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Types of Vaccines II
Type of vaccine
Bacterial
Typhoid (Ty21a)
BCG
Polio (OPV)
Influenza (FluMist)
Measles
Mumps
Rabies (old)
Rotavirus
Rubella
Vaccinia
Varicella
Yellow Fever
Plague
Cholera
Anthrax
Pertussis (old)
Japanese Encephalitis Virus
Polio (IPV)
Hepatitis A
Rabies (HDCV and PCECCV)
Influenza (old)
Live attenuated
Whole
Inactivated
/
Killed
Toxoids
Protein
Subunits
Pure
Polysaccharide
Conjugated
10May06
Diphtheria
Tetanus
Pertussis (new)
KLVadheim
Influenza
HepB
Recombinant
Fractional
Viral
Meningococcal
Pneumococcal
Typhoid Vi
Hib
Meningococcal
Lecture 2
1
Types of Vaccines III
Type of
Administration
Intramuscular
Subcutaneous
Intradermal
Bacterial
Diphtheria
Tetanus
Pertussis (whole cell)
Acellular Pertussis
Plague
Pneumococcal
Typhoid Vi
Anthrax
Meningococcal
Pneumococcal
BCG
10May06
Hepatitis A
Hepatitis B
Haemophilus influenzae b
Most Flu
Rabies
Japanese Encephalitis Virus
Measles
Mumps
Rubella
Polio (IPV)
Varicella
Yellow Fever
Vaccinia (Smallpox)
Rabies (HDCV for pre-exposure vaccine)
FluMist
Inhaled
Oral
Viral
Rotavirus
Ty21a
Polio (OPV)
KLVadheim
Lecture 2
2
The Perfect Vaccine
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100% effective
Oral dosage form
No adverse effects
Highly immunogenic
– life-long immunity from a single dose
– no boosters required
• Cheap
• Stable at room temperature
– no cold chain required
10May06
KLVadheim
Lecture 2
3
Combination vaccines
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DT
DTaP
DTaP-HepB-IPV
HepA-HepB
10May06
KLVadheim
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Hib-HepB
MM
MMR
MMRV
Lecture 2
4
The Bare Minimum Immunology
MedCh 401 Spring 2006
Lecture 2
10May06
KLVadheim
Lecture 2
5
Immunology
• The science of differentiating self from nonself
• Defense against invaders
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Bacterial
Viral
Fungal
Parasitic
Particulate (e.g., slivers)
KLVadheim
Lecture 2
6
Immune system characteristics
• Specificity
• Memory
• Tolerance
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KLVadheim
Lecture 2
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Blood cells
• RBCs - carry oxygen
• WBCs - immune cells
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lymphocytes
Natural Killer cells
Polymorphonuclear leukocytes (PMNs)
macrophages
KLVadheim
Lecture 2
8
The immune system is...
• General and specific
• Innate (natural) and acquired (adaptive)
• Active and passive
– Natural and artificial
• Cell-mediated and humoral
• Primary and secondary immune responses
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KLVadheim
Lecture 2
9
Some General Immune
Responses
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Fever
Malaise
Inflammation
Localized erythema
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KLVadheim
Lecture 2
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Essential Concepts
• Active
– Produced by one’s own immune system, e.g.,
development and recovery from disease
– More permanent (years)
• Passive
– Produced by other humans or animals and
infused, injected, ingested or absorbed into
recipient
– Transient (weeks to months)
10May06
KLVadheim
Lecture 2
11
Active Immunity
• Natural
• Artificial
– Host produces
antibodies in response
to infection
– Host develops
protective response to
live viral vaccine
10May06
KLVadheim
– Host produces
protective immune
response to killed cells,
detoxified toxins, etc.
