questions 2

Immunization

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Topic updated on 05/25/17 7:21am

Schedule
 
Newborn
2 months
4 months
6 months
12 months 15 months 2 years 4-6 years 11-12 years
Hep B #1 Hep B #2   Hep B #3          
  DTaP DTaP DTaP   DTaP   DTaP  
  PPV PPV PPV          
  HiB HiB HiB HiB        
  Polio #1 Polio #2 Polio #3       Polio #4  
  Rota Rota            
        VCZ        
        MMR     MMR  
            HAV    
                Meningitis
 
Introduction
  • Immunization allows for individuals to be protected against disease
  • Immunity can be conferred in two ways including
    • active immunity that is maintained by the immune system
    • passive immunity that is given transiently from outside
  • Vaccinations are a major source of conferring immunity outside normal infection and include
    • viral vaccines divided into
      • killed vaccines
      • live attenuated vaccines
    • bacterial vaccines
  • Often vaccinations require an adjuvent that
    • enhances the immune reaction against the vaccine provided
    • increases the development of memory to non inflammatory antigens
    • can be of several types including
      • aluminum potassium sulfate
      • muramyl dipeptide
      • LPS/polyribonucleotides
  • Though vaccines are generally safe, contraindications to their use include
    • people with egg allergies who should avoid 
      • yellow fever vaccine and other vaccines made in eggs
    • pregnant women who should avoid 
      • rubella vaccines
    • immunocompromised individuals who should avoid
      • all live vaccines
Active vs Passive Immunity
  • Immunity can be either active or passive with several notable differences
Differences Between Active and Passive Immunity
Feature Active
Passive
Acquisition method
  • Receiving preformed antibodies
  • Exposure to infection or to foreign antigens
Examples
  • Maternal IgG crossing placenta
  • Babies getting IgA in breast milk
  • Administration of antitoxin
  • Infection with the specific pathogen
  • Administration of a vaccine
Onset
  • Immediate upon administration
  • Slow to allow for development of full immune response     
Duration
  • Very short with a half life between two weeks and four weeks
  • Long or even lifetime
  • Due to generation of memory
 
Viral Vaccines
  • Viral vaccines can either be live attenuated or killed with several notable differences

Differences between Live and Killed Vaccines

Feature Live
Killed
Production method
  • Design a nonpathogenic version of a virus that can still grow transiently in the host
  • Inactive pathogen or pathogen antigens by treatment with heat or chemicals
Pros
  • Induce both cellular and humoral responses
  • induces lifelong immunity (usually)
  • Safer than live vaccines because they cannot revert to pathogenic state
Cons
  • Cannot give to immunocompromised patients
  • Small chance of reverting to pathogenic state
  • Weaker response (usually only humoral)
  • May require booster shots     
Examples
  • Everything else
  • MMR
  • VZV
  • Polio (Sabin)
  • Etc
  • Rest In Peace Always
  • Rabies
  • Influenza
  • Polio (Salk)
  • Hepatitis A
Bacterial Vaccination
  • Bacterial vaccination involves administration of characteristic protein which can be
    • inactivated toxin produced by pathogen called a toxoid
    • coat protein that surrounds the pathogen called a capsule
    • other important proteins that are conserved by the pathogen
  • Select examples of vaccines against pathogenic bacteria include
    • DTaP that is composed of
      • C. diptheriae toxoid
      • C. tetani toxoid
      • B. pertussis toxoid
    • H. influenzae capsular type B
    • S. pneumoniae that comes in two forms including
      • a pediatric version with
        • 7 capsule types
        • think: a 7 year old gets PCV
      • an adult version with
        • 23 capsular types
    • N. meningitidis with 4 capsular proteins

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(M1.IM.78) A young man about to leave for his freshman year of college visits his physician in order to ensure that his immunizations are up-to-date. Because he is living in a college dormitory, his physician gives him a vaccine that prevents meningococcal disease. What type of vaccine did this patient likely receive? Topic Review Topic

1. Live, attenuated
2. Killed, inactivated
3. Toxoid
4. Conjugated polysaccharide
5. Killed, attenuated

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