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74 Cards in this Set

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? sets standards for the "ideal vaccine".
WHO (world health organization)
List 6 standards set by WHO for vaccines.
1. Affordable worldwide

2. Heat stable

3. Effective after a single dose

4. Applicable to a number of diseases

5. Administered by mucousal route

6. Suitable for administration early in life
4 ways in which passive immunity can be passed on?
1. Natural maternal antibody

2. Immune globulin (receive serum from someone who had the disease)

3. Humanized monoclonal antibody

4. Antitoxin
Name two early pioneers of passive immunity.
Emil von Behring and Hildesaburo Kitasato were the first to show immunity elicited in one animal could be transferred to another by injection of serum
What ist he aim of passive immunity?
The transient protection or alleviation of an existing condition.
List 3 ways in which active immunity may be acquired?
1. Natural infection

2. Vaccines (Attenuated organisms, inactivated organisms, purified microbial macromolecules, cloned microbial antigens, multivalent complexes)

3. Toxoid
Some conditions warranting the use of passive immunization.
1. Deficiency in Ag synthesis due to congenital or acquired B-cell defects (b/c if you can't make these then you can't make memory)

2. Exposure or likely exposure to a disease that will cause or complications

3. When time does not permit adequate protection by active immunization

4. Infection by pathogens whose effects might be ameliorated by Ab
What agent is used for passive immunization against black widow spider bites?
Horse antivenin
What agent is used for passive immunization against botulism?
Horse antitoxin
What agent is used for passive immunization against diptheria?
Horse antitoxin
What agent is used for passive immunization against Hepatitis A and B?
Pooled human immunoglobulin
What agent is used for passive immunization against measles?
Pooled human immunoglobulin
What agent is used for passive immunization against rabies?
Human or horse polyclonal Ab
What agent is used for passive immunization against respiratory disease?
Monoclonal anti-RSV
What agent is used for passive immunization against snake bites?
Horse antivenin
What agent is used for passive immunization against tetanus?
Pooled human immunoglobulin or horse antitoxin
What agent is used for passive immunization against varicella zoster virus?
Human polyclonal Ab
Passive immunization should be used with caution because of what associated risks?
Cross species reactivity
-response is to isotypic determinants
-IgE immune complexes
-Mast cell degranulation and systemic anaphylaxis
-type III hypersensitivity
What is the best kind of immunization?
Active immunization
What does active immunization elicit?
Protective immunity and immunological memory (imm. can not be attained passively)
The two ways in which active immunization is achievable?
1. Natural infection

2. Vaccination
What plays an active role in active immunization?
Immune system plays an active role. Involved in the proliferation of Ag reactive T and B-cell.
What do some vaccines have?
Bad side effects.
What have some of the untoward effects of some vaccines caused parents to do?
To back away from their use. An example is that autism is associated with vaccines falsely. However, there are also real incidences such as pertussis attenuated bacterial vaccine which lead to seizures, encephalitis, brain damage, and death. There were ~19000 cases of this whooping cough in 2004. This is a disease that had once been eradicated.
There has been a recent development of an ? pertussis vaccine that provides what?
There has been a recent development of an acellular pertussis vaccine provides equivalent protection without the untoward side effects.
? is sometimes reqd to obtain effective immunity.
Boosting is sometimes reqd.
Circulating ? Abs exist early in a baby's life.
Circulating maternal Abs exist early in a baby's life. These are passively acquired maternal Abs that bind up epitopes on DPT (diphtheria) vaccine. Passively acquired maternal Abs interfere with efficacy of measles vaccine.
List some risk factors that may require vaccinations in adults.
(based on risk factors)

1. Vaccines for meningitis, pneumonia, and flu to those living in close quarters or the elderly.

2. "travel destinations"

3. Occupation
Explain the idea of herd immunity?
Vaccination is not 100% effective (some respond poorly or not at all). This is not a problem if a majority of the pop. is immunized because the odds of a susceptible individual contacting an infected individual is low. A decrease in herd immunity could be dangerous.
The development of an immune response does not mean the product will ?.
Does not mean the product/vaccine will work. So a state of protective immunity may not be achieved.
How long does polio req to attack immune system?
Only 3 days.
Immunization with a single dose of salk polio vaccine induces what?
A rapid increase in serum Ab levels. Ab levels peak at 2 weeks and then decline. Memory peaks at 6 months and is induced more slowly.
Live attenuated vaccine types are associated with what diseases (8)?
1. Measles

2. Mumps

3. Polio (sabin vaccine)

4. Rotavirus

5. Rubella

6. Tuberculosis

7. Varicella

8. Yellow Fever
What are the disadvantages associated with live attenuated vaccine types?
Requires refrigerated storage; may mutate to virulent form, boosters may be reqd.
What diseases are inactivated/killed vaccine types associated with?
1. Cholera

2. Influenza

3. Hepatitis A

4. Plague

5. Polio (Salk vaccine)

6. Rabies
What are the disadvantages of inactivated/killed vaccine types?
Weaker immune response than live vaccines; booster shots usually reqd.
What are the diseases associated with toxoid vaccine types?
1. Diphtheria

2. Tetanus
What does the term 'attenuated' indicate?
Weakened by growing a virus in a poor environment for it to develop.
What was the first live, attuated vaccine?
Vaccinia virus (cowpox) by Jenner.
What are 2 advantages of live, attenuated viruses?
1. Capacity for transient growth (you get increased systemic exposure, increased immune response, and increased memory)