Lecture 2
12
Passive Immunity
• Natural
• Artificial
– Placental transfer of
maternal antibodies
(IgG)
– Transfer of maternal
antibodies via nursing
(IgA)
10May06
KLVadheim
– injection of immune
serum from person
who has recovered
from disease
– transfusion of
hyperimmune serum
from animal
Lecture 2
13
Summary
Immune System
Active
Natural
Immune response to disease
Passive
Artificial
Response to
killed vaccine
or detoxofied toxin
Natural
Maternal antibodies:
Transplacental (IgG)
Breast milk (IgA)
Artificial
Immune or
Hyperimmune
Serum
Response to live vaccine
e.g., MMR
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KLVadheim
Lecture 2
14
Innate immunity
• Surface barriers
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Skin
Ciliary action of respiratory epithelia
Mucus in respiratory and urogenital tracts
Acid pH of skin secretions
Lysozyme in tears, saliva, perspiration
Extreme acidity of stomach
KLVadheim
Lecture 2
15
Innate immunity II
• Normal flora
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10May06
Staphylococcus aureus on skin
E. coli in gut
Candida in vaginal tract
Corynebacteria diphtheriae in laryngeal
passage
KLVadheim
Lecture 2
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Innate Immunity III
• Macrophages
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Kupffer cells - liver
microglia - CNS
mesoangial cells - kidney
osteoclasts - bone
• Natural killer cells
• PMNs (and other WBCs)
10May06
KLVadheim
Lecture 2
17
Innate Immunity IV
• Complement system
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Enzyme cascade
Not antigen-specific
Enhances phagocytosis
Stimulates inflammation, increasing capillary
permeability to increase plasma and
complement flow to injury
– Can directly lyse cells
10May06
KLVadheim
Lecture 2
18
Innate Immunity V
• Dendritic cells
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10May06
Langerhans cells
Interstitial dendritic cells
Interdigitating dendritic cells
Circulating dendritic cells
KLVadheim
Lecture 2
19
Acquired Immunity I
• Cell-mediated - these are lymphocytes
– T cells
• TH2 (Helper) CD4+ - activate T and B cells
• TH1 (DTH) - role in allergies
• TC (Cytotoxic) CD8+, aka CTLs - kill cells with
foreign Ag on the surface
• Memory
– B cells
• Plasma cells (produce antibodies)
• Memory B cells
10May06
KLVadheim
Lecture 2
20
Acquired immunity II
• Active
– Develop and recover from disease
• Passive
– Transplacental maternal antibodies (IgG)
– Maternal antibodies in human milk (IgA)
10May06
KLVadheim
Lecture 2
21
Summary
Immune system
Innate
Surface Barriers
Complement system
Acquired
Normal flora
Macrophages
Natural Killer cells
PMNs
Dendritic cells
Cell-mediated
T cells
Humoral
(B cells to Plasma cells)
Antibodies
TH1
IgM
TH2
IgG
TC
IgA
Memory T cells
IgD
B Cells
IgE
APCs
Memory B cells
10May06
KLVadheim
Lecture 2
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Variability of the immune response
• Avidity (binding affinity)
– low for recent infections
– high for secondary immune responses
• Specificity
– low for primary immune responses
– high for secondary immune responses
10May06
KLVadheim
Lecture 2
23
Immunoglobulins
• IgA - primary antibody in secretions; halflife ~5 days
• IgM - primary antibody response; half-life
5-10 days
• IgG - secondary antibody response; half-life
21-24 days
• IgD - found on B cell surfaces
• IgE - bound to mast cells; amplifies immune response
10May06
KLVadheim
Lecture 2
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Antibody functions
• Opsonization - coating Ag with Ab enhances
phagocytosis
• Steric hindrance - bind to surfaces of
microorganisms and prevent attachment to cells
• Toxin neutralization
• Agglutination and precipitation - bind to surface
of microbes and precipitate them; reduces number
of infectious units and enhances phagocytosis
10May06
KLVadheim
Lecture 2
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Antibody functions II
• Complement activation
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induces inflammatory response
attracts phagocytes to site of infection
opsonizes cells with foreign antigens
lyses some bacteria and viruses
• Antibody-dependent cell cytotoxicity - IgG
enables Natural Killer cells to recognize and
kill opsonized target cells
10May06
KLVadheim
Lecture 2
26
Primary v. Secondary Immune Responses
IgG
Antibody
Conc.
IgM
Time after immunization
10May06
KLVadheim
Lecture 2
27
When good things go bad...
• Allergies
– Hay fever
– Delayed-type hypersensitivity
– Anaphylaxis
• Autoimmunity
– MS (CNS)
– Amyotrophic Lateral Sclerosis (ALS; a-motor
neurons of spinal cord)
– Primary biliary cirrhosis (liver)
10May06
KLVadheim
Lecture 2
28
Terms to Know
• Anaphylaxis
• Antigen
• Antibodies
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– types
– functions
• Antigen-presenting
cells
• Allergen
10May06
KLVadheim
Complement
WBC v. RBC
T and B Memory cells
Natural v. artificial
responses
• Active v. Passive
responses
• B, T and Plasma cells
• Phagocyte
Lecture 2
29