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Child Health > Immunisation > Flashcards

Immunisation Flashcards

1
Q

What is the primary prevention of disease?

A 
Prevent on sent of disease pre exposure: 
 Childhood immunisation 
Routine vaccines for elderly
Travel vaccines
Occupational vaccines
High risk clinical groups
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2
Q

What is secondary prevention?

A

Alter course of infection/disease to prevent or limit consequences:
Immunoglobulin - hep B, rabies, varicella zoster

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3
Q

How do vaccines work?

A

Teach the immune system to recognise bacteria and viruses before the individual encounters them as potential pathogens so allowing the body to fight against the pathogens

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4
Q

What are the immunological mechanisms in vaccinations?

A

Active immunity
Passive immunity
Herd immunity

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5
Q

What is an antigen?

A

Parts of bacteria and viruses which are recognised by the immune system
Antigens are usually proteins or polysaccharides (sugars)
Immune system generates a response to antigens often by the production of antibodies

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6
Q

What is an antibody?

A

Proteins which binds to antigens
Antibodies are very specific to individual antigens
When an antibody-antigen complex is formed, this alerts other immune cells (lymphocytes: B and T cells)

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7
Q

What is a B cell (humoral immune response)?

A

Triggered to produce antibodies when encountered with a foreign antigen

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8
Q

Where are B cells produced?

A

Bone marrow

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9
Q

Where are T cells produced?

A

Thymus

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10
Q

What are the different types of T cells and what do they do?

A

CD4+ and CD8_

Orchestrate the response of the immune system by binding to other cells and sending out signals

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11
Q

How is passive immunity transferred from mother to baby?

A

Via placenta
Lasts up to one year
Some antigens e.g. measles can pass through but others such as pertissus cannot

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12
Q

How can passive immunity be transferred from another person or animal?

A

Antibodies from blood donors
Human normal Ig
Specific Ig

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13
Q

What human Ig can be given via passive immunity?

A

Hep B
Rabies
Varicella zoster

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14
Q

What anti-toxin can be given via passive immunity?

A

Diphtheria

Botulinum

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15
Q

What are the advantages to passive immunity?

A 
Rapid action 
Post-exposure
Can attenuate illness
Outbreak control
Can be used if contraindication to active vaccination
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16
Q

What are the disadvantages to passive immunity?

A 
Short term protection 
Short term window
Blood derived
Hypersensitivity reaction 
Expensive
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17
Q

What is a live virus vaccine and what are examples of live viruses?

A

Attenuated organism, replicates in host

OPV, measles, mumps, rubella, varicella, rotavirus, flut

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18
Q

What are the different subtypes of inactivated vaccines?

A

Suspensions of killed organisms
Subunit vaccines
Conjugate vaccines

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19
Q

What are examples of suspensions of killed organisms vaccines?

A

Whole cell pertussis

Whole cell typhoid

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20
Q

What are examples of subunit vaccines?

A

Toxoids - diphtheria toxoid, tetanus toxoid, pertussis toxoid
Polysaccharides - pneumococcal, typhoid

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21
Q

What are examples of conjugate vaccines?

A

Polysaccharide attached to immunogenic proteins e.g Hib MenC

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22
Q

What are contraindications to vaccines?

A

Confirmed anaphylaxis
Egg allergy - flu and yellow fever
Severe latex allergy
Acute or evolving illness - defer till resolved/stabilised

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23
Q

What are specific contraindications to live vaccines?

A

Immunosuppression (primary, radiotherapy, high dose steroids, HIV)

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24
Q

What is herd immunity?

A

Protect unvaccinated individuals, through having sufficiently large proportion of population vaccinated
Vaccinated individuals stop transmission of organism

25
Q

What percentage of the population need to be vaccinated to provide herd immunity for measles?

A

90%

26
Q

What percentage of the population need to be vaccinated to provide herd immunity for mumps?

A

75-86%

27
Q

What percentage of the population need to be vaccinated to provide herd immunity for smallpox?

A

80-85%

28
Q

What is the purpose of the routine vaccine schedule?

A

To provide early protection against infections that are most dangerous for the very young - whooping cough, pneumococcal, Hib, meningococcal
To ensure continued protection by providing subsequent immunisations and booster doses before reaching age when risk increase

29
Q

How is the age chosen when to give certain vaccines?

A

Based on age-specific risk of disease, risk of complications and ability to respond to the vaccine
optimal age chosen for scheduling children may be a compromise between risk of disease and level of protection

30
Q

Currently in scotland, what diseases are offered vaccination from?

