Lecture 27: Principles of Vaccination

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Questions and Answers

What is a key consideration in modern vaccine design and development?

  • Excluding adjuvants to minimize allergic reactions.
  • Evolving designs to address various factors and improve effectiveness. (correct)
  • Focusing solely on live-attenuated virus vaccines.
  • Ignoring the clinical trial phases to expedite vaccine availability.

Which type of immunity involves the transfer of antibodies from mother to baby through breast milk?

  • Artificial active immunity
  • Natural passive immunity (correct)
  • Natural active immunity
  • Artificial passive immunity

What was the primary benefit of variolation?

  • Eliminating the need for future vaccinations.
  • Protecting individuals from developing smallpox infections. (correct)
  • Eradicating smallpox completely.
  • Causing a more severe form of smallpox.

What is a common concern among individuals who oppose vaccinations?

<p>Vaccines may not be safe and could cause injury. (A)</p> Signup and view all the answers

How does herd immunity primarily protect populations from disease?

<p>By preventing disease spread when a high percentage is immune. (B)</p> Signup and view all the answers

Which of the following is NOT a type of vaccine formulation?

<p>Antibiotic vaccines (B)</p> Signup and view all the answers

What type of immune response are vaccine formulations designed to generate?

<p>B/T cell memory responses. (D)</p> Signup and view all the answers

What is the main purpose of adjuvants in vaccines?

<p>To increase the immunogenicity of the vaccine. (A)</p> Signup and view all the answers

Which of the following best describes the purpose of Phase I clinical trials for vaccines?

<p>To assess human safety by closely monitoring volunteers for adverse effects. (A)</p> Signup and view all the answers

Under what circumstances can a company apply for Emergency Use Authorization (EUA) for a vaccine in the U.S.?

<p>If Phase II and III results look promising. (D)</p> Signup and view all the answers

What is the purpose of Phase IV (post-marketing surveillance) in vaccine development?

<p>To monitor the long-term safety and effectiveness of the vaccine. (B)</p> Signup and view all the answers

What is the Vaccine Adverse Event Reporting System (VAERS)?

<p>A system for collecting unexpected symptoms post-vaccination. (D)</p> Signup and view all the answers

How does artificial active immunity differ from natural active immunity?

<p>Artificial active immunity is induced by exposure to an antigen via vaccination. (A)</p> Signup and view all the answers

Which of the following statements about passive immunity is most accurate?

<p>It is quick, short-lived, and limited. (B)</p> Signup and view all the answers

What is the primary mechanism of action for Regeneron anti-spike protein antibodies?

<p>Preventing the virus from binding to human cells. (A)</p> Signup and view all the answers

What is the term for the death rate due to a disease?

<p>Mortality (A)</p> Signup and view all the answers

What is the difference between an epidemic and a pandemic?

<p>An epidemic affects a large number of people in a region, while a pandemic affects people over multiple countries. (B)</p> Signup and view all the answers

Edward Jenner is best known for his work related to which disease?

<p>Smallpox (A)</p> Signup and view all the answers

According to the information, what is one of the primary reasons some parents may delay or refuse vaccines for their children?

<p>Fear of serious side effects. (B)</p> Signup and view all the answers

What is a common misconception regarding vaccine ingredients?

<p>Trace amounts of certain substances can be found in vaccines (D)</p> Signup and view all the answers

Which of the following statements is true regarding thimerosal?

<p>It is a mercury-based preservative that has been reduced or eliminated from many vaccines. (B)</p> Signup and view all the answers

What role does formaldehyde play in vaccine manufacturing?

<p>It is used to inactivate viruses or bacterial toxins. (B)</p> Signup and view all the answers

What is the average daily intake of aluminum for a person?

<p>30-50 mg (A)</p> Signup and view all the answers

What is a potential explanation for why some might incorrectly believe that general health measures are sufficient, rather than vaccines?

<p>The misunderstanding of how herd immunity works. (D)</p> Signup and view all the answers

What is the primary role of stabilizers in vaccines?

