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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{AO}}
|QuestionAuthor= {{YD}} (Reviewed by  {{YD}} and  {{AJL}})
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|MainCategory=Immunology, Microbiology
|MainCategory=Immunology
|SubCategory=General Principles
|SubCategory=General Principles
|Prompt=With effect from December 14, 2009, the Centers for Disease Control and Prevention (CDC) commenced a new vaccination criteria to help decide which vaccines should be required as part of the immigration process. Therefore, the human papillomavirus (HPV) and zoster vaccines were removed from the list of vaccines because these viruses are not known to cause outbreaks.
|Prompt=A young boy is brought by his mother to the physician's office for a scheduled vaccination. The boy has no complaints, and physical examination is unremarkable. Prior to the administration of the vaccine, the mother asks the physician if the vaccine is associated with any serious adverse reactions. The physician explains that the vaccine the child is about to receive is generally safe, but there is a very rare risk of inducing an actual disease. Which of the following vaccines is the child most likely receiving during his check-up?
|Explanation=The patient in this vignette is most likely being administered a live attenuated vaccine. Vaccines may be classified according to the table shown below. Only live attenuated vaccines contain real-life weakened bacterial or viral agents that have a rare potential to revert and induce actual disease. On the other hand, inactivated vaccines, subunit vaccines, and toxoid vaccines either contain killed agents or non-living components of agents and do not revert to cause actual disease. Examples of live attenuated vaccines include BCG (tuberculosis vaccine), oral polio vaccine (OPV, Sabin), intranasal influenza vaccine, and vaccines against smallpox, measles, mumps, and rubella (MMR), varicella (chickenpox), zoster (shingles), ''Salmonella typhi'', yellow fever, and rotavirus.
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Which of the following is an inactivated/killed vaccine?
[[Image:Vaccines Table Type Examples Mechanism.jpg|1000px]]
 
|AnswerA=Hepatitis A vaccine
 
|AnswerAExp=Hepatitis A vaccine is an inactivated vaccine.
 
|AnswerB=Oral polio vaccine
 
|AnswerBExp=Oral polio vaccine (Sabin) is a live attenuated vaccine.
 
|AnswerC=Tetanus-diphtheria (Td) vaccine
 
|AnswerCExp=Tetanus-diphtheria (Td) is a toxoid vaccine.
|Explanation= A vaccine is a biological preparation that improves immunity to a particular disease.  A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as foreign, destroy it, and keep a record of it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.
Vaccines may be prophylactic (example: to prevent or ameliorate the effects of a future infection by any natural or "wild" pathogen), or therapeutic (e.g. vaccines against cancer are also being investigated).
 
There are four major types of vaccines:
 
[[File:WBR Question 0608.JPG]]
|AnswerA=Yellow fever
|AnswerAExp=This is a live, attenuated vaccine.
 
|AnswerB=Typhoid vaccine
|AnswerBExp=This is a live, attenuated vaccine.
 
|AnswerC=Diphtheria
|AnswerCExp=This is an example of a toxoid or inactivated toxin.
|AnswerD=Human papillomavirus (HPV)
|AnswerD=Human papillomavirus (HPV)
|AnswerDExp=This belongs to the group subunit/conjugate type i.e., they are prepared using a protein subunit of the microorganism or using a poorly immunogenic polysaccharide capsule.
|AnswerDExp=HPV vaccine is a recombinant vaccine.
|AnswerE=Hepatitis A vaccine
|AnswerE=Acellular pertussis
|AnswerEExp=This is an example of an inactivated or heat killed vaccine.
|AnswerEExp=Acellular pertussis vaccine is a subunit vaccine.
|RightAnswer=E
|EducationalObjectives=Vaccines may be classified according to the table shown below. Only live attenuated vaccines contain real-life weakened bacterial or viral agents that have a rare potential to revert and induce actual disease. Examples include BCG (tuberculosis vaccine), oral polio vaccine (OPV, Sabin), intranasal influenza vaccine, and vaccines against smallpox, measles, mumps, and rubella (MMR), varicella (chickenpox), zoster (shingles), Salmonella typhi, yellow fever, and rotavirus.
|WBRKeyword=Live vaccines, killed vaccines
|References=First Aid 2014 page 207
|Approved=No
|RightAnswer=B
|WBRKeyword=Live attenuated vaccine, Oral polio vaccine, OPV, Sabin, Check-up, Vaccine, Vaccination
|Approved=Yes
}}
}}

Latest revision as of 01:09, 28 October 2020
Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D. and Alison Leibowitz [1])]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Immunology
Sub Category SubCategory::General Principles
Prompt [[Prompt::A young boy is brought by his mother to the physician's office for a scheduled vaccination. The boy has no complaints, and physical examination is unremarkable. Prior to the administration of the vaccine, the mother asks the physician if the vaccine is associated with any serious adverse reactions. The physician explains that the vaccine the child is about to receive is generally safe, but there is a very rare risk of inducing an actual disease. Which of the following vaccines is the child most likely receiving during his check-up?]]
Answer A AnswerA::Hepatitis A vaccine
Answer A Explanation AnswerAExp::Hepatitis A vaccine is an inactivated vaccine.
Answer B AnswerB::Oral polio vaccine
Answer B Explanation AnswerBExp::Oral polio vaccine (Sabin) is a live attenuated vaccine.
Answer C AnswerC::Tetanus-diphtheria (Td) vaccine
Answer C Explanation AnswerCExp::Tetanus-diphtheria (Td) is a toxoid vaccine.
Answer D AnswerD::Human papillomavirus (HPV)
Answer D Explanation AnswerDExp::HPV vaccine is a recombinant vaccine.
Answer E AnswerE::Acellular pertussis
Answer E Explanation AnswerEExp::Acellular pertussis vaccine is a subunit vaccine.
Right Answer RightAnswer::B
Explanation [[Explanation::The patient in this vignette is most likely being administered a live attenuated vaccine. Vaccines may be classified according to the table shown below. Only live attenuated vaccines contain real-life weakened bacterial or viral agents that have a rare potential to revert and induce actual disease. On the other hand, inactivated vaccines, subunit vaccines, and toxoid vaccines either contain killed agents or non-living components of agents and do not revert to cause actual disease. Examples of live attenuated vaccines include BCG (tuberculosis vaccine), oral polio vaccine (OPV, Sabin), intranasal influenza vaccine, and vaccines against smallpox, measles, mumps, and rubella (MMR), varicella (chickenpox), zoster (shingles), Salmonella typhi, yellow fever, and rotavirus.



Educational Objective: Vaccines may be classified according to the table shown below. Only live attenuated vaccines contain real-life weakened bacterial or viral agents that have a rare potential to revert and induce actual disease. Examples include BCG (tuberculosis vaccine), oral polio vaccine (OPV, Sabin), intranasal influenza vaccine, and vaccines against smallpox, measles, mumps, and rubella (MMR), varicella (chickenpox), zoster (shingles), Salmonella typhi, yellow fever, and rotavirus.
References: First Aid 2014 page 207]]

Approved Approved::Yes
Keyword WBRKeyword::Live attenuated vaccine, WBRKeyword::Oral polio vaccine, WBRKeyword::OPV, WBRKeyword::Sabin, WBRKeyword::Check-up, WBRKeyword::Vaccine, WBRKeyword::Vaccination
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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