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NBME 22 Answers

nbme22/Block 1/Question#3

Parenterally administered cholera vaccines ...

Inability of the vaccine to elicit secretory antibody at the epithelial surface

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submitted by upstairs_bumblebee(9),

The question asks about parenteral administration of the vaccine (meaning, not using the oral route). Non-oral vaccines will not strongly elicit IgA response. Non-oral vaccines not super helpful in combating a gut mucosal infection such as V. cholera, where IgA is more salient. Not sure if this is the actual correct reasoning, but it led to the right answer.

aesalmon  I totally skipped over the word "parentally" when taking this - ugh! +6  

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submitted by happysingh(6),

Injection = ONLY IgG
Vs Oral = IgG & IgA

Cholera is transmitted via GI (oral) route , so you'd need the IgA protection, since it's mostly IgA that protects from GIT pathogens