Immunisation Flashcards

1
Q

what is the aim of vaccination

A

to control communicable diseases

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2
Q

primary prevention

A

prevent disease onset

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3
Q

what is primary prevention in most circumstances

A

pre-exposure

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4
Q

secondary prevention

A

alter course of disease to prevent/limit consequences

eg immunoglobulins to help protect people or interruption of transmission

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5
Q

which antibodies are involved in primary and secondary infection

A

IgM = first

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6
Q

active immunity

  • permanent?
A

protection produced by the person’s own immune system

usually permanent

can be stimulated by vaccine or naturally acquired infection

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7
Q

how does secondary and subsequent exposure to antigen compare to primary

A

is more rapid and aggressive as memory cells are present in greater numbers than parent lymphocyte, have already undergone class Ig switching and have enhanced properties of cell adhesion and chemotaxis

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8
Q

passive immunity

  • 4 examples
A

achieved by administering preformed antibodies against a specific antigen

immediate protection of short duration

eg mother to baby, person to animal and injection of human Ig or anti-toxin

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9
Q

which Ig crosses the placenta

A

IgG

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10
Q

what does mother to baby passive immunity work better/worse for

A

better - tetanus (this is why pregnant mothers must have tetanus injection) and measles

worse- pertussis, polio and whooping cough

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11
Q

for which diseases would you inject Ig

A

Hep B, rabies and VZ

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12
Q

for which diseases would you give anti-toxin

A

diptheria, botunilinum

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13
Q

advantages of passive immunity

A

rapid action, post exposure, can attentuate illness, limit outbreak, used if contraindication to vaccine

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14
Q

disadvantages of passive immunity

A

Short term protection, short time effective window, blood derived, hypersensitivity reaction, expensive

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15
Q

herd immunity

A

protect unvaccinated individuals indirectly through a large proportion of the community being protected by vaccine

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16
Q

in herd immunity, what does the required proportion of unvaccinated individuals depend on

A

transmissibility and infectiousness of organism and social mixing in the population - basic reproduction rate (R0) (the number of secondary infections produced by a typical case of infection in a population that is totally susceptible)

there must be no reservoir of infection outside of humans

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17
Q

herd immunity and the measles virus

A

it is very infectious so over 90% of population must be vaccinated in order to achieve herd immunity

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18
Q

how much of the population must be vaccinated for Mumps and Smallpox to achieve herd immunity

A

80%

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19
Q

live vaccines

A

contain organisms with attenuated virulence, which results in a fully integrated T lymphocyte and humoral response

eg measles, mumps, rubella (MMR), VZV, rotavirus, flu

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20
Q

who should use of live vaccines in be carefully considered

A

IC individuals

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21
Q

polio vaccine

A

inactivated vaccine of inactivated virus

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22
Q

inactivated vaccines

A

consist of whole killed organisms or their antigenic components

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23
Q

inactivated vaccine: suspension of whole killed organism

A

whole cell pertussis (whooping cough)

24
Q

inactivated vaccine: subunit vaccine

A

only contain the antigenic part of the antigen

25
Q

inactivated vaccine: toxoid vaccine

A

based on the toxin produced by certain bacteria

indiviudal may clear toxin but remain a carrier of the organism

eg diptheria and tetanus

26
Q

inactivated vaccine: conjugate vaccines

A

polysaccharide attached to immunogenic protein

activate T lymphocytes which results in a sustained response and immunological memory

eg H. influenzae, Neissera meningitidis

27
Q

what are the contra indications to vaccination

A
  • Confirmed anaphylaxis reaction to previous dose or component of the vaccine
  • Live vaccines should not be given to immunosuppressed (high dose steroids, HIV etc.), pregnant women, or in the presence of acute infection
  • Severe latex allergy
  • Acute/evolving illness
28
Q

which vaccine are those with egg allergy contra indicated to

A

yellow fever and flu (if they had more than hives reaction to egg)

29
Q

what are not contra-indications to vaccination that are often thought of being

A

Hay fever, asthma, eczema, sickle-cell disease, topical corticosteroid therapy, antibiotic therapy, prematurity and chronic heart and lung diseases (including TB)

