Immunisation

Question 1

how does immunisation control communicable diseases

Answer 1

prevent onset of disease (primary prevention)
interrupt transmission
alter course of infection/disease to prevent or limit consequences (secondary prevention)

Question 2

give examples secondary prevention immunisation

Answer 2

immunoglobulin e.g. Hep B, rabies, varicella zoster

Question 3

how do vaccine work

Answer 3

teaches immune system to recognise pathogens, which helps to fight them

induce cell mediates immunity responses and serum antibodies

Question 4

what are the immunity mechanisms

Answer 4

active immunity
passive immunity
herd immunity

Question 5

what usually makes up antigens

Answer 5

usually proteins or polysaccharides (sugars)

Question 6

how are antibodies produced

Answer 6

B cells- humoral immune system

T cells- cell mediated immune system (CD4+ and CD8+ cells)

Question 7

where do B cells mature

Answer 7

bone marrow

Question 8

where do T cells mature

Answer 8

in the thymus

Question 9

what is passive immunity

Answer 9

transfer of pre-formed antibodies (immunoglobulins)

Question 10

what are the mechanisms of passive immunity

Answer 10

mother to unborn baby (via placenta)

from another person or animal (blood donors, human normal Ig, specific Ig)

Question 11

what are the two passive immunity vaccines

Answer 11

human immunoglobulin- Hep B, rabies, varicella zoster

anti-toxin- diphtheria, botulinum

Question 12

what are the advantages of passive immunity vaccines

Answer 12

rapid action, post exposure, can attenuate illness, outbreak control, can be used if contraindication to active vaccination

Question 13

what are the disadvantages of passive immunity vaccines

Answer 13

short term protection, short term window, blood-derived, hypersensitivity reaction, expensive

Question 14

what are the mechanisms of active immunisation

Answer 14

natural infection, artificial immunisation

Question 15

what are the two types of vaccine

Answer 15

live virus vaccines- attenuated organism replicates in host

inactivated vaccines- suspensions of killed organisms, subunit vaccines, conjugate vaccines

Question 16

give examples of live virus vaccines

Answer 16

OPV (polio), measles, mumps, rebella, varicella, rotavirus, flu

Question 17

give examples of inactivated viruses that are suspensions of killed organisms

Answer 17

whole cell pertussis, whole cell typhoid

Question 18

give examples of inactivated viruses that are subunit vaccines

Answer 18

toxoids (diphtheria toxoid, tetanus toxoid, pertussis toxoid)
polysaccharides (pneumococcal, typhoid)

Question 19

give examples of inactivated viruses that are conjugate vaccines

Answer 19

polysaccharide attached to immunogenic proteins - Hib, Men C

Question 20

what are the contraindications to vaccines

Answer 20

confirmed anaphylaxis reaction to previous dose

live vaccines- immunosuppression, pregnancy

egg alergy (yellow fever, flu)

severe latex allergy

acute or evolving illness

Question 21

what is the role of herd immunity

Answer 21

protects unvaccinated individuals through having sufficiently large proportion of population vaccinated

vaccinated stop the transmission of the organism

Question 22

what does herd immunity depend on

Answer 22

transmissibility and infectiousness of organism
social mixing in the population
requires that there is no other reservoir of infection

Question 23

why should vaccination schedules be followed closely

Answer 23

as diseases might be age specific, risk of complications, ability to respond

Question 24

what vaccinations may be given to at risk children

Answer 24

flu (annual), pneumococcal polysaccharide vaccine, BCG, hep B

Question 25

what vaccinations do you get as adults

Answer 25

pneumococcal polysaccharide vaccine, shingles, seasonal flu, ones for travel/ occupation

Question 26

what are the symptoms of diphtheria

Answer 26

sore throat, low grade fever, white adherent membrane on the tonsils, pharynx and or nasal cavity

Question 27

what is in hexavalent (6 in one) vaccine

Answer 27

diptheria, tetanus, pertussis, polio, haemophilus influenza type b, hepatitis

Question 28

what causes meningococcal disease (meningitis, septicaemia, men&sept)