<p>To help maintain antigenic structure and effectiveness. (D)</p> Signup and view all the answers

Why are some vaccines administered in multiple doses?

<p>To ensure adequate immunity is generated. (A)</p> Signup and view all the answers

What is a significant advantage of live-attenuated vaccines compared to non-live vaccines?

<p>Can offer lifetime protection. (D)</p> Signup and view all the answers

What is the primary risk associated with live-attenuated vaccines?

<p>They may cause a life-threatening infection in immunocompromised individuals. (B)</p> Signup and view all the answers

What is a key characteristic of non-live vaccines?

<p>Protection fades over time (D)</p> Signup and view all the answers

What is a key advantage of non-live vaccines?

<p>Safe for immunosuppressed (A)</p> Signup and view all the answers

Which type of vaccine uses a weakened form of the virus or bacteria that causes a disease?

<p>Live, attenuated vaccines (D)</p> Signup and view all the answers

If a vaccine uses a killed (inactivated) virus, what is a common characteristic of how it works compared to a live vaccine?

<p>It typically requires multiple doses to achieve sufficient immunity. (A)</p> Signup and view all the answers

A vaccine that contains parts of a virus or bacteria, rather than the entire microbe, is called a what?

<p>Subunit vaccine (B)</p> Signup and view all the answers

If a vaccine contains a toxoid, what type of disease is it designed to prevent?

<p>A disease caused entirely by a toxin produced by a bacterium. (A)</p> Signup and view all the answers

What is primarily responsible for slow immune response (mainly Ig production) in inactivated or killed vaccines?

<p>Not killed properly (A)</p> Signup and view all the answers

What is the purpose of using an attenuated pathogen as a vector in vectored vaccines?

<p>To carry another pathogen's genes and express them, stimulating immunity. (D)</p> Signup and view all the answers

What is a limitation of DNA vaccines compared to traditional vaccines?

<p>The immune response induced by them is often too weak for approved use. (C)</p> Signup and view all the answers

What is the function of the antigen-encoding mRNA in mRNA vaccines?

<p>To be translated into a pathogen-specific antigen by host cells. (D)</p> Signup and view all the answers

What is a major challenge in delivering mRNA effectively for vaccination?

<p>Preventing its degradation by endonucleases and facilitating its transport across cell membranes. (D)</p> Signup and view all the answers

What is the benefit of lipid encapsulation of mRNA in mRNA vaccines?

<p>Lipid is the transporter and is easier to perform an intramuscular injection with. (C)</p> Signup and view all the answers

ACE2 (angiotensin-converting enzyme 2) does NOT have a role in?

<p>Protein expression (D)</p> Signup and view all the answers

Besides Aluminum, which of these can serve as an adjuvant for minimal immunogenic Ags?

<p>Aluminum salts (C)</p> Signup and view all the answers

Considering the evolution of vaccine design, what is the most critical attribute that differentiates contemporary vaccine strategies from those employed in the era of variolation?

<p>The targeted manipulation of the host's adaptive immune response through precisely defined antigenic components. (B)</p> Signup and view all the answers

In the context of vaccine clinical trials, under what highly specific regulatory circumstance would a company be permitted to bypass traditional Phase III efficacy trials and seek initial approval via Emergency Use Authorization (EUA)?

<p>When the disease poses an imminent, grave threat to public health, and the benefits of expedited access demonstrably outweigh the risks, based on available Phase I/II data. (A)</p> Signup and view all the answers

Given the multifactorial nature of vaccine hesitancy, which of the following approaches would be least effective in addressing parental concerns regarding vaccine safety and promoting informed decision-making?

<p>Dismissing concerns as irrational and reinforcing the scientific consensus without addressing the specifics of the expressed fears. (A)</p> Signup and view all the answers

Considering the known limitations of inactivated vaccines, what is the most critical immunological challenge that necessitates the incorporation of potent adjuvants or the administration of multiple doses?

