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Microbiology and Immunology > Week 4 > Flashcards

Week 4 Flashcards

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Biology 101 flashcards
1
Q

What is a vaccine (2)

A
  • intentional exposure to pathogens in a form that cannot cause an infectious disease
  • purpose = long-term immune protection
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2
Q

First vaccine

A

small pox - cow pox pus = small pox immunity

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3
Q

Vaccine in 1870

A
  • ckicken cholera, antrhaz, rabies
  • principle = isolate, inactivate using heat and inject
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4
Q

14 infectious diseases controlled by vaccine

A
  • smallpox
  • rabies
  • measles
  • influenzae type b
  • rubella
  • teatnus
  • hep B
  • Pertussis
  • yellow fever
  • tyhpoid
  • mumps
  • diptheria
  • rotavirus
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5
Q

why is immunization of the majority of the population important?

A

if people are not immunized outbreaks can occur again

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6
Q

Anti-vax - history

A
  • the fear of vaccines is as old as vaccination itself
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7
Q

MMR –> autism? study faults (3)

A
  • small study design
  • speculative design
  • weird conclusions
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8
Q

consequence of MMR –> autism

A
  • measles was considered irradicated
  • but immunization rates decreased, number of infections increased (majority of people getting measles are unvacinated)
  • lots of money disproving the whole thing
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9
Q

Herd immunity

A
  • protects susceptible individuals by stopping transmission
  • risk of infection is reduced when the number of individuals who can spread the pathogen is reduced
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10
Q

Herd immunity protects (3)

A
  • infants who cant be vaccinated
  • people immunocompromised who cant be vaccinated (cancer)
  • elderly
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11
Q

what is herd immunity

A
  • when a sufficient majority of the population is immune to the spread of a disease =
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12
Q

Stop transmission of a given disease

A

1-1/R0

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13
Q

can a vaccine cause the disease

A
  • typically no (esp with dead pathogen)
  • may get ‘small’ disease with live vaccines
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14
Q

70% parents concerned about potential side effects

A
  • fever 10-25%
  • prolonged crying 0.001%
  • vomiting 2-5%
  • headache 5-15%

reactions due to immune reaction not vaccine itself

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15
Q

Nursing role + vaccines

A
  • risk/benefit (ex encephalopathy from vaccine measles is 1/300,000, in cases of measles its 1/1000)
  • necessity
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16
Q

Vaccine hesitancy

A

delay in acceptance or refusal of vaccination despite availiability of vaccine services

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17
Q

WHO and Vaccine hesitancy (2)

A
  • one of the top 10 threats to global health
  • needed to build herd immunity against vaccine preventable diseases
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18
Q

Ontario - non medical vaccine exemptions

A
  • non medical vaccine exemptions have been increasing since 2013
  • particularly high surrounding MMR, HPV, COVID-19
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19
Q

COVID-19 percentages and age

A
  • 5+ and two doses= 82%
  • 5-11 year olds and 2 dose = 7%
  • 5-11 year olds and 1 dose = 49.8%
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20
Q

why are people vaccine hesitant (9)

A
  • mistrust in government and medical system
  • not believing they are safe
  • too many vaccines
  • philosophical or religious beliefs
  • thinking that alternative healthcare can replace
  • vaccine myths are prevalent (online)
  • hard to understand vaccine information
  • worried about vaccine side effects
  • diseases that vaccines prevent aren’t a serious threat to their health
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21
Q

3 C’s of vaccine hesitancy + 2 C’s

A
  • complacency
  • confidence
  • ## convenience (ability to understand, health literacy)
  • calculation (engagement in info searching)
  • collective responsibility (willingness to protect others)
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22
Q

Vaccine hesitancy continuum (7)

A

1) accept all
2) accept but unsure
3) accept some
4) delay
5) refuse some (typically live vaccines)
6) refuse vaccines but unsure
7) refuse all vaccines

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23
Q

Health literacy

A
  • 50% 16-25, 49% of 26-35 had health literacy levels below what is needed to navigate in an industrialized country
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24
Q

Digital health literacy

A
  • aspects of navigating digital environemnt
  • computer literacy
  • media literacy
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25
Q

Why does digital health literacy matter (2)

