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Child Health > Immunisation > Flashcards

Immunisation Flashcards

1
Q

What is the main aim of immunisation?

A

To control communicable disease

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2
Q

How does immunisation work towards controlling communicable disease?

A

Prevent onset of disease (primary prevention)
Interrupt transmission
Limit or prevent consequences after course of infection (secondary prevention)

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3
Q

What are some ways that have been introduced to prevent the onset of disease?

A

Childhood immunisation, travel vaccines, routine vaccination for older people, occupational vaccines, high risk clinical groups

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4
Q

How do vaccines cause the immune system to become resistant to pathogens?

A

Teach immune system to recognise bacteria/viruses before the individual encounters them as potential pathogens, thus allowing the body to fight against them

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5
Q

What are the immunological mechanisms of immunity?

A

Active, passive and herd immunity

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6
Q

What are antigens?

A

Parts of bacteria/viruses which are recognised by the immune system = usually proteins or polysaccharides

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7
Q

How does the immune system respond to antigens?

A

Usually produces antibodies

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8
Q

What are antibodies?

A

Proteins which bind to antigens = very specific to individual antigens

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9
Q

What causes other immune cells to be alerted of an infection?

A

The forming of the antibody-antigen complex

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10
Q

How are B cells involved in the immune system?

A

Has role in humoral immune system, triggered to produce antibody when foreign antigen is encountered, mature in bone marrow

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11
Q

How are T cells involved in the immune system?

A

Have role in cell-mediated immune response,CD4+ and CD8+ cells, mature in thymus, orchestrate response by binding to other cells and sending out signals

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12
Q

What occurs in passive immunity?

A

Transfer of pre-formed antibodies (immunoglobulins)

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13
Q

What are some examples of passive immunity?

A

Mother to unborn baby = via placenta, lasts up to one year, not protective against everything
From another animal = human normal Ig, specific Ig

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14
Q

What are some of the antimicrobial substances that are involved in passive immunity?

A

Human Ig = hep B, rabies, varicella zoster

Anti-toxin = diphtheria, botulinum

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15
Q

What are the advantages of passive immunity?

A

Rapid action, useful post exposure and in outbreak control, can attenuate illness, can be used if contraindication to active vaccination

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16
Q

What are the disadvantages of passive immunity?

A

Short term production, short term window for use, blood derived, hypersensitivity reactions may occur, expensive

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17
Q

How do vaccines work?

A

Induce cell mediated immunity responses and serum antibodies

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18
Q

What are the types of vaccine?

A

Live virus vaccines and inactivated vaccines

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19
Q

What are some features of live virus vaccines?

A

Attenuated organism, replicates in host, used to mumps and measles etc

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20
Q

What are the different types of inactivated vaccines?

A 
Suspensions of killed organisms (e.g whole cell typhoid)
Subunit vaccines (toxoids or polysaccharides)
Conjugate vaccines (polysaccharide attached to immunogenic proteins)
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21
Q

What are some contraindications to vaccines?

A

Confirmed anaphylaxis reaction to previous dose of same antigen/vaccine component, egg allergy (yellow fever, flu), severe latex allergy, acute or evolving illness (must wait until stable)

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22
Q

What are some contraindications to live vaccines?

A

Immunosuppression = primary, high dose steroids, HIV

pregnancy

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23
Q

What is herd immunity?

A

Protecting unvaccinated individuals through having sufficiently large proportion of population vaccinated = vaccinated people stop transmission

24
Q

How is the proportion of the population that needs to be vaccinated in order to provide herd immunity calculated?

A

Derived mathematically based on transmissibility and infectiousness of organism, and the social mixing of the population

25
Q

What is required for herd immunity to work?

A

There must be no other reservoir of infection

26
Q

What are some features of the Scottish Immunisation Programme?

A

Single largest co-ordinated public health programme
Protection against 15 different diseases offered
>1.5 million people are offered

27
Q

What is the purpose of a routine vaccination schedule?

A

To provide early protection against infections that are most dangerous to the very young and to ensure continued protection by providing subsequent vaccines

28
Q

Why should vaccination schedules be followed as closely as possible?

A

The age at which the vaccine is given is based on age specific risk of disease, risk of complications and ability to respond to the vaccine

29
Q

Should children still be given vaccines if they are older than what is recommended?

