,middle and small surface proteins present in the envelope
6
Q
ORF P
A
encodes the polymerase enzyme
- has both DNA and RNA-dependent polymerase activities
7
Q
ORF X
A
encode the X antigen, which is known to act as a Transactivator of transcription
-likely involved in carcinogenesis
8
Q
A transactivator gene
A
express a transcription factor that binds to a specific promoter region of DNA
- causes that gene to be expressed.
9
Q
When ORF C and Pre C are translated together:
A
result is HBeAg
-indicator of active viral replication.
10
Q
HBV enters a new host via
A
genital tract or following direct inoculation of virus into the bloodstream
11
Q
Where does HBV travel once within the blood?
A
the virus travels to the liver, where it infects the Hepatocytes
12
Q
What does HBV do once within the liver cell?
A
the virus replicate, and new virus particles are released directly into the bloodstream
-gain access to every bodily compartment
13
Q
Open Reading Frames (ORF)
A
part of a reading frame that has the potential to be Transcribed
-continuous stretch of codons that contain a Start codon (AUG-Methionine) and stop codon (UAA, UAG, UGA)
14
Q
What are the three routes Hepatitis B virus is spread from person to person?
A
- vertical transmission (mother to baby)
- sexual transmission
- direct blood to blood transfer of virus (parenteral transmission)
15
Q
WHO estimates there are around _____ ______ of _____ carriers and ___ _____ in the _____
A
WHO estimates that worldwide there are around 350 millions of HBV carriers and 1.2 million in the USA
16
Q
What are the three groups the WHO classifies countries into according to their rate of HBV carriage?
A
- High: over 8 % of countries population are carriers
- Intermediate: 2-7%
- Low: under 2%
17
Q
Host response to infection: Innate immunity
A
early stages of infection within the liver, there is IFN induction and NK cell activity.
18
Q
Host response to infection: Adaptive immunity
A
virus encodes a number of distinct Ags
- HBsAg
- HBcAg
- HBeAg: soluble protein released from infected cells, indicates active viral replication
19
Q
Why is the production of anti-HBs antibodies important?
A
enabling the host to overcome the infection and eliminate the virus (Neutralizing Antibodies).
20
Q
Cellular immune response
A
lead to virus-specific Cytotoxic CD8+ T lymphocytes (CTLs) -able to kill infected hepatocytes through recognition of viral antigens present on the infected cell surface in association with HLA class I moleucles
21
Q
pathogenesis
A
host CTL response killing infected cells, in this way-HBV replication within hepatocytes of itself is not cytolytic and does not result in death of infected cells.
- how most damage to hepatocytes in HBV is thought to arise
22
Q
HBV clinical presentation
A
- 55-60% of acute HBV infections are asymptomatic (subclinical infections)
- 1% result in fulminant hepatitis (acute liver failure)
- 5-10% fail to clear infection and become chronic carriers
23
Q
Symptoms of acute hepatitis B
A
- feeling sick (malasie)
- vomiting
- abdominal pains
- fever
- jaundiced (eyes/skin)
- dark urine and pale feces
24
Q
In over _ out of 10 cases in adults, virus is cleared from the body by the ______ system within _ to _ months
A
9, immune. 3-6
25
In over _ out of 10 newborns infected from their mothers, virus remains ____
9, long term
26
Chronic HBV infection
proportion of patients (5-10% of adults) infected will fail to eliminate virus from liver
27
In chronic infection:
virus continues to replicate in infected hepatocytes
| -continuously released into bloodstream
28
Chronic carriers are the
source of infection
29
cirrhosis
over time continual death of liver cells and their replacement by fibrous tissue results in complete loss of normal liver architecture and function
30
What is the average time from acute infection to cirrhosis?
20 years
31
What is another complication of chronic HBV?
development of hepatocellular carcinoma (HCC)
- malignant proliferation of hepatocytes
- HBV carriers are 300 times more likely to develop than individuals who aren't carriers
32
HBV diagnosis
depends on detection of various markers of infection
| -detect HBsAg in blood sample (positve=HBV infection)
33
core Ag
anti-HBc
| -used to distinguish between Acute and chronic infection
34
acute infection
HBsAg+, IgM anti HBc +
| -followed to see if they eliminate the viurs over following 6 months (disappearance of HBsAg and appearance of anti HBs)
35
If _____ persist for longer than __ months, patient is a ____ carrier
HBsAg, 6, chronic
36
The HBeAg/anti-HBe system distinguishes between two types of carrier
HBeAg+ are extremely infectious
- Anti-HBe carrier is much less infectious, and at much lower risk of chronic liver disease
- Anti-HBs arises in patients who clear infection and are vaccinated
37
No specific management for acute HBV infection
bed rest and avoid alcohol
38
In case of fulminant hepatitis what may be the only resort?