A
  • people look for vaccine info from HCP (traditional and alternative), print material, friends and family, celebrities, and online
  • what you put in the search engine matters (parents who use negative search terms find more myths)
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26
Q

Equity and vaccine hesitancy (3)

A
  • high COVID-19 hesitancy prevalence among disadvantaged groups
  • 83% of COVID-19 infection = racialized, 51% reported cases were living in lower income households
  • historical injustices to indigenous, racialized and vulnerable individuals = mistrust towards government
27
Q

Equity and vaccine hesitancy: considerations (7)

A
  • live rurally and no wifi?
  • can’t afford a phone or computer?
  • don’t speak english>
  • under-housed?
  • choose between medical appointment and losing a job?
  • fear that HCP will judge you?
  • bad experience in healthcare system?
28
Q

What can a nurse do with vaccine hesitancy (4)

A
  • listen to patients
  • reflect on our own personal bias’ and learn from our mistakes
  • advocate for equitable access to healthcare services
  • be aware of misinformation and disinformation and educate your future patients about it
29
Q

Passive immunization

A
  • transfer of preformed antibodies from one person to another
  • immediate temporary prevention or reduction of infection
  • transfered antibodies degrade over time
30
Q

Passive immunization - natural

A
  • maternal antibodies passed from mother to fetus
  • protection up to a year
  • better for some illnessess than others MMR > polio
31
Q

Passive immunization - artificial

A

systemic administration of passive immunizing agent
- vaccines contraindicated or not avaliable
- post-exposure immunoprophylaxis

32
Q

Active immunity

A
  • bodies production of humoural and cellular immunity
  • lasts for many years or for a lifetime
33
Q

Active immunity - natural

A
  • surviving the infection
  • once persons recover from infectious diseases, they have lifelong protection from the disease (immunological memory)
34
Q

Active immunity - natural - exemption

A

malaria

35
Q

Active immunity - artificial

A

vaccination
- age, nutrition factors, coexisting disease affect response

36
Q

How do vaccines work? (5)

A
  • biological products designed to produce immune response safely
  • works with body’s natural defenses
  • weakened or killed form of disease injected into the body
  • body creates antibodies to fight the germs
  • if the actual disease germs ever attack the body, the antibodies return to destroy them
37
Q

Vaccines - which immune system

A
  • typically humoural immune system (B)
  • exception = inducing cell-mediated immunity (T cells)
38
Q

Classification of vaccines

A
  • Live attenuated (viral, bacterial)
  • inactivated
39
Q

Inactivated Vaccines; contain

A
  • Whole (viruses/bacgteria)
  • Fractional (protein based, polysaccharide based)
40
Q

Types of fractional vaccines - protein based

A

toxoid
subunit

41
Q

Types of fractional vaccines - polysaccharide based

A

pure
conjugate

42
Q

How effective is a vaccine? general rule

A

the more similar a vaccine is to the disease causing form of the organism, the better immune response to the vaccine
- boosters

43
Q

Live attenuated vaccines - what (7)

A
  • attenuated (weakened) form of the “wild” virus or bacteria
  • must replicate to produce and immune response
  • immune response virtually identical to natural infection (minus side effects)
  • usually produce immunity with one dose except those administered orally (rotavirus)
  • severe reactions possible
  • fragile - must be stored and handled carefully
  • viral = Measles, mumps, rubella, vaccina, varicella, zoster, yellow fever, rotavirus, influenza, intranasal influenza, oral polio, BCG< oral typhoid, rotavirus
44
Q

Inactivated vaccines happen wiTH…. (2)

A
  • microbes that cannot be attenuated
  • vaccines with oncogenic potential
  • always require multiple doses
45
Q

Polysaccharide Vaccines - 2 types

A
  • Pure Polysaccharide
  • Conjugate polysaccharide (add protein)
46
Q

Polysaccharide vaccines - pure polysaccharide (3)

A
  • T-cell independent,
  • not useful in children under 2
  • repeat doses do not cause boost in immunity
47
Q

Polysaccharide vaccines - conjugate polysaccharide (3)

A
  • T cell dependent and B cell dependent
  • increased immunogenicity in infants
  • repeat doses cause increase in immunity
48
Q

