Immunisation and prophylaxis Flashcards
Who tends to receive immunisations?
- Children as part of schedule
- Special patient groups
- Occupational
- Travellers
When is prophylaxis given?
- Travellers
- Post exposure
- Post exposure (HIV)
- Surgical
What different types of vaccines are given?
- Live attenuated
- Inactivated (killed)
- Detoxified exotoxin
- Subunit of microorganism (Purified microbial products/recombinant)
Give some examples of live attenuated vaccines?
- Measles, mumps, rubella (MMR)
- BCG
- Varicella-zoster virus
- Yellow fever
- Smallpox
- Typhoid (oral)
- Polio (oral)
- Rotavirus (oral)
Give some examples of inactivated (killed) vaccines?
- Polio (combined vaccine)
- Hep A
- Cholera (oral)
- Rabies
- Japanese encephalitis
- Tick borne encephalitis
- Influenza
Detoxified exotoxin vaccines are made by treating a toxin with formalin, giving a toxoid. What are examples of these?
- Diphtheria
- Tetanus
Give some examples of subunit vaccines?
- Pertussis
- Haemophilus influenzae type b
- Meningococcus (group c)
- Pneumococcus
- Typhoid
- Anthrax
- Hep B
An example of recombinant vaccine is hep B. How are these made?
>DNA segment coding for HBsAg >Removed, purified, mixed with plasmids >Inserted into yeasts >Fermented >HBsAg produced
Out of killed and live vaccines, which one needs a succession of doses to boost immune response?
Killed vaccine
What is in the “6 in 1” vaccine: 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 = hep B rDNA
Regarding the UK childhood immunisation schedule, what do children get in the first 18 years of life?
> MMR, Hib and Men B vaccines, polio (6 in 1 vaccine) = all in first 6m
MMR = 15m
Tetanus/diphtheria, polio, MMR, pertussis booster = 4-5 years
BCG = 10-14 years
Tetanus/diphtheria booster, polio
What special care groups get treated with BCG vaccine?
- Children found to have TB risk factors
- New immigrants from high TB prevalance countries
- Contacts (<35y) of resp TB patients
- Healthcare workers
What special care groups get treated with influenza vaccine?
- Age >65
- Nursing home residents
- Healthcare workers
- Immunodeficiency/suppression
- Chronic liver/renal/cardiac/lung disease
- DM
- Coeliac disease
- Pregnant women
Does the conjugate pneumococcal polysaccharide vaccine get given as part of childhood schedule or when patient has indication?
Childhood. The pneumococcal polysaccharide vaccine gets given when patient at increased risk.
What are indications for patients to be given pneumococcal vaccine?
- Immunodeficiency/suppression
- Sickle cell disease
- Chronic liver/renal/cardiac/lung disease
- DM,
- Coeliac disease
New born children are now being given hep B vaccine. Other than children, what groups are susceptible to HBV and should be vaccinated?
- Healthcare workers
- Drug injectors
- MSM
- Prisoners
- Chronic liver/kidney disease
Varicella zoster vaccine is given as part of 2 doses, 4-8w apart. Who should be given it?
- Immunosuppression
- Children if in contact with those at high risk of severe VZV
- Healthcare workers
Herpes zoster vaccine is a live attenuated vaccine and is given to who?
-All elderly patients (over 70)
Human normal immunoglobulin is a form of passive immunisation. What is it used for?
- Antibodies against hep A, rubella, measles
- Immunoglobulin deficiencies
- Some autoimmune disorders eg myasthenia gravis
Disease specific immunoglobulin is a form of passive immunoglobulin given post exposure. What is it given for?
- Hep B Ig
- Rabies Ig
- Tetanus anti-toxin Ig
- Varicella (chickenpox) Ig
- Diphtheria anti-toxin Ig
- Botulinum anti-toxin Ig
What is part of risk assessment for a traveller who may need immunisation and prophylaxis?
- Health of traveller
- Previous immunisation and prophylaxis
- Area to be visited
- Duration of visit
- Accomodation
- Activities
- Remote areas
- Recent outbreaks
NEED to look at International Travel Health Advice
What is general measures given as travel advice?
- Care with food/water
- Hand washing
- Sunburn/sunstroke
- Altitude
- Road traffic accidents
- Safer sex
- Mosquitoes - bed bets, sprays
What is common immunisations for travellers?
- Tetanus
- Polio
- Typhoid
- Hep A
- Yellow fever
- Cholera
Name some immunisation for travellers in special circumstances?
- Meningococcus A, C, W, Y
- Rabies
- Diphtheria
- Japanese B encephalitis
- Tick borne encephalitis
