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Immunisation and Prophylaxis Flashcards

1
Q

What is immunisation?

A

Creation of immunity against a disease

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2
Q

What is prophylaxis?

A

Treatment given or taken to prevent disease

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3
Q

Who is immunisation given to?

A
  • Childhood schedule
  • Special patient groups
  • Occupational
  • Travelers
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4
Q

Who is prophylaxis given to?

A
  • Travelers
  • Post-exposure
  • Surgical
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5
Q

What are the different branches of immunity?

A
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6
Q

How does the antibody response to infection differ in the primary and secondary response?

A

Secondary response is much faster

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7
Q

Vaccines can be killed or alive, how does their mechanism of action differ?

A
  • Killed causes production of antibodies, which decreases over time so needs a few doses to produce immunological memory
  • Live vaccine replicates to more antibodies are produced and only one dose needed
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8
Q

What is an example of a disease eradicated by a vaccine?

A

Smallpox

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9
Q

What are the different kinds of vaccines?

A

Live attenuated

Inactivated (killed)

Detoxified exotoxin

Subunit of micro-organism

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10
Q

What are examples of live attenuated vaccines?

A
  • Measles, mumps, rubella (MMR)
  • BCG
  • Varicella-zoster virus
  • Yellow fever
  • Smallpox
  • Typhoid (oral)
  • Polio (oral)
  • Rotavirus (oral)
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11
Q

What are examples of inactivated (killed) vaccines?

A
  • Polio (in combined vaccine D/T/P/Hib)
  • Hepatitis A
  • Cholera (oral)
  • Rabies
  • Japanese encephalitis
  • Tick-borne encephalitis
  • Influenza
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12
Q

What are examples of detoxified exotoxin vaccines?

A
  • Diphtheria
  • Tetanus
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13
Q

What are examples of subunit of microorganism vaccines?

A
  • Pertussis (acellular)
  • Haemophilus influenzae type b
  • Meningococcus (group C)
  • Pneumococcus
  • Typhoid
  • Anthrax
  • Hepatitis B
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14
Q

What is the “6 in 1” vaccine that children get?

A

Children get a “6 in 1” vaccine, called the infanrix hexa:

  • D = purified diphtheria toxoid
  • T = purified tetanus toxoid
  • aP = purified Bordetella pertussis
  • IPV= inactivated polio virus
  • Hib= purified component of Haemophilus influenzae b
  • HBV= hepatitis B rDNA
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15
Q

What is in the 6 in 1 vaccine that children get?

A

Children get a “6 in 1” vaccine, called the infanrix hexa:

  • D = purified diphtheria toxoid
  • T = purified tetanus toxoid
  • aP = purified Bordetella pertussis
  • IPV= inactivated polio virus
  • Hib= purified component of Haemophilus influenzae b
  • HBV= hepatitis B rDNA
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16
Q

Describe the UK immunisation scedule?

A
  • 2 months
    • 6 in 1 vaccine and pneumococcal conjugate and rotavirus and Men B
  • 3 months
    • 6 in 1 vaccine and rotavirus
  • 4 months
    • 6 in 1 vaccine and pneumococcal conjugate and Men B
  • 1 year
    • Hib/Men C and MMR and pneumococcal conjugate and Men B
  • 2-8 years
    • Influenza nasal
  • 3-5 years
    • 4 in 1 booster (DTaP/IPV) and MMR
  • Girls, 12-13 years
    • Human papilloma virus
  • 14 years
    • 3 in 1 booster (dT/IPV) and Men ACWY
17
Q

What is herd immunity?

A

Resistance of the spread of contagious disease that results if a high proportion of individuals are immune to the disease

18
Q

What is the target uptake for herd immunity to work?

19
Q

What are examples of immunisations for special patients and occupational groups?

A
  • BCG (Bacille Calmette-Guerin)
    • Some infants (0-12 months), where incidence in area of TB is >=40/100,000, or have parents/grandparents born in country with annual incidents of TB >=40/100,000
    • Children with TB risk factors
    • New immigrants from high prevalence countries
    • Healthcare workers
  • Influenza
    • Influenza A and B constantly change antigenic structure so new vaccine every year
    • Indications includes
      • Age>65
      • Nursing home resident
      • Healthcare worker
      • Immunodeficiency
      • Chronic liver, renal, cardiac or lung disease
      • Diabetes
      • Pregnant
  • Pneumococcal
    • 2 vaccines
    • Pneomococcal conjugate polysaccharide vaccine (13 serotypes)
      • Part of childhood immunisation schedule
    • Pneomococcal polysaccharide vaccine (23 serotypes)
      • Those at increased risk of pneumococcal infection
  • hepatitis B
    • Part of 6in1 vaccine for new-borns from 2018
    • Healthcare workers
    • Prisoners
    • Chronic liver or kidney disease
  • varicella-zoster (chickenpox)
    • Immunodeficiency
    • Children if in contact with those at risk of severe vzv
    • Healthcare workers (if sero-neg)
  • herpes-zoster (shingles)
    • All elderly patients (70-80 years)
20
Q

Who is offered the BCG vaccine?

