Types of Vaccines — MCQs
Which of the following vaccines is classified as a killed vaccine?
In a 10-year-old school child under the school health program, which vaccine should be administered?
All are live vaccines except
Assertion: VZV vaccine is live attenuated. Reason: It cannot be given to immunocompromised patients.
The following statements are true about DPT vaccine except
Which of the following is not a polysaccharide vaccine?
A 2-year-old child diagnosed provisionally with diphtheria and on examination she has greyish white membrane patch around her tonsils. The child has a 6-year-old sibling at home, who is fully immunized as per the schedule. What is the best measure to prevent disease in the sibling of the child?
Smallpox eradication was not due to:
For which of the following is PPV-23 most beneficial:
Which vaccine is not included in Indradhanush mission?
Types of Vaccines Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following vaccines is classified as a killed vaccine?
- A. Varicella
- B. BCG
- C. OPV
- D. Meningococcal vaccine (Correct Answer)
Explanation: ***Meningococcal vaccine*** - The meningococcal conjugate and polysaccharide vaccines are **killed vaccines**, containing inactivated bacterial components (polysaccharides) that stimulate an immune response. - They provide protection against *Neisseria meningitidis* and are considered safe for most populations due to their non-live nature. *Varicella* - The varicella vaccine is a **live-attenuated vaccine**, meaning it contains a weakened form of the **varicella-zoster virus**. - This attenuated virus can replicate in the recipient, eliciting a strong and long-lasting immune response, similar to natural infection. *BCG* - The **Bacillus Calmette-Guérin (BCG)** vaccine is a **live-attenuated vaccine** used to prevent tuberculosis. - It contains a weakened strain of **_Mycobacterium bovis_**, which is closely related to *Mycobacterium tuberculosis* but has lost its virulence. *OPV* - The **Oral Polio Vaccine (OPV)** is a **live-attenuated vaccine** that contains weakened but live strains of all three poliovirus serotypes. - It induces strong mucosal immunity in the gut, which is crucial for preventing the wild poliovirus from replicating and spreading.
Question 2: In a 10-year-old school child under the school health program, which vaccine should be administered?
- A. DPT
- B. BCG
- C. Td (Correct Answer)
- D. MMR
Explanation: ***Td (Tetanus-Diphtheria)*** - For a 10-year-old child under the school health program in India, the recommended vaccination is a booster dose of **Td (tetanus-diphtheria)**. - This ensures continued **protection against tetanus and diphtheria**, as immunity from the primary series may wane over time. - **Td is preferred over TT** (tetanus toxoid alone) as it provides protection against both tetanus and diphtheria. - This is administered at **10 years and 16 years** as per the Indian Academy of Pediatrics immunization schedule. *DPT* - **DPT (diphtheria, pertussis, tetanus)** is administered in infancy and early childhood (at 6, 10, and 14 weeks, with boosters at 16-24 months and 4-6 years). - The **pertussis component is not given** in later childhood or adolescence due to increased reactogenicity in older children. *BCG* - **BCG (Bacille Calmette-Guérin)** vaccine protects against tuberculosis and is given **at birth** in endemic areas like India. - It is **not routinely administered** to a 10-year-old unless there are specific risk factors or documented non-vaccination status. *MMR* - **MMR (measles, mumps, rubella)** vaccine is given as **two doses**: first at 9-12 months and second at 16-24 months (or 4-6 years). - A 10-year-old child would have **already completed** their MMR vaccination schedule.