Answer 28

neisseria meningitidis

Question 29

what are the persistent symptoms that can occur after meningococcal disease

Answer 29

persistent neurological defects- hearing loss, speech disorders, loss of limbs and paralysis

Question 30

what are the vaccines you should have had at 2 months

Answer 30

hexavalent (DTaP/ IPV/ HiB/ HepB) menB, rotavirus, PCV

Question 31

what are the notifiable diseases that are vaccinated against

Answer 31

diptheria, whooping cough, tetanus, polio, rubella, mumps, measles, hib, meningococcal

Question 32

how is meningococcal disease spread

Answer 32

person to person contact through respiratory droplets of infected people

Question 33

what is the incubation period for meningococcal disease

Answer 33

3-5 days

Question 34

what is a common reservoir of meningococcal disease

Answer 34

colonisation of nasopharynx

Question 35

what are the two age peaks of meningococcal disease

Answer 35

>5 years and 15-24 years

Question 36

what are the symptoms of meningitis

Answer 36

fever and/or vomiting, severe headache, limb/joint/muscle pain, cold hands or feet/shivering, pale or mottled skin, breathing fast/ breathless, rash (non blanching), stiff neck, dislike of bright light, very sleepy/vacant/difficult to wake, confused/delirious, seizures

Question 37

what strains of meningococcal disease are vaccinated against

Answer 37

A, C, W, Y135 and B

Question 38

how do vaccine reduce burden of disease

Answer 38

prevent: acute infection, death, long term complications

Question 39

how is the uptake of vaccines affected by deprivation

Answer 39

most deprived areas have lower uptakes up vaccines

Question 40

what are the challenges to vaccination schedules

Answer 40

continual change and renewal (new evidence), flu (unpredictable), hesitancy of population

Question 41

what is the elimination of disease

Answer 41

reduction to zero of the incidence of a specific disease in a defined geographical area as a result of deliberate efforts - continued intervention measures are required

Question 42

what is the eradication of a disease

Answer 42

permanent reduction to zero of the worldwide incidence of infection as a result of deliberate efforts, intervention measures no longer needed (smallpox)

Question 43

what is the extinction of a disease

Answer 43

specific infectious agent no longer exists in nature or lab

Question 44

define the control of a disease

Answer 44

reduction of disease to locally acceptable level- continues intervention required

Question 45

what is the elimination of INFECTIONS (as apposed to elimination of disease)

Answer 45

reduction to zero incidence of specific infection caused by specific agent

Question 46

where do the majority of malaria cases occur

Answer 46

africa south of the sahara

Question 47

what vaccines exists against non infectious conditions

Answer 47

CYT009-GhrQb- works against obesity, instructs production of anti-ghrelin antibody response (ghrenlin is a peptide regulator of eating behaviour) BCG- (vaccinates against TB but also) bladder cancer treatment and on trial as treatment for type 1 diabetes

Question 48

what diseases do you vaccinate against

Answer 48

``` diphtheria rotavirus meningococcal Hib Hepatitis B measles Mumps rubella HPV- cervical cancer Flu pneumococcal shingles (adults) polio tetanus whooping cough ```

Question 49

what vaccinations do you get at 3 months

Answer 49

hexavalent (DTaP/ IPV/ HiB/ HepB) | rotavirus

Question 50

what vaccinations do you get at 4 months

Answer 50

hexavalent (DTaP/ IPV/ HiB/ HepB) menB PCV

Question 51

what vaccinations do you get at 12-13 months

Answer 51

men B, PCV, Hib/MenC, MMR

Question 52

what vaccines do you get at 3 years 4 months- 5 years

Answer 52

MMR and DTap/ IPV

Question 53

what vaccines do you get at 2 - 12 years

Answer 53

flu

Question 54

what vaccinations do girls get at ages 12-13 (s1 and 2)

Answer 54

HPV (two doses)

Question 55

what do vaccinations do children get at 13-14 years (S3)

Answer 55

Td/ IPV | menACWY

Question 56

what vaccination is given opportunistically in secondary schools

Answer 56

MMR