Immunisation and Prophylaxis Flashcards
when is immunisation indicated?
childhood schedule
special patient groups
occupational
travellers
when is prophylaxis indicated?
travellers
post exposure
surgical
name the 4 types of vaccine
live attenuated
inactivated (killed)
detoxified exotoxin
subunit of microorganism - purified microbial products, recombinant
give examples of live attenuated vaccines
- MMR
- BCG
- Varicella-zoster virus
- Yellow fever
- Smallpox
- Typhoid (oral)
- Polio (oral)
- Rotavirus (oral)
give examples of inactivated vaccines
- Polio (in combined D/T/P/Hib)
- Hepatitis A
- Cholera (oral)
- Rabies
- Japanese encephalitis
- Tick-borne encephalitis
- Influenza
give examples of detoxified exotoxin vaccines
diphtheria
tetanus
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
draw a graph showing the Total Ab, IgG, and IgM response in primary infection
see notes
draw a graph showing the Total Ab, IgG, and IgM response in secondary infection
see notes
draw a graph showing the effect of multiple doses of a vaccine
see notes
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
UK childhood immunisation schedule: 2 months
6 in 1
pneumococcal conjugate
rotavirus
men B
UK childhood immunisation schedule: 3 months
6 in 1
rotavirus
UK childhood immunisation schedule: 4 months
6 in 1
pneumococcal conjugate
men B
UK childhood immunisation schedule: 1 year
Hib/Men C
MMR
penumococcal conjugate
men B
UK childhood immunisation schedule: 2-8 years
nasal influenza
UK childhood immunisation schedule: 3-5 years
4 in 1 booster (DTaP/IPV)
MMR
UK childhood immunisation schedule: girls 12-13 years
HPV
UK childhood immunisation schedule: 14 years
3 in 1 booster (DT/IPV)
men ACWY
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 ?
13
how many does of the pneumococcal conjugate polysaccharide vaccine are needed?
3
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?
23
how many doses of the pneumococcal polysaccharide vaccine are needed?
1
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
