Vaccines Lesson Notes

1. What are the 2 types of innate + adaptive immunity? 2. What is innate immu- - present from birth nity? - non-specific - no memory - fast 3. What is adaptive immunity? - has to be developed - specific - has memory - slow 4. What is innate immu- - physical barriers nity divided into? - chemicals - proteins - cells - physiological processes 5. What is adaptive immunity divided into? - humoral - cell mediated 6. What is an immune re- a reaction of the body against a foreign agent sponse? 7. What is immunisation? procedure for increasing the concentration of antibodies/effector T-cells which react against infection 8. Why is immunisation to protect individuals against disease + to confer done? herd immunity 9. What is herd immuni- point where the number of immune individuals in ty? the pop is sufficient to prevent transmission of the infection 10. What is immunisation active divided into? passive 11. What is active immuni- administration of antigens - patient mount protective sation? immune response 1/7 induction of adaptive immune response 12. What is passive administration? - transfer of antibodies from individual/animal - no cell mediated response to antigen + no T-helper cells 13. What is active immuni- - natural (when you get the flu) sation divided into? - artifical (vaccines) 14. What is passive immu- - natural (maternal serum/milk) nisation divided into? - artificial (serum from immune individual) 15. What was smallpox caused by? a virus called variola of the genus Orthopoxvirus 16. What are the initial symptoms of smallpox? - fever - fatigue - backpain - followed by a rash + blisters - filled with pus - bumps - form a scab - then a scar 17. What is variolation? - to protect people from smallpox people in China + India started to administer dry scabs from patients with mild smallpox, either blowing the scabs up to their nose/implanting them under the skin - this protected people from major smallpox 18. What were the prob- - people inoculated with scabs got ill + 2% still died lems with variolation? - numbers of infected people increased 19. What was Edward Jen- - milkmaids infected from cowpox transmitted from ner's experiment in- the cows were protected against smallpox volving? - this was used as a vaccine for smallpox 20. What is an antigen? a substance that is capable of stimulating an immune response 2/7 21. What are the types of - whole organisms (living/killed) antigens used in vac- - attenuated/mutant organisms (randomly mutatcines? ed/site directed) - antigenic fragments (inactivated toxins, capsular polysaccharides, surface antigens / bacterial pili) - peptide proteins (cloned DNA / synthetic peptides) - DNA/RNA 22. What are the 2 differ- - live attenuated vaccine ent types of vaccine? - inactivated vaccine 23. What are some exam- - MMR ples of live, attenuated - varicella vaccine? - rotavirus vaccines 24. What are the types of - whole cell inactivated vaccines inactivated vaccines? - subunit vaccines - toxoids - recombinant vaccines 25. Give 2 examples of - hepatitis A whole cell inactivated - rabies vaccine: 26. Give an example of a pneumococcal conjugated subunit vaccine: 27. Give 2 examples of toxoids: - diphtheria - tetanus toxoid 28. Give 4 examples of re- - hepatitis B combinant vaccines: - human papillomavirus - flu - COVID 29. Describe pros of live, - a small dose of attenuated virus/bacteria is inocattenuated vaccines: ulated + must replicate in the person to raise an immune response - although these vaccines replicate, does not cause 3/7 the disease as the wild-type form as it is milder - immune response very close to natural infection - long lasting effect 30. Describe cons of live, - in people with a weakened immune system, the attenuated vaccines: attenuated vaccine can cause severe disease - fragile + easily damaged by heat/light, so storage conditions are critical 31. What is the develop- 1) passage of strain in a foreign host ment of live-attenuat- 2) development of temperature-sensitive strains ed vaccines? 