Immunisation and Prophylaxis Flashcards by Laura I

when is immunisation indicated?

childhood schedule
special patient groups
occupational
travellers

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when is prophylaxis indicated?

travellers
post exposure
surgical

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name the 4 types of vaccine

live attenuated
inactivated (killed)
detoxified exotoxin
subunit of microorganism - purified microbial products, recombinant

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give examples of live attenuated vaccines

MMR
BCG
Varicella-zoster virus
Yellow fever
Smallpox
Typhoid (oral)
Polio (oral)
Rotavirus (oral)

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give examples of inactivated vaccines

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

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give examples of detoxified exotoxin vaccines

diphtheria

tetanus

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give examples of subunit vaccines

• Pertussis (acellular)
• Haemophilus infuenzae type B
• Meningococcus group C
o Conjugated, capsular,
polysaccharide antigen
and corynbacterium
diphtheria protein
• Pneumococcus
• Typhoid
• Anthrax
• Hepatitis B

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draw a graph showing the Total Ab, IgG, and IgM response in primary infection

see notes

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draw a graph showing the Total Ab, IgG, and IgM response in secondary infection

see notes

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draw a graph showing the effect of multiple doses of a vaccine

see notes

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what are the components of 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 - hepatitis B rDNA

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UK childhood immunisation schedule: 2 months

6 in 1
pneumococcal conjugate
rotavirus
men B

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UK childhood immunisation schedule: 3 months

6 in 1

rotavirus

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UK childhood immunisation schedule: 4 months

6 in 1
pneumococcal conjugate
men B

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UK childhood immunisation schedule: 1 year

Hib/Men C
MMR
penumococcal conjugate
men B

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UK childhood immunisation schedule: 2-8 years

nasal influenza

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UK childhood immunisation schedule: 3-5 years

4 in 1 booster (DTaP/IPV)

MMR

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UK childhood immunisation schedule: girls 12-13 years

HPV

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UK childhood immunisation schedule: 14 years

3 in 1 booster (DT/IPV)

men ACWY

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what immunisations are there for special patient and occupational groups?

BCG
influenza
pneumococcal
hep B
varicella zoster (chickenpox)
herpes zoster (shingles)

who gets the bacille calmette-guerin (BCG) vaccine?

• Some infants (0-12 months)
o Areas of UK with annual incidence of TB >40/100,000
o Parents/grandparents born in a country with annual incidence of TB >40/100,000
• Children screened at school for TB risk factors, tested and vaccinated if appropriate
• New immigrants (previously unvaccinated) from high prevalence countries for TB)
• Contacts (<35 years) of resp TB patients
• Healthcare workers

who gets the influenza vaccine?

> 65 yr, nursing home, healthcare workers, immunodeficiency, immunosuppression,
asplenia/hyposplenism, chronic liver/renal/cardiac/lung disease, diabetes, coeliac,
pregnancy

people with an allergy to what cannot get the flu vaccine?

egg

who can get the pneumococcal conjugate polysaccharide vaccine (Prevenar 13)?

children

how many serotypes are in the pneumococcal conjugate polysaccharide vaccine ?

how many does of the pneumococcal conjugate polysaccharide vaccine are needed?

who can get the pneumococcal polysaccharide vaccine (Pneumovax II)?

those at increased risk of pneumococcal infection: Immunodeficiency, immunosuppression, asplenia/hyposplenism, sickle cell disease, chronic liver/renal/cardiac/lung disease, diabetes, coeliac

how many serotypes are there in the pneumococcal polysaccharide vaccine?

how many doses of the pneumococcal polysaccharide vaccine are needed?

who can get the hep B vaccine?

* All new born children from 2018 * Children at high risk of HBV exposure * Healthcare workers, PWID, MSM, prisoners, chronic liver disease, chronic renal disease

who can get the chickenpox vaccine?

* Patients who have a suppressed immune system e.g. chemotherapy, organ transplant * Children if in contact with those at risk of severe VZV * Healthcare workers if sero negative and in contact with patients

what kind of vaccine is the chickenpox?

live attenuated

how many doses of the chicken pox vaccine are needed?

2 doses, 4-8 weeks apart

who can get the shingles vaccine?

all elderly aged 70-80

what kind of vaccine is the shingles vaccine?

live attenuated

human normal immunoglobulin contains antibodies against?

hep A rubella measles

what is human normal immunoglobulin used in?

immunoglobulin deficiences | treatment of some autoimmune disease e.g. myasthenia gravis

disease specific immunoglobulin (post-exposure) can be used for?

``` o Hepatitis B Ig o Rabies Ig o Tetanus anti-toxin Ig o Varicella Ig o Diphtheria anti-toxin Ig (horse) o Botulinum anti-toxin Ig ```

what type of immunisation are immunoglobulins?

passive

immunisation and prophylaxis for travellers: risk assessment

``` health of traveller previous immunisation and prophylaxis area to be visited duration of visit accommodation activities remote areas recent outbreaks ```

immunisation and prophylaxis for travellers: general measures

``` care with food/water hand washing sunburn/sunstroke altitude RTA safe sex mosquitoes ```

immunisation and prophylaxis for travellers: common immunisations

``` tetanus polio typhoid hepatitis A yellow fever cholera ```

immunisation and prophylaxis for travellers: immunisations in special circumstances

``` men ACWY rabies diphtheria Japanese B encephalitis tick borne encephalitis ```

immunisation and prophylaxis for travellers: antimicrobial prophylaxis

• Chemoprophylaxis against malaria • Post exposure prophylaxis o E.g. ciprofloxacin for meningococcal disease • HIV post exposure prophylaxis o Needle stick (PEP), sexual intercourse (PEPSI) • Surgical antibiotic prophylaxis o Perioperative

name the 4 areas of malaria prevention

awareness of risk bite prevention chemoprophylaxis diagnosis and treatment

how can you prevent mosquito bites?

cover up at dusk and dawn DEET mosquito coils permethrin impregnated mosquito nets

chemoprophylaxis for malaria

a. Malarone (proquanil and atovaquone) daily b. Doxycycline daily i. Not for <12 yrs, photosensitivity c. Mefloquine weekly i. Psychosis, nightmares ii. Avoid if Hx of psychosis, epilepsy d. Chloroquine weekly and proquanil daily i. For vivax/ovale/malariae only e. Choice depends on country

what is the malaria advice to travellers on return?

Any illness occurring within 1 year and especially within 3 months of return might be malaria. Patients should seek medical attention if they become ill particularly within 3 months and mention malaria risk