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48 Cards in this Set
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Passive Immunization |
*administer pre-formed antibody (from another host)
does not use recipients own immune system *NEUTRALIZES toxin IMMEDIATELY
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Active Immunization |
*administer vaccination (vaccine Ag)
activation of adaptive immune system--> Ab production--> cell-mediated immunity--> induces memory T & B cells for specific antigen--> specific memory cells respond quickly in response to future infection & person is protected |
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How do vaccine Ags induce memory T & B cell formation? |
BCR bind vaccine Ag--> B cell activated & clonal expansion--> Plasma cells secrete vaccine specific Ab--> memory B cells are generated--> Ag processed & presented to B & Th cells--> Th recognize vaccine Ag via TCRs--> Th cells secrete cytokines--> cytokines influence class switch over Ab--> better memory B cell |
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Both pre-formed and vaccine induced Abs neutralize microbes & toxins by ......... |
Abs prevent microbe binding to cell= block infection & spread to healthy cells
Abs neutralize toxins by blocking the binding of toxins to cells |
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(active/passive) immunizations lead to HERD IMMUNITY
what is herd immunity? |
active immunizations
Herd immunity- community becomes immune bc majority of individuals cannot get/spread disease |
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What are the diff types of Active immunizations? |
-live, attenuated vaccines
-whole killed organism vaccines
-inactivated toxin/toxoid vaccines
-subcellular fragment/subunit surface Ag vaccines |
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What type? -mutated live pathogen -produce strong immune response via replication w/i host (IgG & IgA) --> possibility of actually developing disease -life-long protection w/ single dose |
live, attenuated vaccine |
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Live attenuated vaccines are contraindicated in who? |
-pregnancy -immuno-compromised -pts w/ high dose corticosteroids
(*keep in mind risk of disease may outweigh risk of vaccine, may give anyways) |
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What kind of attenuated organisms are not good vaccines? why? |
attenuated avirulent viruses
-often fail to effectively present Ag & induce inflammation that has a adjuvant effect
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BCG (bacterial Tb, M. bovis) OPV (Sabin's polio virus) MMR (measles, rubella & mumps virus) Flumist (influenza virus)
are examples of what type of vaccine?
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live attenuated vaccines |
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_______ is used as an adjunct for bladder cancer, not as effective against adult infections of bacterial Tuberculosis |
BCG (live M. bovis, Bacille Calmette-Gue'rin)
*works better for children |
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__________ vaccine is partially developed in a chick embryo & partially in human diploid cell culture |
MMR
(measles & mumps in chick, rubella in human) |
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Which stains does FluMist contain? |
2 influenza B & 2 influenza A strains (H1N1 & N3N2) |
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What vaccine type? -intact, non-living organisms -no replication -weaker immune response (IgG) -requires booster doses -safe in immunocompromised -usually requires adjuvants |
Killed vaccines |
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salk polio vaccine (IPV) typhoid (salmonella typhi) cholera (vibro cholerae) rabies (rabies virus) Pertussis (bordetella pertussis bacteria) Influenza (H1N1 & H3N2)
are examples of what type of vaccine? |
killed vaccines |
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The whole killed vibro cholerae is combined with ___________ in the cholera vaccine |
recombinant modified toxin |
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Inactivated bordetella pertussis bacteria is administered in combo w/ ______&______ toxoid vaccine as DTP
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bordetella pertussis + diptheria & tetanus toxoid= DTP
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DTaP is mostly used for childhood immunization. What is DTaP? |
diptheria-tetanus toxoids & acellular pertussis
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____________ vaccines are the most successful of all bacterial vaccines*
-usually require booster immunization -induce short term immunity -lack memory cell generation |
Inactivated toxin/toxoid vaccines |
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Tetanus (clostridium tetani) & diptheria (corynebacterium diptheriae) toxoids are based on formalin inactivated _____________ |
exotoxins
(clostridium perfringens also inactivated toxin (formalin) used in newborn lambs) |
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What type of vaccines? -fragment of antigen, usually containing surface polysaccharides -no virulence -requires booster -safe for immunocompromised -no memory B cell development |
subcellular fragments & surface antigen vaccines
(*surface Ags are recognized first by immune cells) |
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Why don't polysaccharide antigens induce IgG Ab or long-lasting immunity? |
They aren't processed & presented to Th cells--> no cytokine secretion--> no ab class switch over--> no affinity maturation--> no memory B cell development |
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Bacterial capsular polysaccharide vaccine is a subunit/recombinant vaccine used for what? |
Pneumococcus (prevnar) & H. flu
^both conjugated to protein carrier CRM 197 to activate Th cell |
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Recombinant vaccine Gardasil is used to prevent HPV infection & HPV- mediated _______________ |
cervical cancer in women
(given to boys & girls to prevent spread) |
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What kind of vaccine is used for Hepatitis B (Engerix-B)? |
viral surface Ag vaccine
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What kind of vaccine is used for Neisseria meningitidis & streptococcus pneumoniae? |
bacteria subunit vaccine |
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How do therapeutic cancer vaccines, such as PROVENGE (for prostate cancer), work? |
activation of tumor specific T cells (or Abs)--> T cells respond against tumor Ag
*doesn't cure cancer but prolongs life |
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Passive immunization involves Abs from human or animal donors who have been previously infected or immunized.