3) administration of attenuated/pathogenic strain via unusual route 4) use of related organism from another animal 32. Describe the development of live, attenuated vaccines by the passage of strain in a foreign host: - live wild-type viruses/bacteria are weakened in a laboratory - the pathogenic virus is isolated from a patient + grown in human cultured cells - the cultured virus is used to infect monkey cells - the virus acquires many mutations that allow it to grow well in monkey cells 33. Describe pros of de- - selection of changes in virus to grow in non-human veloping live, attenu- cells, results in the virus becoming less able to grow ated vaccines via a for- in human cells eign host: - attenuated strain replicates poorly in humans inducing immunity but NOT disease 34. Describe a risk of live, on rare occasions, the attenuated strain of type 3 attenuated vaccines: Sabin polio vaccine has reverted to a virulent strain, causing paralytic disease 35. Describe the development of live, attenuated vaccines by temperature changes: - some strains are attenuated by temp change to develop temp sensitive strain - live, attenuated flu vaccine = contain a flu strain that replicates in cold temp (25 degrees during incubation in eggs) but replicates very poorly at body temperature, therefore it does not cause disease - risk = patients with egg allergy 4/7 36. Describe the develop- - reduces virulence ment of live, attenuat- - used in immunisation of military personal against ed vaccines by admin- adult respiratory distress istration of attenuated/pathogenic strain via an unusual route: 37. Name pros of inactivated vaccines: - (stable) not live + cannot replicate - cannot cause disease - easy to storage - safer than live, attenuated in general 38. Name cons of inactivated vaccines: - immunity is not as long-lasting as in live, attenuated - require several doses to obtain ongoing immunity - immunity is not close to natural response (mostly antibody production) - level of antibodies diminish with time so supplementary doses are required to boost antibody levels 39. Describe whole-cell virus/bacteria killed by physical (heat/radiation) / inactivated vaccines: chemical process 40. Describe subunit inac- formed by a portion of a virus/bacteria tivated vaccines: - proteins of the surface of the pathogen (recombinant flu vaccine) - DNA, RNA vaccines - inactivated toxin (toxoid) - capsular polysaccharide - conjugate protein-polysaccharide 41. Describe inactivata polysaccharide on the surface of the bacteria is ed, subunit conjuchemically attached to a protein gate protein-polysaccharide vaccines: 42. What are the problems - immunisation in adults is very weak of subunit inactivated - short life, no memory virus? - no immunisation at all in infants/children under 5yrs 5/7 (capsular polysaccharide only active mature B cells in children up to 5 yrs) 43. Describe how inactivated, subunit conjugate protein-polysaccharide vaccines are produced + how they work: - capsular polysaccharides is isolated from cultures of the bacteria - CPS is covalently linked to a protein toxoid - the conjugate protein-CPS attaches to the surface of follicular dendritic cells - the conjugate protein-CPS is recognised, internalised + cleaved into protein antigenic determinants that are presented on the surface of beta cells to engage follicular T helper cells - abundant IgG antibodies against the CPS are produced by plasma cells - memory B cells are generated 44. What are other materi- - suspension fluid als used in a vaccine - preservatives + stabilisers besides antigens? - inactivating agents - adjuvants 45. What are examples of - sterile water suspension fluid? - saline - fluid containing proteins - egg proteins - yeast proteins 46. What are examples of - albumin preservatives + sta- phenols bilisers? - monosodium glutamate - antibiotics 47. What are examples are - formaldehyde to inactivate bacterial products inactivating agents? - beta propiolactone which acts as a chemical inactivator of several viruses - glutaraldehyde which inactivates toxins from bacteria 6/7 48. What do adjuvants do? - enhance immunogenicity - usually aluminium gel/salts 49. What is sterility in re- demonstrates that no live microorganisms are prelation to vaccines? sent in the product 50. What is chemistry in demonstrates that the product has the correct relation to vaccines? amount of adjuvant + preservative + pH is correct 51. What is safety in rela- demonstrates that an overdose of the product caustion to vaccines? es no harm 52. What is residual toxi- demonstrates that the product contains no material city in relation to vac- that can cause harm cines? 53. What is efficacy in re- demonstrates that each antigen in the product meets lation to vaccines? the recommend guideline level in internationally recognised tests 7/7