Examples of pure polysaccharide vaccines - 3

A
  • pneumococcal
  • meningococcal
  • salmonella typhi
49
Q

Examples of conjugate polysaccharide (3)

A
  • haemophilus influenzae type b
  • pneumococcal
  • meningococcal
50
Q

Toxoid vaccines (4)

A
  • create immunity to toxins or parts of disease that cause disease reather than the germ itself
  • protein based toxin is rendered harmless and becomes antigen
  • toxoid is absorbed into aluminum or calcium to make immune response (agument)
  • safe because they can’t cause the disease they prevent and they cant revert to virrulence
51
Q

Next generation vaccines

A
  • nucleic acid-based vaccines
  • messenger RNA is used: gives us instructions to make a harmless version of the virus protein, then destroy genetic material from the vaccine = T and B cell
52
Q

Challenges with vaccines for the future (5)

A
  • many vaccines are not effective in immunocompromized people (use adjuvants)
  • antigenic variation due to mutations require constant updating of vaccine formulations (seek conserved antigens, monitor genetic variation)
  • high cost of vaccine development results in premature abandonment of potentially useful vaccines (invest in research)
  • inadequate access to and availability of vaccines in poor countries (tiered pricing, facilitate development of vaccines)
53
Q

mRNA vaccines authorized in Canada

A
  • Pfizer (December 9 2020)
  • Moderna (December 23 2020)
54
Q

how do mRNA viruses work?

A
  • use the lipid nanoparticle system to deliver mRNA to dendritic cell
  • mRNA to tell your body to create a protein (ribosomes in cytoplasm read instructions to build spike protein, mRNA destroyed in this process)
  • this protein sits at cell surface
  • this protein triggers an immune response to produce antibodies (Helper T cells and B cells)
55
Q

History of mRNA viruses (8)

A

1960 - mRNA discovered
1974 - liposomes used for drug delivery
1978 - first liposome mRNA delivery to cell
1993 - first mRNA vaccine tested (influenza in mice)
2005 - discovery of modified RNA that evades immune detection
2013 - first clinical trial of mRNA vaccine (Rabies)
2018 - first drug with lipid nanoparticles approved
2020 - mRNA based COVID vaccines

56
Q

Advantages to mRNA vaccines (2)

A
  • easier and safer to produce than vaccines that require a weakened or inactivated pathogen
  • mRNA can be easily altered for different protein spikes/common viral mutations
57
Q

Disadvantages to mRNA vaccines (2)

A
  • mRNA can be challenge to deliver to cells (innate immune system can enter and destroy mRNA) = use of lipid nanoparticles protect mRNA
  • lipid nanoparticles require uninterrupted refrigeration/freezing and are easily damaged (hard protocols for transportation and vaccine preparation for delivery)
58
Q

Bivalent COVID-19 vaccines availiable in Canada

A
  • moderna bivalent (25mcg original and 25mcg Omicron BA.1)
  • moderna bivalent (25mcg original + 25 mcg BA.4/BA.5)
  • Pfizer comirnaty (15mcg original + 15 mcg BA.4/BA.5)
  • Nuvoxovid (SARS-CoV original with adjuvant Matrix-M = not mRNA)`
59
Q

Protection benefit - factors influencing (3)

A
  • time from last vaccine
  • circulating illness
  • concerning varients
60
Q

Future of mRNA vaccines (4)

A
  • likely many more to come
  • further work on stabilization methods of mRNA for ease of transport and administration
  • limitless possibilities for protection agaisn’t pathogens
  • personalized vaccine to targeting genetic mutations in cancer cells?
61
Q

Current COVID-19 vaccines in Canada-

A
  • Moderna (mRNA)
  • Pfizer (mRNA)
  • Johnson and Johnson (one dose series, less effective adenovirus vector)
  • AstraZeneca (adenovirus vector)
  • Medicago Covifenz (plant based virus-like particle)**
  • Novavax Nuvaxoid (protein based vaccine)
62
Q

Which COVID-19 vaccines are prefered

A

mRNA vaccines > adenovirus vaccines

  • aka moderna and pfizer
63
Q

when are boosters used? (3)

A
  • mRNA vaccines
  • aged 65 and older to prevent hospitalization
  • other ages to reduce symptoms

Microbiology and Immunology (10 decks)

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