Question 3: All are live vaccines except
- A. BCG
- B. OPV
- C. Tetanus (Correct Answer)
- D. Measles
Explanation: ***Tetanus*** - The **tetanus vaccine** is an **inactivated (toxoid) vaccine**, meaning it contains an inactivated form of the bacterial toxin, not a live attenuated pathogen. - Toxoid vaccines work by stimulating an immune response to the **toxin produced by the bacteria**, thereby preventing the disease but not necessarily the infection itself. *BCG* - The **BCG (Bacillus Calmette-Guérin) vaccine** is a **live attenuated vaccine** used to prevent tuberculosis. - It contains a live, weakened strain of *Mycobacterium bovis* that stimulates a protective immune response. *OPV* - The **OPV (Oral Polio Vaccine)** is a **live attenuated vaccine** that contains weakened forms of all three poliovirus serotypes. - It provides both humoral and intestinal immunity, leading to **herd immunity** through fecal-oral transmission of the vaccine virus. *Measles* - The **measles vaccine** (often given as part of MMR) is a **live attenuated vaccine**. - It contains a weakened form of the **measles virus**, which can replicate in the host to induce a strong, long-lasting immune response.
Question 4: Assertion: VZV vaccine is live attenuated. Reason: It cannot be given to immunocompromised patients.
- A. Both true, reason doesn't explain assertion
- B. Assertion true, reason false
- C. Assertion false, reason true
- D. Both true, reason explains assertion (Correct Answer)
Explanation: ***Both true, reason explains assertion*** - The **VZV (varicella-zoster virus) vaccine** is indeed a **live attenuated vaccine** containing weakened virus - the assertion is **TRUE** - It **cannot be given to immunocompromised patients** due to risk of vaccine-strain disease - the reason is **TRUE** - The reason **directly explains the assertion**: BECAUSE the vaccine is live attenuated, it poses infection risk and therefore cannot be used in immunocompromised individuals - The **causal relationship** is clear: live attenuated nature → contraindication in immunocompromised patients *Both true, reason doesn't explain assertion* - While both statements are factually true, this option would only be correct if the reason was unrelated to the assertion - However, the reason **directly explains WHY** the live attenuated nature is clinically significant - The contraindication is a **direct consequence** of the vaccine being live attenuated, so the reason does explain the assertion *Assertion true, reason false* - The assertion is true (VZV vaccine is live attenuated) - However, the reason is also **TRUE** - live attenuated vaccines are indeed contraindicated in immunocompromised patients due to risk of disseminated vaccine-strain infection - Since both statements are true, this option is incorrect *Assertion false, reason true* - The assertion is **TRUE**, not false - VZV vaccine (Varivax, Zostavax) is a **live attenuated vaccine** containing the Oka strain - This option incorrectly claims the assertion is false - Since the assertion is factually correct, this option cannot be right
Question 5: The following statements are true about DPT vaccine except
- A. Whole killed bacteria of Bordetella pertussis has an adjuvant effect
- B. Presence of acellular pertussis component increases its immunogenicity (Correct Answer)
- C. Aluminium salt has an adjuvant effect
- D. Presence of Hemophilus influenza type B component increases the immunogenicity of pertussis component
Explanation: ***Presence of acellular pertussis component increases its immunogenicity*** - This statement is **incorrect** and is the answer to this "except" question. - **Acellular pertussis (aP)** vaccines were developed primarily to **reduce side effects and reactogenicity**, not to increase immunogenicity. - aP vaccines contain purified components (2-5 antigens) compared to whole-cell pertussis (wP) which contains the entire killed bacterium. - **Immunogenicity comparison:** aP vaccines provide **shorter-lived immunity** and may require more boosters compared to wP vaccines, indicating they are not superior in immunogenicity. *Whole killed bacteria of Bordetella pertussis has an adjuvant effect* - **TRUE statement.** Whole-cell pertussis (wP) vaccines naturally possess **adjuvant properties** due to complex bacterial components including lipopolysaccharides (LPS). - These components stimulate strong innate immune responses, leading to robust and longer-lasting immunity, though with more reactogenicity. *Aluminium salt has an adjuvant effect* - **TRUE statement.** Aluminium salts (aluminium hydroxide or phosphate) are standard adjuvants in DPT vaccines. - They enhance immune response through **depot effect** (prolonged antigen release), activation of innate immunity, and recruitment of antigen-presenting cells to the injection site. *Presence of Hemophilus influenza type B component increases the immunogenicity of pertussis component* - **TRUE statement.** When Hib is combined with DPT (forming pentavalent vaccine), each component elicits an **independent immune response** against its specific target. - Hib component does **NOT enhance** the immunogenicity of the pertussis, diphtheria, or tetanus components - they maintain their individual immunogenic properties without mutual enhancement.