liver transplant
39
Carriers of HBV should be advised that
they're potentially infectious
| -No blood donations, share razors or toothbrushes
40
HBV vaccination
using the HBsAg as the immunizing
agent
-three intramuscular injections, the second and third administered 1 and 6 months after the first
-last for around 20 years
- provides greater than 90-95% protection to infants, children, an
41
Human Coronavirus
Enveloped non-segmented positive-sense RNA
-Named for the crown-like spikes on their surface
- First identified in 1965
-Broadly distributed in humans and other species – bats, birds, rabbits, reptiles, cats, dogs, pigs, and monkeys
-Spread by aerosol droplets and contact with infected secretions
-Survival outside the body:
+1-2 days on non-porous surfaces (e.g. hard surfaces)
+8-12 hours on porous surfaces (e.g. soft goods)
42
Community-acquired human coronaviruses (HCoVs)
- 229E (alpha coronavirus)
- NL63 (alpha coronavirus)
- OC43 (beta coronavirus)
- HKU1 (beta coronavirus)
43
Other human coronaviruses
- severe acute respiratory syndrome coronavirus (SARS-CoV)
- Middle East respiratory syndrome coronavirus (MERS-CoV)
- 2019 novel coronavirus (SARS-CoV 2) causes COVID-19
44
Community acquired Human coronaviruses (HCoVs)
- worldwide distribution
- more common in winter and spring
- responsible for 20% of common colds
- symptoms in 50-90% of persons infected
- more common in children
- reinfection is common due to rapid diminution of antibody levels
45
Severe Acute Respiratory Syndrome coronavirus (SARS-CoV)
- first recognized in china in November 2012
- caused worldwide outbreak in 2012-2013
- probable cases 8,098
- deaths=774(10%)
- no cases since 2014
- originated in bats
- transmitted to humans through civets
46
Middle East Respiratory Syndrome coronavirus (MERS-CoV)
- first reported in Saudi Arabia in 2012
- reported in 27 countries all near Arabian peninsula
- confirmed cases 2,494
- deaths 858
- likely originated in bats
- transmitted to humans through camels
47
ACE2
Angiotensin-Converting enzyme 2 receptor
| -helps modulate the many activities of angiotensin II (ANG II) increases blood pressure, tissue injury and inflammation
48
ACE 2R
lung, heart, kidney, blood vessels, liver and gastrointestinal tract
49
COVID-19 clinical presentation
- incubation period 2 to 14 days (average 8 days)
- basic reproductive number R0=2.77
- fever (83-98%) may be prolonged and intermittent
- cough (76-82%)
- myalgia and fatigue (11-44%)
- sore throat in some cases
- anosmia (loss of sense of smell)
- headache, fatigue
- aguesuia (diminished sense of taste)
- less commonly: sputum production, headache, hemoptysis and diarrhea
- asymptomatic infection in young individuals
50
Basic Reproductive Number R0
number of cases that are expected to occur on average in a homogeneous population as a result of infection by a single individual
51
If the average R0 is greater than 1
The infection will spread exponentially
52
The _________ the value of
| ___ , the _______ an epidemic will progress
Higher, R0, faster
53
COVID-19 clinical course
- variable from asymptomatic infection or mild illness to severe or fatal illness
- dyspnea in ~50% after a median
54
Between what phases does symptom onset occur in COVID-19?
```
Incubation period (5.1 days)
Acute mild phase (5-10 days)
```
55
Acute mild phase
nonspecific symptoms
| -most common:fevers, cough, myalgias, fatigue, nausea, diarrhea
56
COVID risk factors for severe illness
-Older patients >65 years old
-Serious chronic medical conditions such
as:
+Heart disease
+Hypertension
+Diabetes
+Lung disease
+Cancer
+Obesity BMI>30
57
COVID laboratory findings
```
In hospitalized patients:
Ø Leukopenia (9–25%)
Ø Leukocytosis (24–30%)
Ø Lymphopenia (63%)
Ø ALT and AST levels (37%)
Ø Normal serum levels of procalcitonin
Ø Chest CT images
-Bilateral involvement in most patients
-Multiple areas of consolidation and ground glass opacities
```
58
What are the types of tests available for COVID-19?
