Immunisation and Prophylaxis Flashcards
What is the primary response to infection?
Slower, smaller
IgG and IgM roughly equal
What is the secondary response to infection?
Faster, larger
IgG much higher than IgM
How do Killed and Live vaccines differ?
Live is one dose with a huge immune response
Killed is a smaller response needing multiple doses
What are the main types of vaccines?
Live attenuated
Inactivated/killed
Detoxified exotoxin
Subunit of microorganism
Name 2 killed vaccines?
Polio
Hep A
Rabies
Influenza
Name 2 live attenuated vaccines?
MMR
BCG
Smallpox
Varicella-zoster
How are detoxified vaccines made?
Toxin is treated with formalin to form Toxoid
Name 2 subunit attenuated vaccines?
Pertussis
Hep B
H. influenzae type B
What is the infant immunisation schedule?
2 months: 6 in 1, pneumococcus, rotavirus, meningitis B
3 months: 6 in 1 + rotavirus
4 months: 6 in 1 + pneumococcal + men B
What is the 6-in-1 vaccine
Diphtheria Tetanus Pertussis Polio H. influenzae type B Hepatitis B
What is the target coverage needed for herd immunity?
90-95%
What immunisations are indicated for special patient/occupation groups?
BCG
Flu
Hep B
Varicella-zoster, herpes zoster
When is BCG indicated?
Healthcare workers
Infants in high incidence areas/family from high incidence
Contact with TB patients
Give 3 indications for flu vaccine
Age >65 years Nursing home residents Some health care workers Immunodeficiency, Immunosuppression Asplenia/hyposplenism Chronic liver disease Chronic renal disease Chronic cardiac disease Chronic lung disease Diabetes mellitus Coeliac disease
What vaccines are offered for pneumococcus?
Pneumococcal conjugate (childhood, 3 doses) Pneumococcal polysaccharide (increased risk patient, single dose)
Give 3 indications for Pneumococcal polysaccharide vaccine?
Immunodeficiency Immunosuppression Asplenia/hyposplenism Sickle cell disease Chronic liver disease Chronic renal disease Chronic cardiac disease Chronic lung disease Diabetes mellitus
Give 3 indications for hep B vaccine?
All newborn children Children at high risk Healthcare workers IVDA MSM
Give 3 indications for Varicella-zoster vaccine?
Immunosuppression
Children at risk
Healthcare workers
What is the indication for Shingles vaccine?
70-80y/os
What passive immunisations with Ig are given?
Human normal immunoglobulin
Disease specific immunoglobulin
Human normal immunoglobulin is indicated for what?
Ig deficiencies
Hep A, rubella, measles
Autoimmune diseases
Disease specific immunoglobulin is indicated for what?
Post-exposure Hep B Rabies Tetanus Varicella zoster Diphtheria/Botulinium anti-toxin
What should be assessed in a risk assessment for infection in travellers?
Traveller health Previous immunisation Area to be visited Duration of visit Accommodation Activities Recent outbreaks
Give 3 sources of information for a patient travelling and their risk of infection
BNF
Immunisation Against Infectious disease
CDC
Schools of Tropical Medicine
What common immunisations are given to travellers?
Tetanus Polio Typhoid Hepatitis A Yellow fever Cholera
What are the main types of prophylaxis?
Chemoprophylaxis against malaria
PEP
HIV PEP
Surgical antibiotic prophylaxis
What is the ABCD of malaria prevention?
A - Awareness of risk
B - Bite prevention
C - Chemoprophylaxis
D - Diagnosis and treatment
How can mosquito bites be prevented?
Cover up at dawn and dusk
Insect repellant
Mosquito coils, nets
What Chemoprophylaxis is indicated against malaria?
Malarone
Doxycycline
Mefloquine
Chloroquine + Proquanil
What malarial advice is given to patients returning from travel?
Any illness within 1 year (esp. first 3 months) may be malaria
Seek medical attention if ill in first 3 months