Passive immunization provides_____________ |
immediate protection |
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Rabies Ab Botulinum Ab Hepatitis B Ab ..are examples of passive immunizations.
What type of patients are these useful for? |
immunocompromised pts pts w acute infection & circulating toxins
*high titer specific Ab required to neutralize infection/toxin
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What are Non-specific immune globulin intravenous (IVIG) used for? |
To boost immune activity* used in Ab immunodeficiency disorders
^ provides short-term protection from a variety of infection, polyvalent IgG Ab from human source (no contraindications) |
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Specific Ab immune globulins (IGs) can also be used to provide infection. What are some examples? |
infectious: -Hep B (HBIG) -Rabies IG -Tetanus IG
Non-infectious: -Rho (D) IG -Pit Viper antivenin -Black widow spider antivenin |
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What are vaccine adjuvants used for? |
used to elicit an earlier, more potent, longer lasting immune response = Enhance immune response* via: - concentrate Ag at injection site: depot effect - deliver Ag to APCs - induce inflammation - target TLR (innate immune system)
*necessary in killed vaccines |
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What are the different types of adjuvants used? |
inorganic salts (Al OH, Al PO3, Ca PO3) bacterial products Cytokines |
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Bacterial products are used w what vaccines commonly? |
bordetella pertusus (w/ diptheria & tetanus) BCG (in bladder cancer) MF59 |
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What are some possible causes of hypersensitivity (allergic rxns) to vaccines? |
allergies to: egg protein (chick embryo in MMR) antibiotic (neomyocin in viral vaccines) preservatives (thimerosol in killed Flu vaccine) |
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Survival of _________________ determines long-lasting immunity (esp in childhood vaccines) |
Ab-secreting plasma cells
(non-survival of plasma-blasts= short live immunity) |
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Immune response in infants/children differs from adults in that the cellular response is usually skewed toward _______________ response |
Th2-type cytokine response |
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__________ vaccines are the overall LEAST protective; T independent (TI) Ag no cytokine secretion
Ex: pertussis depends on both Ab & Th1 immunity |
polysaccharide vaccines |
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Tetanus is caused by the toxin produced by _________
What kind of vaccine is used for tetanus? |
Clostridium tetani |
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what is in the trivalent tetanus vaccine?
who is it used in? |
inactive clostridium tetani toxin + diptheria + pertussis (DTP or DTaP)
used in routine pediatric immunizations
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What is in the Divalent tetanus vaccine?
who is it used in? |
inactive clostridium tetani toxin + diptheria (DT)
used in wound management |
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The _____________ if reformulated annually due to predicted new viral strains Administered annually (prior to Nov-May season) Takes up to 2 weeks for protection
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Influenza vaccine
(contains 2 A & 2 B strains, quadrivalent- H1N1 & H3N2) |
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Which formulation of the flu vaccine is strongly recommended in the at risk: infants, elderly, pregnant, & pts w/ certain health conditions? |
SHOT- inactivated killed virus |
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Which formulation of the BEST (most effective), but can only be used in 2-49 yr olds that are NOT immunocompromised/pregnant? |
INTRANASAL SPRAY- live attenuated virus |
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What are the most common vaccines given prophylactically before travelling? |
-Inactivated Cholera vaccine (if going to an endemic region) -Killed Plague (Y. pestis) vaccine -Typhoid vaccine (S. typhi, 2 forms) |
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What are the 2 forms of the Typhoid vaccine? |
1. ORAL- live attenuated 2. PARENTERAL- either inactivated or capsular polysaccharide |
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In addition to the active (inactivated virus vaccine) immunizations for Rabies, there is also passive immunization.
How/why would you get passive immunization? |
via Rabies immunoglobin (RIG)
*percieved risk of exposure--> post-exposure: 1 dose of RIG + viral vaccine shots on days 3, 7, 14, & 28 (after) |
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T/F Rabies can remain latent in patients body up to 1 yr post exposure before reaching CNS |
TRUE
*one of the few infections where active immmunizations may be carried out after infection |
