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Vaccines

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Topic updated on 06/01/17 9:59pm

 
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 Passive
Active
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.MC.74) Two patients are vaccinated for poliomyelitis. Patient A receives the Sabin oral vaccine, and Patient B receives the Salk intramuscular vaccine. Six weeks after their initial vaccinations, which of the following would be the greatest difference regarding these two patients? Topic Review Topic

1. Patient A has a higher level of duodenal IgA antibodies
2. Patient B has a higher level of duodenal IgA antibodies
3. Patient A has a lower level of serum IgA antibodies
4. Patient B has a lower level of serum IgM antibodies
5. Patient A has a higher level of serum IgG antibodies

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