<p>Inability to elicit a cytotoxic T lymphocyte (CTL) response due to the absence of endogenous antigen processing and presentation. (A)</p> Signup and view all the answers

When considering the limitations of live-attenuated vaccines, what represents the most significant obstacle precluding the use of such vaccines in specific patient populations?

<p>The potential for reversion to virulence, thereby causing disease, particularly in immunocompromised individuals. (D)</p> Signup and view all the answers

Given the established role of adjuvants in enhancing vaccine immunogenicity, what is the most precise mechanism by which aluminum salt adjuvants, such as alum, potentiate the immune response?

<p>Stimulation of the inflammasome, leading to the release of IL-1β and enhanced antigen presentation. (A)</p> Signup and view all the answers

In the development of mRNA vaccines, what presents the foremost challenge in ensuring effective translation of the antigen-encoding mRNA within the host cell cytoplasm:

<p>Evading degradation by ubiquitous exonucleases before translation can occur. (B)</p> Signup and view all the answers

Considering the principles underlying vectored vaccines, what mechanism fundamentally accounts for the enhanced immunogenicity observed when using a replication-competent viral vector?

<p>Enhanced stimulation of cytosolic pattern recognition receptors (PRRs), mimicking a natural infection and augmenting both innate and adaptive immunity. (D)</p> Signup and view all the answers

When formulating hypotheses regarding correlates of protection for a novel vaccine, what constitutes the most critical determinant in predicting long-term efficacy against a pathogen characterized by high antigenic variability?

<p>The breadth and durability of the T cell response, particularly the generation of central memory T cells capable of responding to variant epitopes. (C)</p> Signup and view all the answers

Given the challenges associated with achieving mucosal immunity through systemic vaccination, what represents the most plausible strategy for eliciting robust and durable protection against pathogens that primarily infect via mucosal surfaces?

<p>Targeted delivery of live-attenuated or vectored vaccines directly to mucosal-associated lymphoid tissues (MALTs). (D)</p> Signup and view all the answers

When considering the influence of host genetics on vaccine responses, which factor would most significantly impact the magnitude and quality of CD8+ T cell responses following vaccination?

<p>Allelic diversity within the major histocompatibility complex (MHC) class I locus, influencing antigen presentation to CD8+ T cells. (A)</p> Signup and view all the answers

Among the various methods used to inactivate whole-pathogen vaccines, which approach would be least likely to preserve the immunogenic epitopes necessary for eliciting broadly neutralizing antibodies?

<p>Heat inactivation at elevated temperatures, leading to protein denaturation and aggregation. (D)</p> Signup and view all the answers

What immunological mechanism would be LEAST effective in combatting a pathogen that exhibits significant antigenic drift?

<p>Generating high-affinity antibodies, specific to a single, variable epitope. (C)</p> Signup and view all the answers

In the context of vaccine development for emerging viral threats, what strategy would be LEAST effective as a primary countermeasure against a virus exhibiting high rates of recombination and reassortment?

<p>Relying solely on vaccines that elicit strain-specific immunity limited to a single viral serotype. (A)</p> Signup and view all the answers

What is the primary challenge in formulating effective vaccines against intracellular bacterial pathogens?

<p>The difficulty in eliciting robust cell-mediated immunity, particularly CD8+ T cell responses, required for clearing infected cells. (A)</p> Signup and view all the answers

What is a critical factor in the success of conjugate vaccines?

<p>The ability to allow a T-independent antigen to be presented to T-helper cells. (C)</p> Signup and view all the answers

Why do certain vaccines require administration via the intramuscular route?

<p>To facilitate uptake and presentation of the antigen by muscle-resident dendritic cells. (A)</p> Signup and view all the answers

For an emerging viral variant with mutations primarily affecting antibody epitopes, which vaccine design strategy provides the most promising approach to broad and durable protection?

<p>A combination vaccine including mRNA for highly conserved viral proteins with a strong Th1 adjuvant. (C)</p> Signup and view all the answers

What is the MOST relevant translational consideration when transitioning from promising preclinical vaccine data to human clinical trials?