2. Usually require only a single immunization
What are 2 disadvantages associated with live, attenuated vaccines?
1. Possibly can revert to a virulent form

2. May be associated with complications similar to those seen in the natural disease.
What does BCG stand for?
Bacillus Calmette-Guerin
How is BCG derived?
Mycobacterium bovis grown on a medium containing increasing concentration of bile. After 13 years, M. bovis had adapted to growth in strong bile and had become sufficiently attenuated so it was suitable to become a vaccine for TB. Not used in USA because it is variably effective.
What does the Sabin Polio Vaccine consists of?
Consists of 3 attenuated strains of poliovirus administered in sugar cube or in sugar liquid. Attenuated viruses colonize in the intestine and induce protective immunity to all 3 strains of virulent poliovirus. Causes:

1. Production of intestinal secretory IgA

2. Also induced IgG and IgM

3. Requires boostering because the 3 strains interfere with one another in the intestine.
Inactivated vaccines are ? vaccines.
Killed vaccines.
Inactivation of vaccines is by ? or ?.
Inactivation is by heat or chemicals.
With inactivated vaccines how is the immune response manifested?
It is still raised but the pathogen is not capable of replication in the host.
To be effective epitopes (this is what the immune system recognizes) must be ?.
Maintained
Why is heat inactivation not usually worthwhile?
Because of denaturation.
What has been more successful than heat inactivation?
Chemical inactivation with formaldehyde or alkylating agents has been more successful. For example, Salk polio vaccine is produced by formaldehyde inactivation of the polio virus.
List 5 disadvantages of 'killed' vaccines.
1. Req frequent boosting

2. Induce a predominantly humoral response (humoral, so just a b-cell response)

3. In the case of the Salk vaccine, formaldehyde failed to kill all the virus in 2 vaccine lots resulting in paralytic polio in a large percentage of recipients.

4. Workers exposed to the process of inactivation are at risk

5. In general, still 'safer' than attenuated vaccines.
What are subunit vaccines developed against?
Developed against a part of the pathogen.
Subunit vaccines are vaccines consisting of what?
Vaccines consisting of specific, purifies macromolecules derived from pathogens.
List 3 general forms of subunit vaccines.
1. Inactivated exotoxins or toxoids

2. Capsular polysaccharides

3. Recombinant protein Ags
Inactivated exotoxin or toxoids are subunit vaccines for what conditions?
Diphtheria and tetanus.
Capsular polysaccharides are subunit vaccines that are used for what condition?
Strep pneumoniae (by induction of opsonizing Abs)
Conjugate vaccines are almost exclusively what?
Almost exclusively for B-cells.
Polysaccharide vaccines are limites because of what?
Because they can't activate Th cells.
Conjugate vaccines can activate what?
Can activate B-cells in a Thymus independent manner resulting in IgM production.

-Little class switching
-No affinity maturation
-Little to no memory cells

Not very good vaccines.
Protection against Hemophilis influenzae type b (Hib) is by a what?
By a conjugate vaccine.
What does Hib cause?
Major cause of bacterial meningitis in kids < 5yo.
How is the conjugate vaccine for Hib prepared?
Prepared by covalently linking surface polysaccharide of Hib to a protein molecule. More immunogenic than polysaccharide alone. Activate Th cells. Enable class switching from IgM to IgG. Can induce memory B-cells but not memory T-cells. Not a bad vaccine but requires boosting.
Hib vaccine has dramatically decreased what?
Has dramatically decreased the incidence of bacterial meningitis in USA.
Hib infection can lead to what?
Hib infection can lead to deafness and neurological defects. (it is a high value vaccine)
DNA vaccines are currently in what?
Still in clinical trials.
DNA vaccines involve the utilization of what?
Utilization of plasmid DNA encoding antigenic proteins.
DNA vaccine injections are where?
Injection is directly into the muscle.
List 6 advantages of DNA vaccines.
1. Encoded protein is expressed in its natural form

2. Immune system is directed to the Ag exactly as it is expressed by pathogen

3. Induce cell-mediated and humoral immune responses

4. Cause prolonged expression of Ag and results in significant memory

5. No refrigeration reqd (so worldwide mkt)

6. Animal studies indicate these vaccines can induce protective immunity against a number of pathogens ranging from flu to rabies.
How is the plasmid (in the DNA vaccine) put into a cell's nucleus?
It is shocked into cells
Recombinant vector vaccines involve the introduction of genes that do what?
Introduction of genes that encode major Ags or very virulent pathogens into attenuated viruses or bacteria.
In recombinant vector vaccines attenuated organisms act as a what?
Attenuated organism acts as a vector.
What are chimeras?
Involved with recombinant vector vaccines. Yellow fever vaccine was engineered to express Ags of West Nile Virus. Vaccinia virus (smallpox) is widely used as a vector. (Large complex virus with 200 genes is engineered to carry several dozen foreign genes0
The production of Vaccinia Vector Vaccines involve genes that encode for what?
Gene that encodes for desired Ag inserts into plasmid vector beside vaccinia promotor. Flanking regions are tyrosine kinase genes. Selection of recombinant vaccinia virus is by addition of bromodeoxyuridine which kill TK+ cells.
What is H5N1?
Bird flu