Vaccine and Vaccination Practice Questions

Q: Which of the following is a live attenuated vaccine?

Yellow Fever Vaccine. ***Yellow Fever Vaccine*** - The Yellow Fever vaccine is a **live attenuated vaccine**, meaning it contains a weakened form of the virus that stimulates a strong immune response without causing the disease. - It is highly effective in providing long-lasting immunity against **yellow fever**, a viral hemorrhagic disease transmitted by mosquitoes. *Salk Vaccine* - The Salk vaccine is an **inactivated polio vaccine (IPV)**, meaning it contains killed poliovirus. - It works by stimulating an immune response to the killed virus, but it does not replicate in the host. *Rabies vaccine* - The rabies vaccine is an **inactivated vaccine** prepared from killed rabies virus. - It provides protection by inducing antibodies against the rabies virus glycoprotein. *Hepatitis B vaccine* - The Hepatitis B vaccine is a **recombinant vaccine**, meaning it is produced using genetic engineering techniques to synthesize hepatitis B surface antigen (HBsAg). - It does not contain live or killed virus but rather a purified viral protein to stimulate immunity.

Q: Which one of the following vaccines is a killed vaccine?

Hepatitis B vaccine. ***Hepatitis B vaccine*** - The Hepatitis B vaccine is a **recombinant subunit vaccine** containing only the **hepatitis B surface antigen (HBsAg)** produced through genetic engineering. - It does **not contain live or killed viral particles**, making it distinct from traditional killed vaccines. - However, it is sometimes **grouped with inactivated vaccines** in broader classifications as it contains no live components and cannot cause infection. - Among the given options, this is the **only non-live vaccine**, making it the **best answer** in this context. *Mumps vaccine* - The mumps vaccine is a **live-attenuated vaccine**, containing a weakened form of the mumps virus. - Live-attenuated vaccines stimulate a strong, long-lasting immune response similar to natural infection. *Yellow fever vaccine* - The yellow fever vaccine is a **live-attenuated vaccine** prepared from the 17D strain of the yellow fever virus. - It induces robust and long-term immunity against yellow fever. *Rubella vaccine* - The rubella vaccine is a **live-attenuated vaccine**, containing a weakened form of the rubella virus. - It is typically administered as part of the **MMR (measles, mumps, rubella)** vaccine.

Q: The addition of killed Bordetella pertussis microorganisms to diphtheria toxoid enhances the antibody response of the latter because of

endotoxin of the Bordetella organism. ***endotoxin of the Bordetella organism*** - The **endotoxin** (specifically **lipopolysaccharide** or LPS) of *Bordetella pertussis* acts as an **adjuvant**, stimulating the immune system non-specifically. - This adjuvant effect enhances the antigen presentation and lymphocyte activation, leading to a stronger and more sustained **antibody response** against the diphtheria toxoid. *formation of local granuloma* - While some adjuvants can induce granuloma formation to *sustain* antigen presentation, the primary mechanism of *Bordetella pertussis* *killed organisms* as an adjuvant is not solely due to granuloma formation. - Granuloma formation is more typical of adjuvants like **aluminum salts**, which create a depot effect rather than directly stimulating immune cells via endotoxin. *exotoxin of the Bordetella organism* - **Exotoxins** are typically highly potent toxins produced and secreted by bacteria that can cause specific clinical effects. - The adjuvant effect of killed *Bordetella pertussis* is primarily due to its **cell wall components** (endotoxin), not isolated exotoxins, which would likely be neutralized or removed during vaccine preparation. *additive action of the two antigens* - The enhancement is not merely an "additive action" of two antigens generating separate immune responses. - Instead, the *Bordetella pertussis* components (specifically endotoxin) *potentiate* the immune response to the diphtheria toxoid, acting as an **adjuvant** rather than just another antigen.