<p>Establishing that the mechanistic pathways of immune activation observed in animals are conserved in humans. (B)</p> Signup and view all the answers

What is the foremost challenge to formulating effective vaccines against highly mutable viruses characterized by frequent antigenic drift?

<p>Priming of broadly reactive T cells capable of recognizing multiple variant epitopes. (A)</p> Signup and view all the answers

In the development of a novel subunit vaccine, what is the most crucial consideration when selecting an appropriate adjuvant?

<p>The adjuvant's capacity to stimulate both humoral and cell-mediated immunity, tailored to the specific pathogen and target population. (D)</p> Signup and view all the answers

Which innate immune pathway is LEAST likely to be activated by mRNA based vaccines?

<p>NOD-like receptors (NLRs). (C)</p> Signup and view all the answers

If a patient has known mutations in genes encoding proteins involved in innate immunity, how should this MOST influence your vaccine selection?

<p>Inactivated or subunit vaccines with potent adjuvants may be most appropriate. (D)</p> Signup and view all the answers

In the formulation of multivalent vaccines, what is MOST critical?

<p>Balancing the immune response to all vaccine components to prevent immunological subversion. (D)</p> Signup and view all the answers

When faced with a novel, highly pathogenic virus, what is the LEAST useful immediate step?

<p>Rapidly developing and deploying a live-attenuated vaccine to achieve herd immunity. (B)</p> Signup and view all the answers

Why are multiple vaccine doses MOST critical.

<p>Expansion of the population of memory B and T cells. (A)</p> Signup and view all the answers

When considering vaccine strategies for elderly individuals, what is MOST concerning?

<p>Elderly are likely to have low thymic output and reduced T cell diversity. (C)</p> Signup and view all the answers

When considering a protein subunit vaccine, what is the MOST important aspect to test in Phase I clinical trials?

<p>Assessment of adverse advents and potential dose-limiting toxicities. (A)</p> Signup and view all the answers

What is the chief reason that public health initiatives, on their own, are unable to eradicate a disease that is vaccine preventable?

<p>Public health measures cannot provide long-term immunity. (A)</p> Signup and view all the answers

What is the MOST likely reason for vaccine failure?

<p>Patient non-compliance to vaccine schedule. (D)</p> Signup and view all the answers

What is the MOST compelling reason to get vaccinated?

<p>Vaccines can induce sterilizing immunity and eradication of a disease. (D)</p> Signup and view all the answers

Under what circumstances should a physician delay vaccination?

<p>If the patient is taking immunosuppressive therapy. (B)</p> Signup and view all the answers

In a population with significant vaccine dissent, what is the the LEAST helpful thing to do?

<p>Make it more difficult to opt out of vaccine mandates. (C)</p> Signup and view all the answers

A medical device company has a technology that can perform continuous measurements of neutralizing antibody titers against a respiratory virus. How should this technology be BEST used for a vaccine development project?

<p>Enroll subjects and correlate infection events with antibody levels. (C)</p> Signup and view all the answers

A trial is enrolling patients, but most of hte patients are immunologically naive. What is MOST urgent to add to the study?

<p>An active comparator group of vaccination with another vaccine. (B)</p> Signup and view all the answers

What is MOST important to consider in a vaccine campaign that aims to protect against disease X?

<p>The seroprevalence of the population against disease X. (B)</p> Signup and view all the answers

Why is the recombinant protein in a subunit vaccination often fused to another carrier protein?

<p>To improve solubility and protect it from immediate degradation. (B)</p> Signup and view all the answers

A novel adjuvant is highly specific for a single Toll-like receptor. In what circumstance should you MOST avoid using it?

<p>Patients who have autoimmunity. (B)</p> Signup and view all the answers

What is the MOST critical reason to perform downstream analytics of B cell isotypes and IgG subclasses after vaccination?