A

Yes = every effort should be made to ensure all children are vaccinated

30
Q

What are the vaccines given in childhood?

A

Hexavalent, meningococcal group B, rotavirus, pneumococcal, Hib/meningococcal group C, measles/mumps/rubella, influenza (annually)

31
Q

What makes up the hexavalent vaccine that is now given to children routinely?

A

Diphtheria, tetanus, pertussis, polio, haemophilus influenzae type B (Hib), hepatitis B

32
Q

What are some vaccinations that may be given to children in at risk groups?

A

Flu (annually) = aged 2 or older
BCG = aged up to 16
PPV23 = aged 2 or older
Hepatitis B = all ages

33
Q

What vaccines are included in adult programmes?

A 
PPv23 = 65 year olds
Shingles = 70 year olds
Seasonal flu (annually) = aged 65 or older, pregnant
Various selective programmes (travel, occupational)
34
Q

Are doctors responsible for notifying health boards about certain diseases?

A

Yes = legal duty to notify health boards on clinical suspicion of specified diseases or health risk state posing significant public health risk

35
Q

How should doctors get in touch to notify health boards of disease outbreaks?

A

Notify in writing within 3 days (includes emails)

Notify by phone as soon as possible if urgent (still also need to give notification in writing)

36
Q

Do doctors need to wait for lab confirmation before notifying health boards of a disease outbreak?

A

No = diseases have to be notified as soon as there is clinical suspicion of their presence

37
Q

What are some examples of diseases that health boards must be notified of?

A

Plague, SARDS, smallpox, cholera, HUS, diphtheria, necrotising fasciitis

38
Q

What is diphtheria?

A

URTI characterised by sore throat and low grade fever

White adherent membrane on tonsils, pharynx and nasal cavity

39
Q

What causes diphtheria?

A

Aerobic gram positive bacteria = Corynebacterium diphtheriae

40
Q

What is meningococcal disease?

A

Invasive infection caused by Neisseria meningitidis = causes meningitis, septicaemia or both

41
Q

What are some long term complications of meningococcal disease?

A

Neurological defects = hearing loss, speech disorders, loss of limbs, paralysis

42
Q

What serotypes of meningococcal disease are there vaccines available for?

A

Serotypes A, C, W, Y135 and B

43
Q

How is meningococcal disease spread?

A

Person to person contact through respiratory droplets of infected people = incubation period of 3-5 days

44
Q

What questions do you need to ask when deciding if a vaccine should be offered?

A

Is it needed? = disease incidence/complications, case fatality ratios, age distribution, trends
Does it work?

45
Q

What are some factors that may influence whether a vaccine is offered?

A

Cost, model of delivery, acceptability, political factors, aim of programme

46
Q

What are the phases of new vaccine investigation?

A 
1 = is it safe? is it immunogenic?
2 = how reactogenic is it? what dose should be used? how does it compare with current vaccines?
3 = is it efficacious? are there any safety issues?
4 = post marketing surveillance
47
Q

What are the costs of vaccines?

A

Cost benefit and effectiveness important
Economic cost of disease = visits to GP, hospitalisations
Economic cost of vaccination = vaccine cost, adverse effects, opportunity costs

48
Q

What does the acceptability of a vaccine relate to?

A

The safety issues associated with the vaccine

49
Q

What is the decision to use a vaccine based on?

A

Considering the balance of benefits and risks = disease burden versus known risk of vaccine

50
Q

When may a vaccine be removed or changed?

A

If the safety concerns are valid

51
Q

What does the uptake of immunisations depend on?

A

Perception of relative risks and benefits

52
Q

What are the benefits of vaccines for individuals?

A

Reduce burden of disease = acute infection, death, long term complications
Maintain underlying health

53
Q

What are the benefits of vaccines at a population level?

A

Reduce community transmission = minimise spread
Reduce healthcare utilisation and societal burden
Tackle inequalities

54
Q

What does elimination of a disease mean?

A

Reduction to zero of incidence in a defined geographical area

55
Q

What does the eradication of a disease mean?

A

Permanent reduction to zero of worldwide incidence

56
Q

What does it mean if a disease is said to be extinct?

A

The disease no longer exists in nature or in the lab

57
Q

What is meant if a disease is said to be controlled?

A

It has been reduced to a locally acceptable level

Child Health (27 decks)

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