respiratory vaccines

vaccine strain

specific variant of a virus or microorganism selected for use in vaccine production

how many types of Influenza Vaccines

6 types

standard-dose, unadjuvanted inactivated (IIV3)

• egg based used for more than 70 years

• candidate vaccine strain grown in fertilized chicken eggs & incubated to replicate

egg allergies

• cdc says you can still get any flu shots, unless anaphylaxis

• flu changes strain every year

cell culture-based inactivated (ccIIV3)

• not grown on eggs (designed for egg allergies)

• vaccine strain grown in mammalian cells (MDCK)

adjuvanted inactivated (aIIV3)

• egg-based methods

• viruses are grown in fertilized chicken eggs, harvested, and then split/inactivated to isolate viral surface proteins

• An oil-in-water adjuvant (MF59) added —> stronger response.

high-dose inactivated (HD-IIV3)

• pts over 65

• uses egg-based method w/ 4 times the antigen

recombinant (RIV3)

• do not need candidate vaccine virus (CVV)

• take hemagglutinin (HA) gene → put in baculovirus (virus infects invertebrates cells) → recombinant virus produces large amts of HA protein for vaccine

live attenuated influenza vaccine (LAIV3)

• egg-based

• weakened live virus are injected in fertilized chicken eggs & incubated to replicate

• strains → genetically modified to be ‘cold-adapted’

  • temp sensitive

  • survives in cooler nasal passages but not reproduce in warmer lungs

influenza vaccine composition for 26-27

egg- based vaccines

• an A/Missouri/11/2025 (H1N1) pdm09-like virus

• an A/Darwin/1454/2025 (H3N2) -like virus

• a B/Tokyo/EIS13-175/2025 (B/Victoria lineage) - like virus

Cell culture & recombinant vaccines

• an A/Missouri/11/2025 (H1N1) pdm09-like virus

• an A/Darwin/1415/2025 (H3N2) -like virus

• a B/Pennsylvania/14/2025 (B/Victoria lineage) - like virus

reading components

an A/Missouri/11/2025 (H1N1) pdm09-like virus

• A/B: strain (a is more circulated)

• location: flu is found

• H1N1: strain, virus subtype

practice: did child receive at least 2 flu vaccine before July 1, 2026

• ages 6 month - 8 years

yes: give 1 dose of 26-27 flu vaccine

no/ unknown: give 2 doses of 26-27

• one now and 4 weeks later

influenza: 6m - 18 years

flu vaccine very year

influenza: 18-64 years

age appropriate vaccines

• live vac up to 49

influenza: solid organ transplant, 18 -64 , immcom

• high dose inactivated HD-IIV3

• adjuvanted inactivated allIV3

65 and older

• high dose inac (HD-II3)

• Adj inac (all3)

• recombinant influenza vaccine (RIV3)

timing for influenza vac

• try not to vaccinate before september —> too early

• some people might need a get two shots in a year

  • flu season starts in sept

  • ex: got flu shot in feb 26, not equipped for 26-27 season

• continue give out unexpired vaccines after October thruout influenza season

exceptions for vaccinations in July/ august

• pregnant in 3rd trimester

  • mom can pass passive immunity to baby in 1st 6 months

• children <9 years who need 2 doses a season

what is pneumococcal vaccine for

• serious infections by Streptococcus pneumoniae bacteria, pneumococcus

• Pneumonia (lung infection)

• Meningitis (brain and spinal cord infection)

• Sepsis (bloodstream infection)

• Ear and sinus infections

how many types of pneumococal vaccines?

2

polysaccharide (PPSV)

• dif polysac (chains of complex sugars) from dif versions of antigen

• T-cell independent

  • produces weaker immune response (older vac, not used much rn)

conjugate (PCV)

• poly sac of diff bacterial versions attached to a protein carrier -→ protein act T-cells

• T-cell dependent —> make memory B-cells reduce bacterial carriage in the nose

• better, stronger response

  • effective, once & done

Are PCV 20 & 21 interchangeble

yes, 20 more in stock

pneu in children

KEY: PCV20 can complete series without PPSV23; if PCV15 is used, PPSV23 8 weeks later

• under 2; series of 4, PCV 15 or 20

  • healthy 24-59 months w/ incomplete PCV: receive 1 dose 15/20

• 2-18 (w/ medical condition & vaccinated before 6):

  • received ≥1 dose of PCV20: done

  • no: give PCV20 or PPSV23, at least 8 weeks later

• 6-18 (w/ med cond & no prior PCV)

  • 1 dose of 20/15

  • IF PCV 15 is used → give PPSV 23 8 weeks later