Childhood vaccinations Flashcards
At what age is the MMR given?
two doses:
1st dose @ 1yr
2nd dose @ 3 years and 4 months
what vaccinations contain porcine gelatine, and is there any alternatives?
MMR
influenza spray
shingles
for MMR - priorix is available
for shingles - no alternative
for influenza spray- jab can be given instead (but this is not as effective in children) hence only given if child is deemed high risk for complications from influenza infections
When should the influenza spray be delayed?
If child has a fever
If child has a severely blocked or runny nose (prevents the vaccine from being absorbed)
If they’re wheezy (postponed for three days until wheeze free)
Which children cannot receive the influenza spray?
if they have severe asthma (controlled by oral steroids or high dose ICS)
If severe egg allergy
if neomycin allergy
weakened immune system
What are the live vaccines?
MMR BCG ORAL polio Yellow fever shingles chicken pox influnzae spray rotavirus
which vaccines contain egg peptides
MMR and influenza spray
what is an adjuvant?
this is an alumminum based compound, which can be added to vaccines to boost the response of the immune system. this means that a lower dose of the antigen can be used, and less doses
aluminium @high doses can be harmful, but no evidence of harm at the doses used for those vaccines
what does the hexavalent vaccine contain?
DTaP/IPV/HiB/HepB
when is the HPV vaccine given
12-13 years (girls only)
what is the routine vaccination for Tetanus?
five shots to give life-long immunity
given at 8,12 and 16 weeks as part of hexavalent vaccine
given at 3 years and 4 months as part of the pre-school 4 in 1 booster (DTaP/IPV)
given at 14 years as part of the 3 in 1 booster: Td/IPV
what vaccines can be given with MMR?
at 1 year: MenB, PCV, Hib/MenC
at 3 years 4 months: DTaP/IPV
what meningitis protecting vaccines are given?
MenB @ 8wks and 16wks and 1 year
Hib/MenC @ 1 year
13-14 years: Men ACWY
how many doses of the PCV are given in total, and when?
three doses in total at 8wks, 16wks and 1 year
what type of vaccine is the rotavirus, and when is it given?
what is the risk of this vaccine?
this is a live vaccine given at 8wks and 12wks
small risk of intuccesption
what precautions should be given with the hexavalent vaccine?
do not give if child has fever
if child has uncontrolled epilepsy
if child has had previous hx of anaphylaxis
what vaccinations are given at 8wks?
Hexavalent vaccine, Rotavirus, MenB and PCV
what vaccinations are given at 14 yrs
the 3in1 booster Td/IPV and menACWY
HPV for girls @ 13
what vaccinations are given at 1 year?
MMR, MenB, Hib/menC, PCV
what vaccinations are given at 12 wks?
Hexavalent and rotavirus
what vaccinations are given at 16wks?
hexavalent, PCV and MenB
what vaccine is given from the ages of 2-8?
live nasal influenza
what vaccine is given at 3 years and 4 months
the 4 in 1 booster: DTaP/IPV and MMR
what vaccines should be given during pregnancy
inactivated influenza shot and pertussis. (dTaP/IPV)
we also test for HepB carriage, incase child needs to be vaccinated
when should the pertussis vaccine be given to pregnant females?
16-32 wks for maximal passive immunity transference
how long should a female wait before getting pregnant if taken MMR?
should wait about 4wks, because of risk of transmitting an infection to the foetus from the live vaccine
can the MMR vaccine be given before 1 year?
we start at 1 year, because thats when passive immunity (from mother weans) hence vaccine more effective
but if there has been an outbreak, can be given between 6-to-9months to protect child, but then child will be vaccinated again according to the national programme.
if theres an outbreak before the child’s second dose, then the second dose maybe moved closer to the first - to protect the child
what vaccines are given to high risk children, and when are they given?
BCG - at birth
HepB - at birth, 4wks and 12 months
which vaccinations are provided to the older population?
PPV (pneumococcal vaccine) @ 65
flu jab annually after 65
shingles (one off), but not after 80
what determines whether or not a vaccine becomes routine in the UK?
whether it reaches a cost-effective threshold (whether economical or QALY)
how many doses of diphtheria are required for life-long immunity?
5 doses are required, but reduced dose from 10 yrs (hence the teen booster the 3in1 is denotaed by little d)
there’s no upper age limit to when it can be given
given as hexavalent at 8,12 and 16wks
given at 3 years and 4 months
given at 14 years
what protection does the MMR vaccine offer?
highest protection from rubella, then measles and the mumps is the least- with weaning off immunity
which vaccines are conjugate vaccines?
HiB. MenC, MenACWY and pneumococcal
what type of vaccine is polio?
this is an inactivated vaccine
it is only available in combination
no upper age limit
and 5 doses are required for life-long immunity
what is the WHO target for immunisations
95% uptake for vaccines
what factors increase the risk of partial immunisation?
single parents large family size disadvantaged background or BME smoking during pregnancy teenage mother Hx of atlas one hospital admission
what are the risk factors for a child having NO immunisations?
lone parents large family size disadvantaged background BME mother older (>=40) mothers more educated mothers
what is the most common reason mothers do not vaccinate their children?
beliefs and attitudes
what Is the most common reason for partial immunisations?
most common: medical reasons
2nd most common:
accessibility issues
what increases the risk of NO MMR vaccines?
highly educated mother mother >34 larger family size lone parent mother <20 maternal smoking in pregnancy
increased risk of having single antigen vaccines?
mother more highly educated
older mothers
increasing income families
arguments against immune overload?
immune system is constantly challenged and therefore cells replenished
no increase in serious bacterial or viral infection post MMR vaccine. no increase of hospitalisations for infection after MMR
what is the advice with regards to MMR and egg allergy?
children allergic to egg should still receive the MMR.
those with documented anaphylaxis to the vaccine, should be referred to an allergist (they maybe allergic to other components)
note: this advice has changed from previously where the vaccine was CI
what is the advice with regards to children with egg allergy and influenza
children with egg anaphylaxis should be referred
however, if only allergy can safely have the vaccine