Q: Covaxin is a/an

Inactivated whole virus vaccine. ***Inactivated whole virus vaccine*** - Covaxin is an **inactivated** vaccine, meaning it uses a **killed version of the SARS-CoV-2 virus** that cannot cause disease but can still stimulate an immune response. - This type of vaccine presents the **entire viral structure** to the immune system, leading to a broad immune response against various viral proteins. *Live attenuated vaccine* - A live attenuated vaccine uses a **weakened form of the virus** that can still replicate but does not cause severe disease. - While effective, live attenuated vaccines often carry a small risk of reversion to virulence, which is not the case for Covaxin. *Nucleic acid vaccine* - Nucleic acid vaccines (like mRNA or DNA vaccines) deliver **genetic material** (e.g., mRNA for the spike protein) into host cells to produce viral proteins, triggering an immune response. - Covaxin does not use genetic material directly for antigen production. *Protein subunit vaccine* - Protein subunit vaccines contain only specific, purified viral proteins (e.g., the spike protein) that are highly immunogenic. - Unlike subunit vaccines, Covaxin presents the immune system with the **entire inactivated virus**, not just isolated proteins.

Q: Which of the following is an example of ‘live attenuated vaccine’?

B.C.G.. ***B.C.G.*** - The **Bacillus Calmette-Guérin (BCG)** vaccine is a **live attenuated vaccine** used worldwide for **tuberculosis prevention**. - It contains a live, but weakened, strain of *Mycobacterium bovis*, which stimulates a strong cellular immune response. *D.P.T.* - The **DPT vaccine** is a **combination vaccine** for diphtheria, pertussis (whooping cough), and tetanus. - It is currently available as an **inactivated vaccine**, specifically a **toxoid for diphtheria and tetanus** and either a whole-cell or acellular component for pertussis. *Hepatitis ‘B’* - The **Hepatitis B vaccine** is a **recombinant vaccine**, meaning it is produced using genetic engineering techniques. - It contains only the **surface antigen protein** of the Hepatitis B virus, not the whole virus, making it a non-live vaccine. *Typhoid (TAB)* - The **Typhoid (TAB) vaccine** is an **inactivated (killed) whole-cell vaccine** against *Salmonella Typhi*. - Newer typhoid vaccines, such as the polysaccharide vaccine and conjugate vaccine, are also non-live vaccines.

Q: Consider the following statements: 1. The duration of immunity is longer when live vaccine is administered as compared to the administration of killed vaccine. 2. In the case of killed vaccine, single dose is sufficient whereas multiple doses are always required in the case of live vaccines. Which of these statements is/are correct?

1 only. ***1 only*** - **Live attenuated vaccines** stimulate a more robust, long-lasting immune response, often mimicking natural infection, leading to **longer duration of immunity** compared to killed vaccines. - This is because live vaccines can replicate in the host, providing a continuous antigenic stimulus that enhances the breadth and memory of the immune response. *2 only* - This statement is incorrect because **killed vaccines** typically require **multiple doses** (prime and booster shots) to achieve and maintain adequate protective immunity. - In contrast, **live vaccines** often achieve sufficient immunity with a **single dose** due to their ability to replicate and elicit a strong cellular and humoral response. *Both 1 and 2* - This option is incorrect as statement 2 is false. Live vaccines generally provide longer immunity, and killed vaccines usually require multiple doses, while live vaccines often need only one. *Neither 1 nor 2* - This option is incorrect because statement 1 is accurate regarding the longer duration of immunity provided by live vaccines.

Q: Which quadivalent HPV vaccine protects against both cervical cancer and genital warts?

Gardasil. ***Gardasil***- This **quadrivalent** vaccine protects against **HPV types 6, 11, 16, and 18**. [1]- **HPV 16 and 18** are responsible for most cases of **cervical cancer**, while **HPV 6 and 11** cause approximately 90% of **genital warts**. [1]- Gardasil was the first quadrivalent HPV vaccine approved and remains widely used globally.*Shingrix*- **Shingrix** is a recombinant zoster vaccine used to prevent **herpes zoster (shingles)** in adults.- It is **not an HPV vaccine** and does not provide protection against cervical cancer or genital warts.- It targets varicella-zoster virus, not human papillomavirus.*Gardasil 9*- **Gardasil 9** is a **nonavalent** vaccine, meaning it protects against nine HPV types (6, 11, 16, 18, 31, 33, 45, 52, and 58).- While it does cover the types responsible for cervical cancer and genital warts, it is **not a quadrivalent vaccine** as specified in the question.*Cervarix*- **Cervarix** is a **bivalent** HPV vaccine that protects against **HPV types 16 and 18** only. [1]- While it offers protection against the HPV types most commonly associated with **cervical cancer**, it does not protect against **genital warts** (caused by HPV 6 and 11).