Viral tests and antibody tests
59
Viral test
tells you if you have a current infection (Molecular and Antigen)
60
antibody test
might tell you if you had a past infection (serological)
-might not show if you have a current infection because it can take 1–3 weeks after infection for your body to make antibodies
61
True or False: Having antibodies to the virus that causes COVID-19 might provide protection from getting infected with the virus again.
True
62
True or False: The level of immunity and how long immunity lasts against COVID are known
False
63
Specimen Collection for Viral test
Nasopharyngeal swab:
Ø Use only synthetic fiber swabs with plastic shafts
Ø Don’t use calcium alginate or swabs with wooden shafts
Nasopharyngeal wash/aspirate or nasal aspirate
Ø Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry
container
64
Molecular test
test detects genetic material of the virus by PCR test
-health care worker collects fluid from a nasal or throat swab or from saliva
-Results may be available in a short period of time if analyzed onsite or one to
two days if sent to an outside lab
-considered very accurate
65
antigen test
COVID-19 rapid test (LFCT) detects certain proteins that are part of the virus
-using a nasal or throat swab to get a fluid sample, antigen tests can produce results in 10-15
minutes
66
_______ test result is considered very accurate, but there's an increased chance of false _________results
antigen, negative
67
______ tests aren't as ________ as ________ test
antigen tests aren't as sensitive as molecular tests
68
COVID treatment
infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support
69
convalescent plasma
at this time is an investigational product
70
Regeneron’s Monoclonal antibody (Casirivimab, Indevimab)
```
single 8 g dose of the Regeneron’s cocktail (REGN-COV2)
-Blocks attachment of viral spike protein to the human
ACE2 receptor (not very effective against the Omicron variant)
```
71
Remdesivir
has in vitro activity against MERS-CoV and SARS-CoV
- Inhibits virus RNA synthesis
- Only drug so far FDA approved for treatment of adults and children 12 and older and weight at least 88 pounds.
72
Tocilizumab
Monoclonal antibody that inhibits receptors for IL-6, an inflammatory cytokine released during the acute phase response
-FDA approved for rheumatologic diseases
-Emergency
Use Authorization (EUA) for adults in intensive care on high flow oxygen or ventilator support
73
Dexamethasone
corticosteroid used for its antiinflammatory and immunosuppressant effects
- found to have benefits for critically ill patients
- shown to reduce mortality by about 1/3
- patients requiring only oxygen, mortality was cut by about 1/5
74
Paxlovid:
oral antiviral (Nirmatrelvir and Ritonavir)
-authorized for the treatment of "mild-to-moderate" COVID-19 in adults and pediatric patients with positive test at his risk for severe disease
-has 89% reduction in the risk of hospitalization and death of unvaccinated
participants
-Take the medication within 5 days of developing symptoms
-3 Paxlovid pills twice daily for 5 days for a full course (30 pills)
75
Precautions for respiratory viruses
-Wash hands frequently soap and water for at least 20 seconds (or alcohol based sanitizer >70%)
-Cover coughs and sneezes with a tissue
-Avoid touching eyes, nose or mouth
-Cover your mouth and nose with a face mask
when around others
-Social distance (6 feet)
-stay home when sick
76
failure of host defese mechanisms
The avoidance or subversion of a normal immune response by pathogens
77
Why do most successful pathogens persist?
- they don't elicit an immune response
| - they evade the response once it has occurred.
78
Why do inherited failures of immune defenses occur?
Genetic defects
79
Acquired Immune Deficiency Syndrome (AIDS)
generalized susceptibility to infection that it is itself due to the failure of the host to control and eliminate the Human Immunodeficiency
Virus (HIV)
80
Immunodeficiency diseases
defective gene results in the elimination of one or more components of the immune system
- Defects in T- or B-Lymphocytes development,
- Defects in phagocyte function,
- Defects or absence of complement components
81
antigenic variation
Allows Pathogens to Escape from Immunity
-particularly important for extracellular pathogens, which are generally eliminated by antibodies against their surface structures.
