[03.21a] Principles of Immunization (Part 1) V2.1

Protection from an infectious or any disease

What is immunity?

A preparation to stimulate the body's immune response

What is a vaccine?

The act of introducing a vaccine

What is vaccination?

Process by which a person becomes protected through vaccination

What is immunization?

Vaccination means injecting a vaccine while immunization stimulates the immune system

What is the strict definition difference between vaccination and immunization?

China and India

Where did inoculation start?

Variolation

What practice involved injecting scabbed lesions from those infected with smallpox into uninfected individuals?

Lack of safety procedures and high risk of death

Why was variolation stopped?

Edward Jenner

Who discovered the process of vaccination in 1796?

Used matter from cowpox pustules against smallpox

What material did Edward Jenner use to develop the process of vaccination?

Louis Pasteur

Who developed a vaccine against Pasteurella multocida in 1879?

Smallpox and Rabies

Name the two human virus vaccines that had given rise by 1900.

Typhoid, Cholera, and Plague

Name the three bacterial vaccines that had given rise by 1900.

1974

When did WHO launch the Expanded Program on Immunization (EPI)?

Expanded Program on Immunization

What does EPI stand for?

Schedules and the recommended vaccinations to give to children at certain ages

What does the EPI consist of?

TB, polio, diphtheria, pertussis, tetanus, and measles

Name three of the original six vaccines included in the EPI in the Philippines.

Hep B, Rotavirus, Hib, pneumococcal vaccines

Which vaccines were later added to the EPI in the Philippines?

Global Vaccination Plan 2011-2020

What was the WHO's strategic initiative implemented until 2020?

Reverse Vaccinology

What process involves determining and searching for the target antigen in the DNA and RNA before developing the vaccine?

Meningococcal vaccine for Neisseria meningitidis

Give an example of a vaccine developed using reverse vaccinology.

Over 20

How many vaccine preventable diseases are there now?

Smallpox

Which disease was already eradicated because of vaccination in the past?

Smallpox vaccines

Which vaccines were also used against monkeypox when the illness had no specific vaccine?

Polio

Which disease is not fully eradicated yet, according to the sources?

A live or inactivated substance (protein or polysaccharide capable of producing an immune response)

What is an antigen?

Protein molecule produced by B lymphocytes to help eliminate an antigen

What is an antibody?

Immunoglobulin

What is another name for antibody?

Antibodies develop in response to an infection

How is natural active immunity acquired?

Antibodies develop in response to vaccination

How is vaccine-induced active immunity acquired?

Mimic the infection without having the infection

What does vaccine-induced immunity do?

Antibodies received through breastfeeding or the placenta

How is natural passive immunity acquired?

9 months

How long do the antibodies received from the mother typically last, delaying the measles vaccine until this time?

Antibodies received from medicine, injection, or infusion

How is induced passive immunity acquired?

Immunoglobulins and Antiserum

Give two examples of agents used for induced passive immunity.

Tetanus toxoid and Tetanus immunoglobulin

What two substances are typically given when someone gets wounded?

The antigen itself that helps the body develop active immunity

What does Tetanus Toxoid provide?

Provides temporary protection and fights the infection

What does Tetanus Immunoglobulin provide?

Active learning

What analogy is used to describe active immunity?

Long-lasting, usually permanent

What is the duration of active immunity?

Passive learning

What analogy is used to describe passive immunity?

Temporary

What is the duration of passive immunity?

Administration of the microorganisms (all or part or its modified product) to evoke an immunologic response, mimic natural infection

What is active immunization?

Administration of preformed antibodies (from humans or animals) to the recipients

What is passive immunization?

Varicella, Measles, MMR, BCG

Name two vaccines that do not require boosters in adults, even if administered multiple times in childhood.

Preservatives, Surfactants, Diluent, Adjuvant, Stabilizers, Residuals

Name three substances found in a vaccine besides the antigen.

Prevent contamination once vial is opened

What is the function of preservatives in vaccines?

2-phenoxyethanol

Give an example of a preservative.

Keep ingredients from blending together, prevent clumping

What is the function of surfactants in vaccines?

Vehicle for dilution (usually just sterile water)

What is a diluent?

Improve immune response

What is the function of an adjuvant?

Aluminum salts

Give an example of an adjuvant.

Keep vaccine components from sticking to the vial

What is the function of stabilizers?

Sugars (lactose, sucrose), amino acids (glycine), gelatin, proteins

Give two examples of stabilizers.

Egg proteins, yeast, or antibiotics

Give two examples of residuals found in vaccines.

Prevents diseases, prevents complications, prevents transmission

Name two benefits of vaccination.

Antigen

If a vaccinated person gets infected, they do not develop a lot of this, leading to lesser transfer when they cough/sneeze.