Q: Hepatitis B subunit vaccine contains which of the following antigens?

HbsAg. ***HbsAg*** - The Hepatitis B vaccine is a **subunit vaccine** that contains recombinant **hepatitis B surface antigen (HBsAg)**. - This antigen is highly immunogenic and elicits a protective antibody response (anti-HBs) that neutralizes the virus. *HbeAg* - **HBeAg** indicates active viral replication and high infectivity, but it is not the antigen used in the vaccine. - While important for diagnostic purposes, antibodies to HBeAg (anti-HBe) indicate reduced viral replication. *HbcAg* - **HBcAg (hepatitis B core antigen)** is an internal component of the virion and is not found in the subunit vaccine. - Antibodies to HBcAg (anti-HBc) indicate past or current infection but do not confer protective immunity. *HBV DNA* - **HBV DNA** represents the viral genetic material and is a marker of active viral replication and infectivity. - It is not an antigen and therefore not included in a subunit vaccine designed to induce an immune response to viral proteins.

Q: An 18-year-old girl is brought to the emergency department because of a 1-day history of severe headache with photophobia and diffuse myalgias. She is a college student and lives in a dormitory in a large urban area. She has not traveled recently. On arrival, she is lethargic. Her temperature is 39.3°C (102.7°F), pulse is 120/min, and blood pressure is 88/58 mm Hg. Examination shows scattered petechiae and ecchymoses on the trunk and lower extremities. There is decreased range of motion of the neck. Cerebrospinal fluid analysis shows a cell count of 1,600/μL (80% neutrophils) and a lactate concentration of 5.1 mmol/L. Which of the following is most likely to have prevented this patient's condition?

Polysaccharide conjugate vaccine. ***Polysaccharide conjugate vaccine*** - This patient presents with symptoms highly suggestive of **bacterial meningitis** and **septic shock**, likely caused by *Neisseria meningitidis*, given the petechiae, ecchymoses, and rapid deterioration. - A **meningococcal conjugate vaccine** would have provided protection against most common serogroups of *N. meningitidis* (A, C, W-135, Y) and is strongly recommended for college students living in dormitories due to increased risk of transmission. *Intravenous vancomycin* - This is an **acute treatment** for bacterial meningitis, specifically active against *Streptococcus pneumoniae* and some resistant strains. - It would not have **prevented** the condition; preventative measures are typically vaccines or prophylactic antibiotics. *Erythromycin therapy* - Erythromycin is an antibiotic used for various bacterial infections, including atypical pneumonia and some skin infections. - It is **not the primary prophylactic agent** for meningococcal disease and would not have prevented this specific condition. *Doxycycline therapy* - Doxycycline is a broad-spectrum antibiotic used for a range of infections, including tick-borne diseases and certain respiratory infections. - It is **not indicated for the prevention** of meningococcal meningitis. *Toxoid vaccine* - **Toxoid vaccines** protect against diseases caused by bacterial toxins, such as tetanus and diphtheria. - *Neisseria meningitidis* causes disease primarily through direct invasion and immune response to its capsular polysaccharides, not primarily exotoxins, so a toxoid vaccine would not be effective here.

Q: Bivalent HPV vaccine contains which types?