82
3 main forms of antigenic variations
1. Many infectious agents exist in a wide variety of antigenic types distinguish by their different serotypes
2. antigenic drift and shift
3. Programmed gene rearrangement
83
antigenic drift
point mutation in the main surface H protein of the virus
-involves the emergence of point mutants with
altered binding sites for protective antibodies
-new virus can grow in a host that is immune to the previous strain of virus, but as T-cells and some antibodies can still recognize epitopes that have not been altered, the new variants cause only mild disease in previously infected
individuals
84
Antigenic shift
due to major changes in
the hemagglutinin of the virus which can cause global pandemics of severe diseases as the new hemagglutinin
(antigenic glycoprotein) is poorly recognized
-is a rare event involving the reassortment of the segmented RNA viral genomes of two different influenza virus
85
programmed gene rearrangement
which involves periodic switching of the major cell surface protein (variable surface glycoprotein)
86
How many types of influenza virus are there?
3
| -A,B and C
87
Human influenza A and B viruses cause
seasonal epidemics of disease almost every Winter in the US
88
Influenza type C
infections cause a mild respiratory illness and are not thought to cause epidemics
89
Influenza A viruses
divided into subtypes based
on 2 proteins on the surface of the virus: Hemagglutinin (H) and Neuraminidase (N)
-Broken down into different strains: H1N1 and H3N2
90
How many different Hemagglutinin subtypes are there?
18
91
How many different Neuraminidase subtypes are there?
11
92
Neutralizing antibodies
mediate protective immunity which is directed at the viral surface protein Hemagglutinin (H), which is responsible for viral binding to and entry into cells
93
Latency
virus is not being replicated
- in latent state virus doesn't cause disease but it can not be eliminated (no viral peptides to signal its presence)
- Latent infections can be reactivated resulting in recurrent illness
- ex Herpes Simplex Virus (HSV-1, oral herpes)
94
Herpes Simplex Virus (HSV-1, oral herpes)
infects epithelial cells and spreads to sensory
neurons serving the infected area
-initial infection in the skin is cleared by an effective immune response, but residual infection persists in sensory neurons such as those of the trigeminal ganglion, whose axons innervate the lips
-virus is reactivated, usually by some environmental stress and/or alteration in immune status
95
active immunity
conferred by natural exposure to an infectious agent
- depends on the action of a person’s own Lymphocytes and the resulting Memory cells specific for the invading pathogen
- can develop following immunization (vaccination)
96
First vaccine
consisted of the virus causing Cowpox
97
cowpox virus (CPXV)
protects against Smallpox virus or variola virus because the two viruses are so similar that the immune system cannot distinguish them
98
Vaccine is an example of
Artificially-acquired active immunity
99
Vaccines include
inactivated bacterial toxins (Toxoid vaccines), killed microbes, parts of microbes,
viable but weakened microbes that generally do not cause illness, and even genes encoding
microbial proteins
100
Reasons more measles outbreaks can occur
- increase in the number of travelers who get measles abroad and bring it into the U.S., and/or
- further spread of measles in U.S. communities with pockets of unvaccinated people.
- majority of people who got measles were unvaccinated
101
fundamental principle of vaccination
to administer a killed or attenuated form of an infectious agent, or a component of a microbe, that doesn't cause disease but elicits an immune response that provides protection against infection by the live, pathogenic microbe
102
Vaccine success depends on
- Vaccines are effective if the infectious agent does not establish latency
- If it does not undergo much/any antigenic variation -If it does not interfere with the host immune response
- Vaccines are also most effective against infections that are limited to human hosts and do not have animals reservoirs
103
humoral immunity
inducing antibodies against the pathogen
| -how most vaccines in use today work
104
Diseases that effective vaccine is still needed
malaria, schistosomiases, intestinal worm infestation, tuberculosis, diarrheal disease, respiratory infections, HIV/AIDS
105
effective vaccine for extracellular organisms
Antibodies provide the most important adaptive mechanisms of host defense
106
effective vaccine for intracellular organisms
CD8 T-cell response
107
Ideal vaccine
provides host defense at the point of entry of the infectious agent
-stimulation of Mucosal Immunity is therefore an important goal of vaccination against those many organisms that enter through mucosal surfaces
108
Vaccine must
-be safe, low level of toxicity is unacceptable
-must be able to produce protective immunity in a very high proportion of the people to whom it is given
-generate Long-Lived Immunological Memory.
o must prime T and B-lymphocytes.
