Australian Immunisation

Question 1

Which vaccinations in the primary childhood vaccination schedule are to be given subcutaneously?

Answer 1

MMR, varicella and IPV (when by itself)

Question 2

What vaccinations are indicated at birth

Answer 2

Hepatitis B

Question 3

Following the Australian primary childhood vaccination schedule, which vaccinations should be given at 2,4 & 6 months?

Answer 3

HepB-DTPa-Hib-IPV
Rotavirus
Pneumococcus

Question 4

Following the Australian primary childhood vaccination schedule, which vaccinations should be given at 12 months?

Answer 4

Meningococcal C
Hib
MMR

Question 5

Following the Australian primary childhood vaccination schedule, which vaccinations should be given at 18 months

Answer 5

MMRV

measles, mumps, rubella and varicella

Question 6

Following the Australian primary childhood vaccination schedule, which vaccinations should be given at 4 years

Answer 6

DTPa-IPV

MMR (only until the end of 2015, as wouldn’t have had MMRV at 18m)

Question 7

Differences in vaccination scheduling if premature

Answer 7

Premature infants should be vaccinated according to the schedule, correction for prematurity is not required provided they are well.
However, may not mount a sufficient response to Hep B, and will require an additional booster at 12 m

Question 8

Different types of vaccines available

Answer 8

Live attenuated vaccines
Inactivated vaccines
Subunit vaccines
Toxoid vaccines
Conjugate vaccines

Question 9

What is a conjugate vaccine (definition + example)

Answer 9

A vaccine made from covalent bond between polysaccharide of bacterial cell wall and a protein antigen. Improves the immune response to the vaccine
e.g. Hib

Question 10

What is a toxoid vaccine (definition + example)

Answer 10

A toxin secreted from a bacteria that would usually cause disease, but is inactivated with formalin solution
e.g. DTP

Question 11

What is a subunit vaccine (definition + example)

Answer 11

Vaccine including only the antigens that best stimulate the immune system, rather than the entire microbe
e.g. recombinant Hep B vaccine

Question 12

Pros and cons of subunit vaccines

Answer 12

Pros:
lower risk of adverse reactions
Can be manufactured through recombinant DNA or by growing the microbe in lab and chemically separating the desired antigens
Cons:
Scientists must identify which antigens best stimulate the immune system first (this may be 1-20)

Question 13

What is an inactivated vaccine (definition + examples)

Answer 13

Vaccine produced by killing the disease-causing microbe with chemicals, heat or radiation
E.g. IPV, influenza, HepA

Question 14

Pros and cons of inactivated vaccines

Answer 14

PROS:
Cannot mutate back to disease-causing state
Don’t usually require refrigeration (therefore easy to store and transport, especially in developing world)
CONS:
stimulate a weaker immune response than live vaccines

Question 15

What are live attenuated vaccines (definition + examples)

Answer 15

Vaccines containing a version of the living microbe that has been weakened so that it cannot cause disease

e. g. viral: MMR, VZV, rotavirus
bacterial: vibrio cholerae

Question 16

What are pros and cons of live attenuated vaccines

Answer 16

PROS:
Elicit strong cellular and antibody responses
Often lead to lifelong immunity after 1-2 doses

CONS:
cannot be given to those with damaged or weak immune systems
Must be refrigerated (not suitable in some developing areas)
Easier to create for viruses than for bacteria