Stimulate the cells of the body (e.g. dendritic cells, T lymphocytes, B cells, killer T cells)

What does active immunity stimulate?

Give immunoglobulins to temporarily fight the infection

What does passive immunity involve?

Vaccines, Immunoglobulins, Antisera

What are the three categories of immunizing agents?

Human Specific Ig (Hyperimmune)

What type of immunoglobulin is used for Hepatitis B, Varicella, Tetanus, and Rabies?

Human Normal Ig

What type of immunoglobulin is used for Hepatitis A, Measles, Polio, and Rubella?

Antisera (Nonhuman Ig)

What type of immunizing agent comes from animals and is used for Diphtheria, Tetanus, Gas gangrene, Botulism, and Rabies?

BVTR

What mnemonic is used for Human Specific Ig (Hyperimmune)?

AMPR

What mnemonic is used for Human Normal Ig?

Transplacental

What is the most important source of passive immunity in infancy?

Last 2 months of pregnancy

When does the transfer of antibodies usually happen via the transplacental route?

Low natural passive immunity

What are preterm babies at risk for due to early delivery?

Breast milk

How can preterm babies obtain extra antibodies?

Almost all blood or blood products

What is a source of passive artificial immunity where the antibodies are not specific?

Homologous pooled human antibody (Ig)

What form of pure immunoglobulins is obtained from thousands of adult donors and used for post-exposure prophylaxis of Hep A and measles?

Homologous human hyperimmune globulin

What form of hyperimmune globulin has high titers of specific antibody and is used for post-exposure prophylaxis of Hep B, rabies, Tetanus, and Varicella?

Heterologous hyperimmune serum (antitoxin)

Which source of passive artificial immunity comes from animal products (equine) and is used for botulism and diphtheria?

Serum sickness

What adverse effect must be watched out for with heterologous hyperimmune serum?

Monoclonal antibodies

What are derived from a single type or clone of plasma cells and are specific to a single antigen?

Diagnosis and therapy of certain cancers and autoimmune and infectious diseases

Name one use of monoclonal antibodies besides immunization.

Palivizumab

What is an example of a monoclonal antibody used for Respiratory Syncytial Virus (RSV) antibodies?

Combination of different antibodies found at the surface of a particular microbe

What constitutes polyclonal antibodies?

Hepatitis B Ig (HBIg)

What is given for people following percutaneous, mucosal, sexual, or perinatal exposure to Hepatitis B?

Kawasaki Disease

Immunoglobulin is available to prevent coronary aneurysm, a complication of what disease?

Within 6 days after exposure

When is immunoglobulin for Measles usually given?

Rabies, Rubella, Tetanus, Varicella, Snake bite (pit vipers) antivenom

Name two other preparations available for passive immunization besides Hepatitis B and Measles immunoglobulin.

Bind to some other receptors in the immune cells (i.e., APC dendritic cells) to stimulate it further

How do adjuvants promote a stronger immune response?

Phagocytosed by dendritic cells (APCs)

What happens to the antigen once it is introduced?

MHC class II receptors

Through what structure do APCs present the antigen to CD4+ T cells (helper T cells)?

CD4+ T cells (helper T cells) or CD8+ T cells (killer T cells)

To which two types of T cells can APCs present the antigen?

CD8+effector T cells (directly fight infection) and CD8+ memory T cells (multiply in the future)

What two types of cells do killer T cells divide into?

Memory B cells and B cells that undergo differentiation and antibody production

What two types of cells do B cells proliferate into?

It was not standardized, and they are testing without knowing that antibodies are the only ones produced

What are two reasons why checking antibody titers after COVID-19 vaccination was not generally recommended?

Whole Pathogen (Live Attenuated, Inactivated), Subunit Vaccines, Nucleic Acid Vaccines, Viral Vector

What are the four main types of vaccines?

Live Attenuated

What type of whole pathogen vaccine is still alive but weakened?

Toxoid, Polysaccharide, Virus-like particles, Outer membrane Vesicles

Name three types of Subunit Vaccines.

RNA and DNA

What are the two types of Nucleic Acid Vaccines?

Considered as the “delivery person”

What analogy describes the function of a viral vector vaccine?

Whole virus

What vaccine type is analogous to giving the whole cookie with chocolate chips (e.g., Sinovac)?

Protein subunit

What vaccine type is analogous to getting only the chocolate chips (surface antigens) (e.g., Novavax)?

Viral vector

What vaccine type is analogous to the rider carrying the recipe of the chocolate chip cookie (e.g., Astrazeneca)?

Nucleic acid vaccine

What vaccine type is analogous to giving the actual recipe of the chocolate chips, with no rider (e.g., Pfizer)?

Weakened whole bacteria or viruses

What do live-attenuated vaccines contain?

Genetic modification of pathogens

How is the weakening of pathogens achieved in live-attenuated vaccines?