Immunisation and prophylaxis Flashcards
What are the different types of vaccine?
Live attenuated
Inactivated (killed)
Detoxified exotoxin
Subunit of micro-organism (purified microbial products or recombinant)
What are examples of live attenuated vaccines?
MMR BCG VZV Yellow fever Smallpox Typhoid Polio Rotavirus
What are examples of inactivated (killed) vaccines?
Polio Hep A Cholera Rabies Japanese encephalitis Tick-bourne encephalitis Influenza
What are examples of detoxified exotoxin vaccines?
Diphtheria
Tetanus
How are detoxified exotoxin vaccines made?
Treat toxin with formalin = toxoid
What are examples of subunit vaccines?
Pertussis Haemophilus influenzae type B Meningococcus (group C) Pneumococcus Typhoid Anthrax Hep B
What is a recombinant vaccine example?
Hep B
What is the 6 in 1 vaccine?
Infanrix hexa D = diphtheria T = tetanus aP = Bordetella pertussis IPV = inactivated polio virus Hib = Haemophilus influenzae b HBV = hep B
What immunisations do children typically get at 2 months?
- 6-in-1 vaccine
- Pneumococcal conjugate
- Rotavirus
- Men B
What immunisations do children typically get at 3 months?
- 6-in-1 vaccine
- Rotavirus
What immunisations do children typically get at 4 months?
- 6-in-1 vaccine
- Pneumoccocal conjugate
- Men B
How many doses of the 6-in-1 vaccine are given?
3
What immunisations do children typically get at 1 year?
- Hib/Men C
- MMR
- Pneumococcal conjugate
- Men B
What immunisations do children typically get at 2-8yrs?
- Influenza nasal
What immunisations do children typically get at 3-5yrs?
- 4-in-1 booster (DTaP/IPV)
- MMR
What immunisations do girls typically get at 12-13yrs?
HPV
What immunisations do children typically get at 14yrs?
- 3-in-1 booster (dT/IPV)
- Men ACWY
How much coverage does herd immunity typically get?
90-95%
What vaccines are specifically given to special patient and occupational groups?
BCG Flu Pneumococcal Hep B VZV HSV (shingles)
Who is given BCG vaccine?
- Infants in areas of UK with high annual incidence
- Infants with parents/grandparents born in country with high annual incidence of TB
- Children screened at school for risk factors
- New immigrants
- Contact with resp TB patients
- Healthcare workers
Who should you not give an influenza vaccine to?
Egg allergies
What are the indications for flu vaccine?
>65yrs Nursing home residents Some health care workers Immunodeficiency Immunosuppression Asplenia/hyposplenism Chronic liver/renal/cardiac/lung disease DM Pregnant women Coeliac disease
What are the 2 different pneumococcal vaccines?
- Pneuomococcal conjugate polysaccharide vaccine = childhood immunisation
- Pneumococcal polysaccharide vaccine = those at increased risk of pneumococcal infection
Who receives the hep B vaccination?
- All new born children from 2018 (6-in-1)
- Children at high risk exposure to HBV
- Health care workers, IVDU, MSM, prisoners
Who receives the VZV (chickenpox) vaccine?
- Patients with suppressed immune systems
- Children if risk severe VZV
- Health care workers
Who receives the shingles vaccine?
All elderly patients 70+
What does human normal immunoglobulin contain?
Antibodies against hep A, rubella, measles
When is human normal immunoglobulin used?
Immunoglobulin deficiencies
Treatment of some autoimmune disorders
When is disease specific immunoglobulin used?
Post-exposure to disease e.g. hep B, rabies, tetanus anti-toxin
What is the risk assessment for travel immunisation/prophylaxis?
Health of traveller Previous immunisations/prophylaxis Area visited Duration visit Accommodation Activities Remote areas Recent outbreaks
What are general measures to advice for travel?
Care with food/water Hand washing Sunburn/stroke Altitude RTAs Safe sex Mosquitoes
What are common immunisations for travellers?
Tetanus Polio Typhoid Hep A Yellow fever Cholera
What are less common immunisations for travellers?
Meningococcus A, C, W, Y Rabies Diphtheria Japanese B encephalitis Tick borne encephalitis
What are some travel prophylaxis?
Chemoprophylaxis against malaria
Post-exposure prophylaxis e.g. ciprofloxacin for meningococcal disease
HIV post-exposure prophylaxis
Surgical antibiotic prophylaxis
What is the ABCD of malaria prevention?
Awareness of risk
Bite prevention
Chemoprophylaxis
Diagnosis and treatment
What is the bite awareness for malaria prevention?
Cover-up dusk and dawn Insect repellent Mosquito coils Permethrin-impregnated mosquito nets Chemoprophylaxis against malaria
What are the chemoprophylaxis options against malaria?
Malarone daily
Doxyclcine daily
Mefloquine weekly
Chloroquine weekly + proquanil daily
What are the side effects of mefloquine?
Psychosis
Nightmares
What is malaria advice to travellers on return?
Any illness occurring within 1yr (esp. 3mo) might be malaria