-Must be relatively cheap if they are to be administered to large populations
109
Adjuvants activate
APC (antigen presenting cells) by engaging the Innate Immune System and providing ligands for Toll-like and other receptors on APC cells
110
adjuvants
mixed with the Antigen and usually render it particulate
- helps to retain the antigen in the body and promote uptake by macrophages
- most include bacteria or bacteria components that stimulate macrophages, aiding in the induction of the immune response
111
Incomplete freunds adjuvant
- oil in water emulsion
- delayed release of antigen
- enhanced uptake of macrophages
112
complete freund's adjuvant
- oil in water emulsion with dead mycobacteria
- delayed release of antigen
- enhanced uptake by macrophages
- induction of co-stimulators in macrophages
113
freunds' adjuvant with MDP
oil in water emulsion with muramyldipeptide (MDP), constituent of mycobacteria
-similar to complete freund's adjuvant
114
alum (aluminum hydroxide)
aluminum hydroxide gel
- delayed release of antigen
- enhanced macrophage uptake
115
alum plus bordetella pertussis
aluminum hydroxide gel with killed B.pertussis
- delayed release of antigen
- enhanced uptake by macrophages
- induction of co-stimulators in macrophages
116
immune stimulatory complexes (ISCOMs)
matrix of Quil A containing viral proteins
- delivers antigen to cytosol
- allows induction of cytotoxic T cells
117
Most antiviral vaccines
currently in use consist of Inactivated or Live Attenuated viruses
118
first generation vaccines
viral vaccines consist of viruses treated so that they
are unable to replicate
-Inactivated, or killed
-peptides from the viral antigens can not be presented by MHC class I molecules and thus CD8+ cells are not generated by these vaccines
-ex flu vaccine
119
second generation vaccines
generally far more potent, because they elicit a greater number of relevant effector mechanisms
- Live-attenuated viral vaccines
- ex polio, measles, mumps, rubella, varicella and the “nasal spray flu vaccine”.
120
attenuation
achieved by growing the virus in cultured cells. to produce an attenuated virus
-virus must first be isolated by growing it in cultured human cells
121
Flu vaccine
-inactivated or killed is widely used
-everyone 6 months of age and older is a candidate
-quadrivalent (four components) inactivated (killed) vaccine that is used
in the flu shot that is given intramuscularly (IM).
-live attenuated virus and is used as a Nasal spray
-designed to protect against main flu virus
122
trivalent (three-component) egg-based vaccines are recommended to contain:
A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus (updated)
A/Hong Kong/2671/2019 (H3N2)-like virus (updated)
B/Washington/02/2019 (B/Victoria lineage)-like virus (updated)
123
Quadrivalent (four-component) egg-based vaccines, which
protect against a second lineage of B viruses, are recommended
to contain:
the three recommended viruses above, plus B/Phuket/3073/2013-
like (Yamagata lineage) virus.
124
Bacille Calmette-Guerin (BCG)
Live Attenuated vaccine derived from Mycobacterium bovis
- closely related to Mycobacterium tuberculosis
- provides protection against the more severe types of tuberculosis
- freeze-dried and need to be mixed with the correct diluent from the same manufacturer before administration
125
BCG dose
vial with 20 doses, dose for a new born is 0.05 ml
126
BCG route
ID into the Right arm
BCG vaccine vials must be discarded 6 hrs after mixing.
BCG can give up to babies 1 year old.
127
human paillomavirus (HPV)
comprise a family of double-stranded DNA (dsDNA) viruses
- causes several different infections
- Many infections are asymptomatic but some progress to genital warts
- Can cause cervical neoplasia, and a few progress to cervical cancers
- Diagnostic: genital warts, PAP and DNA tests
128
Most HPV infections resolve
spontaneously but as with many viral infections, there is no adequate treatment or cure for active infections
129
Genital warts are most commonly caused by types
6 and 11
130
Cervical cancer is the result of persistent oncogenic types of HPV
16, 18, 31,33,45
131
Gardasil 9
non-infectious recombinant vaccine prepared from the purified VLPs of the major capsid(L1) protein of HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58
132
DNA vaccines
circular or linear plasmids that encode an Antigenic Protein (AP) from a
pathogen that is directly injected into the cells.