<p>To better define the quality and class switching in response to vaccination. (A)</p> Signup and view all the answers

A vaccine manufacturer has developed a pentavalent vaccine and has received approval for its use, but is noticing low seroconversion rates. What is the MOST important consideration?

<p>The seroconversion rate for each component in the pentavalent vaccine, as one may be blunting the response. (A)</p> Signup and view all the answers

Flashcards

Immune Correlates of Protection

Specific immune targets that scientists hypothesize will result in protection from infection.

Natural Passive Immunity

Transfer of antibodies from mom to baby (placenta, breast milk).

Natural Active Immunity

Development of antibodies because of natural infection.

Artificial Passive Immunity

Transfer of ready-made antibodies to immunocompromised individual.

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Artificial Active Immunity

Induce immunity by exposure to antigen via vaccination.

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Passive immunity

Individual receiving antibody did not make own immune response to pathogen.

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Active immunity

Natural infection or inducing immune response.

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Who is Edward Jenner?

Edward Jenner gets credit for developing and sharing the practice of immunization.

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Toxic vaccine additives

Vaccines are full of toxic additives.

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Vaccines unnecessary?

States vaccines are not needed because health measures are sufficient.

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Vaccines evil empires?

Companies are simply out to make money at the expense of the patient.

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Vaccine components

An antigenic molecule that serves as the immunogen.

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Vaccines multiple doses

May only provide limited amounts of Ag to mount an immune response.

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Vaccine factors

Administered to protect and deliver the immunogen to the immune system.

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Types of vaccines

Live attenuated, killed, subunit and conjugate vaccines.

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Live, Attenuated Vaccines

Infectious agent modified to transiently or weakly replicate in inoculated host.

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Killed, Inactivated Vaccines

Uses complete pathogen in a form that has been killed by heat or chemical treatment.

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Toxoids

Used with diseases caused entirely by a toxin.

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Capsular Polysaccharides

Used with diseases caused by bacteria with species-specific and strain-specific outer coverings or capsules

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Vectored vaccines

Uses modified pathogens as a vector.

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Nucleic Acid Vaccines

Plasmids or mRNAs carrying pathogen genes are injected into muscle tissue.

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Adjuvants

They are substances that enhance the immunogenicity of Ags by establishing a state of inflammation.

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Intrinsic immunity influence

Age, genetics, sex and comorbidities.

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Environment immunity influence

Rural vs urban, Geographic location, Season, Family size and Toxins.

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Extrinsic immunity influence

Infections, Parasites, Antibiotics, Probiotics & prebiotics and Microbiota.

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Vaccine clinical testing

Rigorous testing in vitro, animal models, and human subjects

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Clinical trials: Phase I

assess human safety by testing the product in a small number of volunteers who are closely monitored for adverse effects

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Clinical trials: Phase II

evaluates the efficacy of the vaccine in humans, or the ability to elicit the desired response

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Clinical trials: Phase III

evaluate vaccine effectiveness against benchmark linked to pathogen exposure

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Clinical trials: Phase IV

Post-marketing surveillance when the safety and effectiveness of a vaccine or drug is being monitored.

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Emergency Use Authorization

May be granted during public health emergencies, when the risk of life-threatening disease and the lack of available treatments offset potential risks from the vaccine

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Infectious diseases

Leading cause of death worldwide, preventable with vaccines

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Outbreak

Pathogen infects many people in an area in a short time

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Endemic

Outbreak remains constant and predictable within specific population

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Epidemic

Pathogen infects large numbers of people in region

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Pandemic

Pathogen infects large numbers of people over multiple countries

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Communicable

Ability to spread from person to person

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Vaccine components: Immunogen and packaging

An antigenic molecule that serves as the immunogen and packaging to protect the immunogen

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Maternal Immunity Timing impact

Maternal Ig interferes with Measles and Varicella vaccines which delays use until 12-15 months of age

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Variolation Protection

the number of deaths from exposure due to variolation was 1 in 100, compared to 1 in 4 with active infection

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Thimerosal

a mercury-based preservative used in US for multi-dose vaccines and other medicines