Question 6: Which of the following is not a polysaccharide vaccine?
- A. Pneumococcal vaccine
- B. Meningococcal vaccine
- C. H. Influenzae B vaccine
- D. Hepatitis B vaccine (Correct Answer)
Explanation: ***Hepatitis B vaccine (recombinant protein vaccine)*** - This is a **recombinant protein vaccine** which contains **HBsAg** (Hepatitis B surface antigen) produced in yeast. - As it uses a protein antigen, it is not a polysaccharide vaccine. *Pneumococcal vaccine (includes polysaccharide forms)* - There are two types: **Pneumococcal Polysaccharide Vaccine (PPSV23)** which is a pure polysaccharide vaccine, and **Pneumococcal Conjugate Vaccine (PCV13, PCV15, PCV20)** which contains polysaccharides conjugated to a protein carrier. - Both types utilize **polysaccharide antigens** from *Streptococcus pneumoniae* to elicit an immune response. *Meningococcal vaccine (includes polysaccharide forms)* - Similar to pneumococcal vaccines, there are **meningococcal polysaccharide vaccines (MPSV4)** and **meningococcal conjugate vaccines (MCV4)**. - These vaccines use **polysaccharides** from the capsule of *Neisseria meningitidis* as their immunogenic component, either alone or conjugated. *H. Influenza B vaccine (conjugate vaccine derived from polysaccharides)* - This is a **conjugate vaccine** that uses a **polysaccharide capsule antigen** from *Haemophilus influenzae type B* (Hib) chemically linked to a protein carrier. - Conjugation improves immunogenicity, especially in infants, by converting the T-independent polysaccharide antigen into a T-dependent one.
Question 7: A 2-year-old child diagnosed provisionally with diphtheria and on examination she has greyish white membrane patch around her tonsils. The child has a 6-year-old sibling at home, who is fully immunized as per the schedule. What is the best measure to prevent disease in the sibling of the child?
- A. Prophylactic erythromycin to be given (Correct Answer)
- B. Nothing is required to be done
- C. Full course of DPT
- D. Booster dose of DPT
Explanation: ***Prophylactic erythromycin to be given*** - All **close contacts** of a diphtheria patient, regardless of their immunization status, should receive **antibiotic prophylaxis** to eliminate carriage of *C. diphtheriae*. - **Erythromycin** is a commonly recommended antibiotic for this purpose, given its effectiveness against the bacteria. *Nothing is required to be done* - This is incorrect because, even if immunized, a close contact can still be a **carrier** of *C. diphtheriae* and transmit the infection to others. - **Diphtheria toxin** can still be produced by carriers, posing a risk of disease development if not cleared. *Full course of DPT* - This is unnecessary for a fully immunized child; a full course is typically for **unimmunized** or **incompletely immunized** - **Antibiotic prophylaxis** is the immediate priority for preventing illness in contacts. *Booster dose of DPT* - A booster dose offers **active immunity** but does not immediately address potential asymptomatic carriage of *C. diphtheriae*. - The primary goal for a contact is to eliminate the bacteria, which antibiotics can achieve more rapidly.