-after vaccine is injected into patients the plasmid is taken up by cells at the site of injection
-Inside the cell, the viral genes are expressed into
protein
-The viral proteins are degraded into small peptide fragments, which are then presented by MHC class I molecules
133
DNA vaccines represent a favored vaccine strategy because
they are safe, stable, easy to engineer and
produce, an immune response which pose no
interference against later boost immunizations
-disadvantage: DNA vaccines are poor (weak) in terms of Immunogenicity compared to 1st and 2nd generation vaccines
134
gene expression
increased by optimizing both the coding sequence and the gene regulatory elements
135
traditionally DNA has been delivered
by injection or gene gun into muscles or skin, or administration into nasal or oral cavity
136
Novel delivery technologies include use of
-Bacterial and viral vectors
-Particle-mediated delivery into Antigen Presenting Cells (APC) using lipid polymers
-Gold microparticles that encapsulate and condense the DNA allowing slow release
-Physical delivery methods such as:
+electroporation
+needle-free devices such as epidermal patches
137
electroporation
electrical pulses causes temporary and reversible pores in the protective membranes of the cells such as skin, muscle and APC cells
-It can increase the entrance of the plasmids inside the cells by a 1,000 or more
138
Immune responses are modulated by addition of
- Co-stimulatory molecules such as ICAM-1 and CD40L
- Genes encoding cytokines such as IL-12 and GM-CSF
- Chemokines such as RANTES (Regulated on activation, normal T cell expressed and secreted) and MIP-1α (Macrophage Inflammatory Proteins); and
- TLR ligands such as CpG oligonucleotides and heat-shock proteins.
139
No ____ vaccines have been approved for _____ use in the US
DNA, human
140
DNA vaccines
- Uses only the DNA from infectious organisms.
- Avoid the risk of using actual infectious organism.
- Provide both Humoral & Cell mediated immunity
- Refrigeration is not required
- Low immunogenicity
141
Traditional vaccines
Uses weakened or killed form of infectious
organism.
-Create possible risk of the vaccine being fatal.
-Provide primarily Humoral
immunity
-Usually requires Refrigeration
-Higher immunogenicity
142
RNA vaccines
give instructions to our cells to make a harmless piece of a viral protein
-vaccine can be given in the upper arm muscle
-Once the instructions are inside the muscle or the immune cells, the cells use them to make the protein piece. After the protein piece is made,
the cell breaks down the instructions and gets rid of them
-immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies
143
Pfizer-BioNTech
Doses: 2 (21 days apart)
Effectivity: 95%
Storage: 80 C, distributed in a five-dose vial, must be diluted in 0.9 NaCl
before administered
Approve to use in: people over the age of 16
Side Effects : Injection site reaction, Fatigue, Headache, Muscle pain, Chills, Joint pain, Fever
144
Moderna
Doses: 2 (28 days apart)
Effectivity: 94.5%
Storage: 20 C, distributed in a ten dose vial, it does not need to be diluted before administered.
Approve to use in: people over 18
Side Effects: Injection site pain, Fatigue, Headache, Muscle pain, Chills, Joint pain
145
J & J
Doses: 1
Effectivity: 74%
Storage: 4C, distributed in a 5
doses vial, it does not need to be diluted before administered
Approve to use in: People over 18
Side effects: Injection site pain, Fatigue, Headache, Muscle aches, nausea
146
CDC recommendation for J&J vaccine
not recommend for women < 50 years
| -6.8 million doses of J&J vaccines and 6 cases of Blood clots after receiving the vaccine
147
Novavax
```
Doses: 2 (three weeks apart)
Effectivity:
-90.4%
->65 years: 78.6%
Approve to use in: over 18
Side effects: pain/tenderness, redness and swelling at the injection site, fatigue, muscle pain, headache, joint pain,
Allergic reactions
storage: Unopened vials 6 months at 2C to 8C
```
148
passive immunity
transferring Antibodies from an individual who is immune to a particular infectious agent to someone who isn't
-doesn't result from the action of the recipient’s own
B and T-cells
-provides immediate protection, but it persists only as long as the transferred antibodies last (a few weeks to a few months)
149
Passive immunization occurs
naturally when IgG antibodies of a pregnant woman cross the
placenta to her fetus
-IgA antibodies are passed from a mother to her nursing infant in breast milk
-help protect the infant from infection while the baby’s own immune system is maturing
150
Passive immunization ________ induce memory,
does not
151
active immunity
specificity: yes
memory: yes
152
passive immunity
specificity: yes
memory: no
