Case Introduction

Question 1

Smallpox

Answer 1

-Variola virus that is highly contagious and can spread through saliva droplets from
breath
- Causes symptoms of blistering rash, blindness and arthritis
- Mortality of 30-50% from variola major strain
- T. noted that those who survived didn’t get re-infected

Question 2

Cowpox

Answer 2

• Closely related to the vaccinia virus
• Related to smallpox but causes milder infections
• Dr Edward Jenner noted that dairy milkmaids contracted cowpox but not smallpox

Question 3

Why vaccinate?

Answer 3

-Most countries have recommended routine vaccinations for their citizens
- Vaccination’s primary purpose is to protect the individual from infectious diseases
that cause significant harm
- The recommended vaccines depend on lots of factors, such as which organism are
prevalent in that area and who is most at risk
- Vaccination can also benefit the wider population in the following ways:
- Vaccinated individuals pose less of a threat to others as the disease doesn’t spread so much
- If enough members of the population are vaccinated, you can eradicate the disease completely from that community
- This is called herd/community immunity

Question 4

Benefits

Answer 4

-Save lives
- Eliminates the disease if enough people are vaccinated
- Herd/community immunity benefits those who can’t be vaccinated or are more
vulnerable including:
-Infants
-Elderly
-Pregnant women
-Immunosuppressed
-Easier, safer and a lot more convenient than contracting the disease and having to treat it

Question 5

Risks

Answer 5

 Mild illness, fever and rashes
 Pain, redness, swelling and tenderness at injection site
 Vaccines may fail due to insufficient immune response
 Small anaphylaxis risk – MHRA data suggests incidence of 1 in a million doses
approximately
 Can be related to excipients or antigen e.g. ovalbumin (used as an antigen – can
cause egg allergy)

Question 6

Joint Committee on Vaccination and immunisation (JCVI)

Answer 6

 Specialist branch of Public Health England
 Responsible for monitoring and updating the vaccination schedule
 Make recommendations to government about all matters relating to vaccination
 Publish and update: The Green Book

Question 7

JCVI decisions to include a vaccine in the primary schedule can depend on many influencing factors: Population

Answer 7

 Age
 Risk category
 Social changes
 Public/media campaigns

Question 8

JCVI decisions to include a vaccine in the primary schedule can depend on many influencing factors: Disease

Answer 8

 Prevalence of organisms and environmental factors e.g. flu in the UK
 Sudden outbreaks of a disease
 Desire to increase herd immunity
 Prevention of other risks related to the diseases e.g. more serious complications

Question 9

JCVI decisions to include a vaccine in the primary schedule can depend on many influencing factors: Pharmaceutical

Answer 9

 Cost of manufacturing vs effectiveness of vaccine programme
 Antigenic shift meaning new strains becoming prevalent
 If vaccine product is able to be produced – none so far for HIV, malaria
 Sometimes, need to produce a vaccine quickly in response to sudden pandemics