Vaccines

Dermal HPVs lead to what?

"common" warts (hands/feet)

What are the net savings from vaccine use (societal cost)?

$1.38 trillion (societal cost)

What are the net savings from vaccine use (direct cost)?

$295 billion (direct cost)

Genital HPVs lead to what types of infection? (2)

- "high-risk" - "low-risk"

Describe the process/timeline of producing an inactivated influenza vaccine. (5)

- Jan-May: virus selection & production begins - Jun-Jul: FDA testing & licensure - Aug: filling/packaging - Sep: product release/shipping - Oct-Nov: vaccination begins

Describe the virology of HPV.

- Papovaviridae family (Papilloma, Polyoma, Vacuolating) - small (55nm) non-enveloped virion - 8 kb circular genome - dsDNA; codes ~9 proteins - species specific - relatively site specific (skin vs. anogenital)

What are the sites of cancer for females due to HPV infections? (4)

- cervix - vulva - vagina - anus

What are other examples of attenuated vaccines? (5)

- chicken pox - polio - rabies - BCG (Tb) - typhoid

Describe the risk statistics associated with MMR usage. (6)

- fever (5-15%) - rash (5%) - joint symptoms (25%) - thrombocytopenia (<1/30,000) - deafness (rare) - encephalopathy (<1/1,000,000)

What are the outcomes for people who get infected with HPV? (3)

- for most people, nothing will happen - some people with "low-risk" will develop symptoms - people with "high-risk" may develop cancer

What are the types of vaccines? (5)

- inactivated "killed" vaccine - attenuated/modified "live" vaccine - toxoid or "antigen" vaccine - recombinant vaccine - DNA vaccine

Describe memory T cells. (3)

- long-lived - ready - quick

Describe memory B cells. (3)

- long-lived - system ready for next time - respond quickly

What are the practical considerations of effective vaccines? (4)

- low cost - biological stability - ease of administration - few side effects*

"High-risk" HPV types lead to what? (3)

- low grade cervical abnormalities - cancer precursors - genital cancers

"Low-risk" HPV types lead to what? (3)

- low grade cervical abnormalities - genital warts - respiratory papillomatosis

What are the lymphocytes of the adaptive immunity that are of interest when talking about vaccines? (2)

- memory B cells - memory T cells

Describe Jenner's development of smallpox vaccine. (5)

- noted that milkmaids got cowpox, but not smallpox - injected pus from a cowpox lesion under the skin of a child - waited 2 weeks - deliberately infected the child with smallpox - boy survived

What are the sites of cancer for males due to HPV infections? (2)

- penis - anus

What are the features of an effective vaccine? (6)

- safe - protective - sustained protection - induce neutralizing antibodies - induce protective T cell response - practical considerations

Describe variolation. (2)

- scratch a healthy person w/ pus from infected person - if they don't die, they are immune for life

Why is it true for most people with HPV infections that nothing will happen? (2)

- the body's immune system usually eliminates HPV infection - after HPV is found on the cervix, it becomes undetectable within 2 years in at least 90% of women

Describe the history of vaccination (smallpox). (4)

- up to 30% mortality - ancient chinese history: once in a lifetime disease - 11th century China & India: "variolation" - May 14, 1796, Edward Jenner

Some people who get "low-risk" types of HPV will develop what? (2)

- visible genital warts - low-grade Pap smear abnormalities that usually go away on their own

Describe the mechanism of active immunization. (3)

- when administered, the immune system recognizes it as foreign & produces antibodies or cytotoxic T cells or both AND memory cells - the immune response is the same as the one that occurs during the course of a disease - the disease doesn't occur b/c whole organisms aren't used or (if whole organism used) they have been weakened so that they are no longer virulent

Describe the steps to flu vaccine production the old way. (7)

1. identification of seasonal virus 2. preparation of vaccine virus 3. make reagents 4. injects vaccine virus into eggs 5. millions of VVs harvested 6. virus killed, purified 7. diluted, packed into vials, syringes for distribution

How many U.S. cases of cervical cancer were estimated in 2014?

12,360

How many hospitalizations have vaccinations prevented in the last 20 years?

21 million

How many diseases/illnesses have vaccinations prevented in the last 20 years?

322 million

How many U.S deaths from cervical cancer were estimated in 2014?

4,020

How many deaths have occurred with vaccinated individuals since their existence?

732,000

There are more than how many HPV types?

80

Gardasil is for girls and young women ages _____ to ____.

8; 26

Genital HPVs account for how many types of HPV?

>30

Dermal HPVs account for how many types of HPV?

>50

Who develop the first vaccine? What was the vaccine for?

Edward Jenner (1796); smallpox

True or False: Polio has been eradicated through vaccine use.

False: we are reintroducing live virus to populations that do not have the living organism under current vaccination program (oral); plan is to eradicate

Gardasil will not protect against diseases caused by other what? (2)

HPV types or other diseases not caused by HPV

What does HPV stand for?

Human Papiloma Virus

What is the name of the measles vaccine?

MMR

What does MMR stand for/immunize for?

Mumps, Measles, Rubella

True of False: HPV is ubiquitous and can be completely asymptomatic.

True

True or False: 75% of non-vaccinated women will become infected with HPV in their lifetime.

True

True or False: Small pox has been eradicated through vaccine use.

True

True or False: The CDC states that vaccines have prevented 322 million diseases in the last 20 years.

True

True or False: The mechanism of active immunization is the same regardless of the nature of the immunizing substance.

True

True or False: Gardasil may not fully protect everyone and does not prevent all types of cervical cancer.

True: be sure to continue routine cervical cancer screenings

Immunization is what type of immunity (chart)?

artificial, active

What do other types of HPV cause? (3)

cancer of the uterus, cervix, & other epithelial cancers

Gardasil does not treat what? (2)

cervical cancer or genital warts

Why was the original vaccine for smallpox (1796) developed using cowpox?

cowpox (Vaccinia virus) shares antigens with smallpox, but is not virulent to humans

What is an effective vaccine called?

efficacious

What is the vaccine for HPV?

gardasil

What is the link between thimerosal-containing immunizations and ASD outcomes?

immunizations did not increase risk of any of the ASD outcomes (during pregnancy or as young child)

What is the major cause of cervical cancer?

infection with high-risk Human Papiloma virus

What type of vaccine is the measles vaccine?

live attentuated/modified

When is a vaccine considered to be safe?

must not cause illness or death

When is a vaccine considered to be protective?

must protect against illness

What is the link between vaccines and autism?

no link is seen b/w MMR & onset of autism; paper redacted due to unethical behavior on the part of A.J. Wakefield

Dermal HPVs are transmitted through what?

nonsexual contact

What is community or herd immunity?

occurs when the vaccination of a significant portion of a population provide a measure of protection to individuals who have not yet developed immunity

What mutants are vaccine developers looking for?

ones w/ low pathogenicity; won't grow well in host

Gardasil is not for women who are what?

pregnant

How is gardasil produced?

recombinant yeast

Genital HPVs are transmitted through what?

sexual contact

HPV is species specific as well as _________ specific.

site

What is a papilloma?

skin wart

Some types of HPV cause benign what?

skin warts (papillomas)

What is gardasil?

the only cervical cancer vaccine that helps protect against 4 types of HPV (for men & women) - 2 types cause 70% of cervical cancer cases - 2 types cause 90% of genital warts cases

How is a virus attenuated?

via passage through a foreign host (tissue culture, eggs, live animals)

Why use live attentuated/modified vaccines? (2)

weakened pathogen still grows, H/E: - induces good immunity - immune system can clear easily

About how many HPV genotypes/serotypes are theres?

~100