A 
Diphtheria 
Rotavirus
Meningococcal
Hib
Hepatitis B 
Measles
Mumps
Rubella
HPV - cervical cancer
Flu
Pneumococcal
Polio
Tetanus
Whooping cough
31
Q

What is the hexavalent vaccine?

A 
Diphtheria
Tetanus
Pertussis
Polio
Haemophilus infleunza type b 
Hepatitis  B
32
Q

What vaccines are given at 2 months?

A

Pneumococcal, hexavalent,meningococcal group B, rotavirus

33
Q

What vaccines are given at 3 months?

A

Hexavalent

Rotavirus

34
Q

What vaccines are given at 4 months?

A

Hexavalent
MenB
Pneumococcal

35
Q

What vaccines are given at 12-13 months?

A

MenB
Pneumococcal
Hib/MenC
MMR

36
Q

What vaccines are given at 3 years 4months - 5 years?

A

MMR

Diphtheria, tetanus, pertussis and polio booster

37
Q

What vaccine is given between 2-12 years?

A

Flu

38
Q

What vaccine is given to girls in S1 and S2?

A

2 doses of HPV

39
Q

What vaccine is given between 13-14 years?

A

Tetanus, diphtheria and polio booster

Meningococcal groups A, C, W and Y

40
Q

What are the selective childhood vaccines for children in at-risk groups?

A

Flu (annual) aged 2 or older
Pneumococcal polysaccharide vaccine aged 2 or older
bCG up to 16
Hep B all ages

41
Q

What adult vaccine programmes are available?

A

Pneumococcal polysaccharide vaccine - 65 years old
Shingles - 70 years old
Seasonal flu - over 65s, at-risk groups, pregnant women
Hep B
Travel
Occupational

42
Q

What is a public health notification?

A

Legal duty of medical practitioners to notify health board on clinical suspicion of specified diseases or a health risk state posing significant public health risk
Notification in writing with in 3 days
Notification by phone as soon as reasonably practicable if urgent

43
Q

What diseases are to be registered by medical practitioners based on reasonable clinical suspicion and should not await lab confirmation?

A 
Anthrax
Botulism
Brucellosis
Cholera
E.coli O157 infection
Diphtheria
HUS
Hib
Measles
Meningococcal disease
Mumps
Necrotizing fasciitis
Paratyphoid
Pertussis
Plague
Poliomyelitis
Rabies
Rubella
SARS
Smalpox
Tetanus
TB
Tularemia
Typhoid
Vrial haemorrhagic fevers
West nile fever
Yellow fever
44
Q

What is the presentation os diphtheria?

A

URTI characterised by sore throat, low rade fever

White adherent membrane on tonsils, pharynx and/or nasal cavity

45
Q

What causes diphtheria?

A

Aerobic gram positive bacterium - corynebacterium diphtheriae

46
Q

What causes meningococcal disease?

A

Invasive infection due to neisseria meningitidis

47
Q

What different infections can meningococcal disease cause?

A

Meningitis
Septicaemia
Men and sept

48
Q

How is meningococcal disease spread?

A

Person to person contact through respiratory droplets of infected people
Colonisation of nasopharynx common, important reservoir for disease

49
Q

What is the incubation period of meningococcal?

A

3-5 days

50
Q

What is the peak ages in meningococcal disease?

A

Less than 5 years

15-24 years

51
Q

How are new vaccines investigated?

A

Phase 1 = is it safe, is it immunogenic
Phase 2 = how reactogenic is it, what dose should be used, how does it compare with current vaccines
Phase 3 - is it efficacious, are there any rare reactions/ safety issues

52
Q

What is the yellow card scheme?

A

Passive reporting

Suspected adverse drug reactions

53
Q

What does the uptake of vaccines depend on?

A

Perception of relative risks and benefits

54
Q

What is the definition of control of a disease?

A

Reduction of the disease to a locally acceptable level; continued intervention required to maintain reduction e.g. diarrhoeal disease

55
Q

What is the definition of elimination of a disease?

A

Reduction to zero incidence of specified disease in defined geographical areas; continued intervention measures required e.g. neonatal tetanus

56
Q

What is the definitino of elimination of infections?

A

Reduction to zero incidence of infection caused by a specific agent in a defined geographical area/ continued measures to prevent re-establishment of transmission required e.g. measles, polio

57
Q

What is the definition of eradication of a disease?

A

Permanent reduction to zero fo the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed e.g. smallpox, rinderperst

58
Q

What is extinction of a disease?

A

The specific infectious agent no longer exists in nature of in the lab. There are no examples of this

Child Health (12 decks)

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