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USPHS action in 1999

reduce or eliminate thimerosal from vaccine formulations

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Toxoid Vaccination Result

vaccination leads to seroconversion and the creation of neutralizing Ig

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Capsular Antigen Vaccination

Vaccination with capsule antigens to produce seroconversion and opsonizing Ig

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Role of adjuvants

are substances that enhance the immunogenicity of Ags by establishing a state of inflammation

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Study Notes

  • Vaccine design and development has evolved over time, considering multiple factors.
  • Artificial passive immunity assists in the transfer of ready-made antibodies to immunocompromised individuals.

Natural vs. Artificial Immunity

  • Natural immunity is acquired naturally.
  • Active natural immunity involves developing antibodies because of natural infection.
  • Passive natural immunity involves the transfer of antibodies from the mother to the baby via the placenta or breast milk.
  • Artificial immunity supplements one's immunity through vaccination.
  • Active artificial immunity induces immunity through antigen exposure via vaccination.
  • Passive artificial immunity consists of transferring ready-made antibodies to immunocompromised individuals.
  • Active immunity comes from natural infection or inducing an immune response.
  • Passive immunity can be transferred between individuals.

Infectious Disease

  • Leading cause of death worldwide
  • Caused by viruses, bacteria, fungi, and parasites
  • Outbreak: pathogen infects numerous people in short time within a small area.
  • Endemic: outbreak remains predictable and constant within specific population group.
  • Communicable: contagious
  • Epidemic: pathogen infects large populations in a region
  • Pandemic: pathogen infecting multiple populations over multiple countries.

Vaccine Design & Development

  • Vaccine development requires defining specific immune targets, such as effector lymphocytes or soluble proteins.
  • Basic safety criteria must be met for vaccines.
  • Vaccine effectiveness is determined by monitoring volunteers and collecting samples over time.
  • Pathogen-specific factors, like incubation period and mutation rate, are considered.
  • Other factors include administration method, storage stability, and cost-effectiveness.
  • Clinical testing involves in vitro studies, animal models, and human subjects; only about 10% of subjects make it to distribution.
  • The US has four clinical trial phases, each requiring FDA review. These targets are called immune correlates of protection, a goal to protect.

Clinical Trials

  • Phase I assesses human safety with a small, closely monitored group.
  • Phase II evaluates the vaccine's efficacy or its ability to trigger the desired response.
  • Phase III assesses vaccine effectiveness against a benchmark linked to the pathogen.
  • This can have a control group
  • Emergency Use Authorization (EUA) is applicable with positive Phase II and III results.
  • Phase IV involves post-marketing surveillance for safety and effectiveness. Any unexpected symptoms are entered into the Vaccine Adverse Event Reporting System , VAERS, which is run by the FDA and CDC.
  • Emergency Use Authorization (EUA) may be granted during health emergencies if the serious/life-threatening disease risk outweighs the vaccine's risks and available treatment lacks.
    • It requires at least 2 months of test subject follow up
    • Full approval requires 6 months of monitoring
  • Marketing and distribution can start with the trial participants.
  • Safety and efficacy are continually monitored, specifically through VAERS.

Concepts of Immunization

  • Variolation is a method where people are infected with a weaker version of a disease.
  • This can protect people from more severe forms of the disease.
  • Variolation for small pox protected individuals
  • It had a mortality rate of 1 in 100 compared to 1 in 4 with active infection.
  • Edward Jenner is credited with developing and sharing immunization practices, and many others were involved, including Onesimus and Dr. John Fewster.
  • Dr. John Fewster was using variolation to inoculate farmers for cowpox.
  • 1796 - Jenner collected cowpox pustule material and inoculated James Phipps

Anti-Vaxxers

  • Common arguments involve vaccine formulations not being safe, human disease being mostly prevented by hygiene, and vaccine companies being out to make money.
  • Despite these arguments, vaccines are supported by evidence and regulated by CDC guidelines.
  • The main reasons why people are against vaccines are additives, belief that health measures alone are enough and negative perceptions of drug companies.
  • Aluminum & Formaldehyde are falsely accused of being toxic components of vaccines.
  • Vaccine hesitancy rates are much higher than the refusal rates.
  • Of parents who delay and refuse vaccines:
    • 70% believe that vaccines are needed to protect their health.
    • 63% fear their children will have side effects.
    • 57% had concerns about autism.
    • 78% believed their children get too many shots
    • 77% say medical professionals have their best interests at heart.