A
  • Some infants (0-12 months), where incidence in area of TB is >=40/100,000, or have parents/grandparents born in country with annual incidents of TB >=40/100,000
  • Children with TB risk factors
  • New immigrants from high prevalence countries
  • Healthcare workers
21
Q

What are some indications to get the influenza vaccine?

A
  • Age>65
  • Nursing home resident
  • Healthcare worker
  • Immunodeficiency
  • Chronic liver, renal, cardiac or lung disease
  • Diabetes
  • Pregnant
22
Q

What are the 2 pneomococcal vaccines?

A
  • Pneomococcal conjugate polysaccharide vaccine (13 serotypes)
    • Part of childhood immunisation schedule
  • Pneomococcal polysaccharide vaccine (23 serotypes)
    • Those at increased risk of pneumococcal infection
23
Q

Who gets the hepatitis B vaccine?

A
  • Part of 6in1 vaccine for new-borns from 2018
  • Healthcare workers
  • Prisoners
  • Chronic liver or kidney disease
24
Q

Who is offered the varicella-zoster vaccine?

A
  • Immunodeficiency
  • Children if in contact with those at risk of severe vzv
  • Healthcare workers (if sero-neg)
25
What is varizella-zoster also known as?
Chickenpox
26
What is herpes-zoster also known as?
Shingles
27
What is passive immunisation?
Antibody formed in one person is given to another who is at risk of infection
28
Does passive immunisation given permanent or temporary protection?
Temporary
29
What immunoglobulins can be given for passive protection?
Human normal immunoglobulin is normally given: * Contains antibodies against hep A, rubella and measles * Used in immunoglobulin deficiencies or treatment of some autoimmune disorders such as myasthenia gravis Disease specific immunoglobulin can be given post-exposure, such as for: * hepatitis B Ig * rabies Ig * tetanus anti-toxin Ig * Varicella zoster (chickenpox) Ig * diphtheria anti-toxin Ig (horse) * botulinum anti-toxin Ig
30
What are examples of diseases where disease specific immunoglobulins can be given post-exposure for?
* hepatitis B Ig * rabies Ig * tetanus anti-toxin Ig * Varicella zoster (chickenpox) Ig * diphtheria anti-toxin Ig (horse) * botulinum anti-toxin Ig
31
What does the risk assessment for immunisation and prophylaxis for travellers involve?
* Health of Traveller * Previous immunisation and prophylaxis * Area to be visited * Duration of visit * Accommodation * Activities * Remote areas * Recent outbreaks
32
Where can sources of information about immunisation and prophylaxis for travellers be found?
* British National Formulary (BNF) * “Immunisation Against Infectious Diseases” (green book)
33
What are examples of some travel advice?
* General measures * Care with food/water * Hand washing * Sunburn / Sunstroke * Altitude * Road traffic accidents * Safer sex * Mosquitoes - bed nets, sprays, “cover up * Immunisation * Tetanus * Polio * Typhoid * Hepatitis A * Yellow fever * Cholera * In special circumstances: * Meningococcus A, C, W, Y * Rabies * Diphtheria * Japanese B encephalitis * Tick borne encephalitis * Chemoprophylaxis (antimicrobial prophylaxis) * Chemoprophylaxis against malaria * Post-exposure prophylaxis * Such as ciprofloxacin for meningococcal disease * HIV post-exposure prophylaxis * Surgical antibiotic prophylaxes
34
What are some vaccines maybe offered to travellers?
* Tetanus * Polio * Typhoid * Hepatitis A * Yellow fever * Cholera * In special circumstances: * Meningococcus A, C, W, Y * Rabies * Diphtheria * Japanese B encephalitis * Tick borne encephalitis
35
What are examples of chemoprophylaxis (antimicrobial prophylaxis)?
* Chemoprophylaxis against malaria * Post-exposure prophylaxis * Such as ciprofloxacin for meningococcal disease * HIV post-exposure prophylaxis * Surgical antibiotic prophylaxes
36
Describe malaria prevention advice?
* Awareness of risk * Know risk in country * Bite prevention * Cover up at dawn and dusk * Insect repellent sprays * Mosquito coils * Chemoprophylaxis * Malarone daily * Doxycycline daily * Not for \<12 years * Mefloquine weekly * Side effects: psychosis, nightmares * Chloroquine weekly and proquinil daily * Diagnosis and treatment
37
What is some chemoprophylaxis options for malaria?
* Malarone daily * Doxycycline daily * Not for \<12 years * Mefloquine weekly * Side effects: psychosis, nightmares * Chloroquine weekly and proquinil daily

Infection (15 decks)

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