Type 16,18. ***Type 16,18*** - The **bivalent HPV vaccine** (Cervarix) specifically targets HPV types 16 and 18, which are responsible for the majority of **cervical cancers**. - These two types are considered **high-risk HPV strains** due to their strong oncogenic potential. *Type 6,16* - This combination is partially correct as **HPV 16** is a high-risk type, but **HPV 6** is primarily associated with **genital warts** and is included in the quadrivalent and nonavalent vaccines, not the bivalent. - The bivalent vaccine aims solely for **oncogenic types 16 and 18** for cervical cancer prevention. *Type 11,18* - This combination incorrectly includes **HPV 11**, which, like HPV 6, causes **genital warts** and is not a target of the bivalent vaccine. - While **HPV 18** is a key oncogenic target, HPV 11 does not contribute to the efficacy of the bivalent vaccine against cervical cancer. *Type 6,11* - These HPV types are known to cause approximately 90% of **genital warts** and are considered **low-risk types**, not associated with cervical cancer. - The bivalent vaccine's primary goal is **cervical cancer prevention** by targeting high-risk oncogenic types, rendering this option incorrect.

Question 1

Which of the following is a live attenuated vaccine?

Accepted Answer

Yellow Fever Vaccine

Answer

Salk Vaccine

Answer

Hepatitis B vaccine

Answer

Rabies Vaccine

Question 2

Which one of the following vaccines is a killed vaccine?

Accepted Answer

Hepatitis B vaccine

Answer

Mumps vaccine

Answer

Yellow fever vaccine

Answer

Rubella vaccine

Question 3

The addition of killed Bordetella pertussis microorganisms to diphtheria toxoid enhances the antibody response of the latter because of

Accepted Answer

endotoxin of the Bordetella organism

Answer

formation of local granuloma

Answer

exotoxin of the Bordetella organism

Answer

additive action of the two antigens

Question 4

Covaxin is a/an

Accepted Answer

Inactivated whole virus vaccine

Answer

Live attenuated vaccine

Answer

Nucleic acid vaccine

Answer

Protein subunit vaccine

Question 5

Which of the following is an example of ‘live attenuated vaccine’?

Accepted Answer

B.C.G.

Answer

D.P.T.

Answer

Hepatitis ‘B’

Answer

Typhoid (TAB)

Question 6

Consider the following statements:

1. The duration of immunity is longer when live vaccine is administered as compared to the administration of killed vaccine.

2. In the case of killed vaccine, single dose is sufficient whereas multiple doses are always required in the case of live vaccines. Which of these statements is/are correct?

Accepted Answer

1 only

Answer

2 only

Answer

Both 1 and 2

Answer

Neither 1 nor 2

Question 7

Which quadivalent HPV vaccine protects against both cervical cancer and genital warts?

Accepted Answer

Gardasil

Answer

Shingrix

Answer

Gardasil 9

Answer

Cervarix

Question 8

Hepatitis B subunit vaccine contains which of the following antigens?

Accepted Answer

HbsAg

Answer

HbeAg

Answer

HbcAg

Answer

HBV DNA

Question 9

An 18-year-old girl is brought to the emergency department because of a 1-day history of severe headache with photophobia and diffuse myalgias. She is a college student and lives in a dormitory in a large urban area. She has not traveled recently. On arrival, she is lethargic. Her temperature is 39.3°C (102.7°F), pulse is 120/min, and blood pressure is 88/58 mm Hg. Examination shows scattered petechiae and ecchymoses on the trunk and lower extremities. There is decreased range of motion of the neck. Cerebrospinal fluid analysis shows a cell count of 1,600/μL (80% neutrophils) and a lactate concentration of 5.1 mmol/L. Which of the following is most likely to have prevented this patient's condition?

Accepted Answer

Polysaccharide conjugate vaccine

Answer

Intravenous vancomycin

Answer

Erythromycin therapy

Answer

Doxycycline therapy

Answer

Toxoid vaccine

Question 10

Bivalent HPV vaccine contains which types?

Accepted Answer

Type 16,18

Answer

Type 6,16

Answer

Type 11,18

Answer

Type 6,11

Vaccine and Vaccination — MCQs

Vaccine and Vaccination — MCQs

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