Vaccine Components

  • The components include:
    • An antigenic molecule that serves as the immunogen.
    • Packaging is required to protect and deliver the immunogen to the system.
    • Conjugates or Adjuvants to increase immunogenicity
    • Stabilizers to maintain antigenic structure.
  • There also may be carry-over substances from the manufacturing process.

Multiple Dose Vaccinations

  • Required because vaccine formulation provides limited antigen amounts to mount an immune response.
  • Needed based on if the antigen is live or not.
  • Polio vaccine Immunizations ensure adequate immunity to the three poliovirus strains.
  • Live-attenuated vaccines has a long-lasting, even lifetime protection.
  • Non-live vaccines require three or more doses to achieve maximum safety, and protection fades overtime.
  • Examples of multiple vaccinations include; DTaP, flu, & Covid-19.

Vaccine Delivery Timing

  • Earlier deliveries can provide reduced risk of contact, where as.
  • Later vaccine deliveries can affect maternal antibodies. Maternal Ig can bind to vaccine Ags and block adequate immune responses.

Vaccine Formulations/Types

  • Whole Pathogen Vaccines - Live/killed microbes
  • Subunit Vaccines
  • Particle-Based
  • Vectored
  • Nucleic Acid

Whole Pathogen Vaccines

  • Live/Attenuated vaccines involve an infectious agent that is modified to replicate weakly in the host.
    • This provides a strong memory response due to prolonged antigen presentation.
    • They have the potential to cause disease.
  • Killed/Inactivated Vaccines
    • Uses the complete killed pathogen by heat or chemical treatment.
    • This is incapable of replication but often requires boosters.

Live vs Killed Vaccines

  • Characteristics of Live Attenuated vaccines:* - Strong immune response (presentation on HLA I/ CTL action) & lifelong memory. - Few doses (due to transient growth). - Can mutate to virulence and cause complications, leading to inability to immunize some patients
  • Characteristics of Inactivated or Killed vaccines:* - Stable storage properties, safe for attenuated patients & safer than pathogens. - Weaker immune response requiring multiple doses and adjuvants. - Potentially dangerous if pathogen is not killed

Subunit/Conjugate Vaccines

  • Subunit/conjugate vaccines contain purified Ags that are weaker immunogens if the adjuvant is not present.
  • Toxoids
    • Inactivate exotoxins and leads to neutralizing lg.
    • Includes tetanus and diphtheria vaccines
  • Capsular Polysaccharides
    • Are used with disease caused by bacteria species-specific
    • Creates capsule antigens resluting in opsonizing Ig
    • Eg. Streptococcus Pneumoniae
  • Recombinant Proteins
    • Pathogens with unique expressed protein uses Ags for cell virulence
    • Vaccination with recombinant protein creates neutralizing/opsonizing lg
    • Virus such as Hepatitis B.

Vectored Vaccines

  • Uses an attenuated pathogen to carry the gene for another pathogen
  • J&J and AstraZeneca COVID vaccines used a vector vaccine.

RNA Vaccines

  • mRNA Vaccines deliver sequences of host proteins to turn into pathogen-specific antigens.
  • The mRNA delivers the antigen by creating a lipid barrier for intramuscular injection
  • This Induces humoral and cell-mediated responses
  • Pfizer & Moderna

Adjuvants

  • Adjuvants enhance the immunogenicity of Ags.
  • Aluminium salts can serve as a mineral immunogenic
  • Cytokines may also serve as adjuvants

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