Question 8: Smallpox eradication was not due to:
- A. Highly effective vaccine
- B. Cross-immunity with animal pox virus (Correct Answer)
- C. Subclinical infections do not transmit the disease
- D. Life long immunity
Explanation: ***Cross-immunity with animal pox virus*** - While cowpox provided the basis for the smallpox vaccine, **cross-immunity with naturally circulating animal pox viruses** did not contribute to the eradication of smallpox itself. - The eradication was achieved through targeted vaccination campaigns with a **human-specific vaccine**, not by incidental cross-protection from wildlife. *Highly effective vaccine* - The smallpox vaccine was highly effective, providing **strong and long-lasting immunity** against the Variola virus. - This effectiveness was crucial for establishing herd immunity and breaking the chains of transmission. *Subclinical infections do not transmit the disease* - Individuals infected with smallpox either developed **symptomatic disease** or were **immune/resistant** to infection. - The absence of asymptomatic carriers who could silently transmit the virus made it feasible to interrupt transmission through targeted vaccination and surveillance. *Life long immunity* - Both natural infection and successful vaccination provided **long-lasting, often lifelong immunity** to smallpox. - This durable immunity prevented reinfection and helped sustain the protection achieved through vaccination campaigns over time.
Question 9: For which of the following is PPV-23 most beneficial:
- A. Child less than 2 years
- B. Sickle cell anemia patient (Correct Answer)
- C. Cystic fibrosis patient
- D. Patient with recurrent rhinitis and sinusitis
Explanation: ***Sickle cell anemia patient*** - Individuals with **sickle cell anemia** are at a **high risk of invasive pneumococcal disease** due to functional asplenia, making PPV-23 highly beneficial for them. - The **PPV-23 vaccine** targets 23 serotypes of *Streptococcus pneumoniae* and is recommended for those aged 2 years and older with certain chronic medical conditions, including sickle cell disease. - This is one of the **strongest indications** for PPV-23 due to the severe immunocompromise from splenic dysfunction. *Child less than 2 years* - The **polysaccharide vaccines** like PPV-23 are generally **not effective in children younger than 2 years** as their immature immune system does not respond well to polysaccharide antigens. - For children in this age group, the **pneumococcal conjugate vaccine (PCV13)**, which elicits a T-cell-dependent immune response, is recommended. *Cystic fibrosis patient* - While patients with **cystic fibrosis** are at increased risk for respiratory infections, the primary pathogens are typically *Pseudomonas aeruginosa* and *Staphylococcus aureus*, not *Streptococcus pneumoniae*. - Although pneumococcal vaccination (including PPV-23) is generally recommended for individuals with chronic lung disease, it is **not as specifically indicated or beneficial as for sickle cell patients** who demonstrate profoundly impaired splenic function. *Patient with recurrent rhinitis and sinusitis* - **Recurrent rhinitis and sinusitis** are commonly caused by **viral infections**, allergies, or anatomical abnormalities, not typically by serious invasive pneumococcal disease against which PPV-23 offers protection. - While some episodes might involve *Streptococcus pneumoniae*, this condition does not place a patient in the same **high-risk category for severe, invasive pneumococcal infections** that would mandate PPV-23 vaccination as a primary intervention.
Question 10: Which vaccine is not included in Indradhanush mission?
- A. Tuberculosis
- B. Measles
- C. Japanese Encephalitis (Correct Answer)
- D. Diphtheria
Explanation: ***Japanese Encephalitis*** - **Japanese Encephalitis (JE)** vaccine was not among the original seven vaccines covered under the initial Mission Indradhanush program. - While other vaccines have been added in subsequent phases, JE was not part of the initial seven. *Tuberculosis* - The vaccine for **Tuberculosis (TB)**, BCG, is one of the essential vaccines included in the initial Mission Indradhanush to protect children. - It targets a widespread infectious disease, making its inclusion critical for public health. *Measles* - The **Measles** vaccine is a core component of the initial Mission Indradhanush, aimed at preventing a highly contagious and potentially severe childhood disease. - Its inclusion is vital for achieving herd immunity and reducing child mortality. *Diphtheria* - The vaccine for **Diphtheria** is included in the initial Mission Indradhanush, typically given as part of the DPT (Diphtheria, Pertussis, Tetanus) vaccine. - This vaccine protects against a serious bacterial infection that can lead to severe complications and death.
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