30
Q

UK ROUTINE VACCINATION SCHEDULE

2 months

A

pneumococcal disease - PCV

rotavirus

diptheria, tetanus, whooping cough, polio and H. influenzae type B= 5 in 1 vaccine

MenB

31
Q

UK ROUTINE VACCINATION SCHEDULE

3 months

A

diptheria, tetanus, pertussis, polio, HiB (5 in 1 vaccine)

meningococcal group C

rotavirus

32
Q

UK ROUTINE VACCINATION SCHEDULE

4 months

A

diptheria, tetanus, pertussis, polio, HiB (5 in 1 vaccine)

pneumococcal disease - PCV

MenB

33
Q

UK ROUTINE VACCINATION SCHEDULE

first birthday

A

Hib MenC

pneumococcal

measles, mumps, rubella (MMR)

MenB

34
Q

UK ROUTINE VACCINATION SCHEDULE

2,3,4

A

infleunza

35
Q

UK ROUTINE VACCINATION SCHEDULE

3y4m or after

A

diptheria, tetanus, polio and pertussis

MMR

36
Q

UK ROUTINE VACCINATION SCHEDULE

girls 12-13y

A

cervical cancer caused by HPV types 16 and 18

and also genital warts caused by types 6 and 11

37
Q

UK ROUTINE VACCINATION SCHEDULE

14 y

A

tetanusm diptheria and polio

MenC

38
Q

UK ROUTINE VACCINATION SCHEDULE

from 28w of pregnancy

A

pertussis

39
Q

UK ROUTINE VACCINATION SCHEDULE

65y

A

pneumococcal disease - PPV

40
Q

UK ROUTINE VACCINATION SCHEDULE

≥65y

A

influenza

41
Q

UK ROUTINE VACCINATION SCHEDULE

70y

A

shingles

42
Q

what does the 5 in 1 vaccine cover and at what ages is it given in UK

A

diptheria, tetanus, pertussis, polio and HiB

DTaP/IPV/Hib

2,3,4 months

43
Q

diphtheria

A
  • An URT illness characterised by sore throat, low-grade fever, and an adherent pseudomembrane (a layer of exudate resembling a membrane) that can cover the tonsils and the mucosa of the pharynx, larynx, and nose.
  • The toxin causes tissue necrosis and formation of the pseudomembrane. It also causes the major complications of myocarditis and neuritis.
44
Q

what is diphtheria caused by

A

Corynebacterium Diphtheriae

aerobic Gram positive bacterium

45
Q

what are the 3 phases of determining a suitable vaccine

A

safe?

how reactogenic is it? (what dose should be given and how does it compare to other vaccines?)

is it efficacious, and are there any rarer reactions?

46
Q

yellow card scheme

A

way of passive reporting used for suspected adverse drug reactions etc

47
Q

define elimination of disease

A

reducing incidence to 0 within defined geographical area as a result of deliberate efforts, continued intervention measures required

48
Q

define eradication of disease

A

permanent reduction to 0 of worldwide incidence of infection as a result of deliberate efforts, intervention measures no longer required eg small pox

49
Q

define extinction of disease

A

the specific infectious agent no longer exists in the nature or laboratory

there are no examples

50
Q

UK VACCINATION SCHEDULE

when do you get MMR

A

within a month of first birthday and 3y4m or soon after

51
Q

UK VACCINATION SCHEDULE

when do you get rotavirus

A

2 and 3 months

52
Q

UK VACCINATION SCHEDULE

when do you get HPV

A

girls aged 12-13 years

53
Q

UK VACCINATION SCHEDULE

influenza

A

2, 3, 4 years old

>65 years

54
Q

UK VACCINATION SCHEDULE

Men C

A

3m

within month of 1st birthday with Hib

14y

55
Q

UK VACCINATION SCHEDULE

pneumococcal

A

2 and 4 months

first birthday

65 years

56
Q

MenACWY vaccine

A

MenACWY vaccine protects against meningitis (caused by meningococcal disease types A, C, W and Y bacteria. Given at 14 years and new university students aged 19-25

57
Q

UK ROUTINE VACCINATION SCHEDULE when do you get Men B

A

2 months, 4 months and 12-13 months