Immunisation and prophylaxis Flashcards by Anna Coull

What are the 2 main divisions of the immune system?

Innate

Adapative

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What is innate immunity?

The body’s own immune system – involves white cells e.g neutrophils + lymphocytes

Nonspecific, meaning anything that is identified as foreign or non-self is a target for the innate immune response.

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Adaptive immunity can be further divided into what?

Natural and artificial adaptive immunity

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Natural immunity

Passive - maternal

Active - infection

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Artificial immunity

Passive - antibody transfer + breast milk give immunity to baby against respiratory or enteric infections straight away

Active - immunisation

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Antibody primary response to infection

IgM produced first then IgG. Total antibody goes up then comes back down

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Antibody secondary response to infection

Production of antibodies occurs much quicker and at a higher level due to immunological memory

This hopefully prevents the individual becoming infected with that pathogen again

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How does a killed vaccine work to produce an immune response?

Killed vaccine causes a production of antibody – after a period of weeks or months will gradually come down again. This is when you need a 2nd – due to immunological memory that does will result in a quicker and higher response. A 3rd dose is needed to make a decent level of humoral immunological memory

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How does a live vaccine work to produce an immune response?

As the live vaccine begins to replicate and produce more antibodies this becomes like a cascade – quicker and more sustained response to the vaccination

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Types of vaccines you can get (4)

live attenuated

inactivated (killed)

detoxified exotoxin

subunit of micro-
organism: purified microbial products or recombinant

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Give some examples of common live attenuated vaccines (8)

MMR

BCG

Varicella-zoster virus - chicken pox

Yellow fever

Smallpox

Typhoid, polio, rotavirus (oral vaccines)

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Give some examples of common killed vaccines (7)

Polio (in combined vaccine D/T/P/Hib)

Hep A

Cholera (oral)

Rabies

Japanese encephalitis

Tick-borne encephalitis

Influenza

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Give 2 examples of vaccines that contain detoxified exotoxins produced by the micro-organism

Tetanus

Diphtheria

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Give examples of vaccines that contain only a subunit of the micro-organism

Pertussis

Haemophilus influenzae type b

Meningococcus - group C

Pneumococcus

Typhoid

Hep B

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What is the main vaccine started from the age of 2 months to prevent illness in young children?

6 in 1 vaccine

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What is the BCG vaccine for?

Immunisation against TB

Children screened at school for TB risk factors, tested and vaccinated if appropriate

Who is the BCG vaccine given to in the UK?

BCG vaccine is only offered to some children either those in areas of the UK with a high incidence of TB or those with parents/grandparents born in a high risk TB country

Also new immigrants

Contacts of resp TB patients

Healthcare workers

Influenza vaccine

There is a new influenza vaccine each year with different strains

Indicated for elderly, nursing home residents, immunodeficient, immunosuppressed, asplenia, chronic liver, renal, cardiac and lung disease, DM and pregnant women

Name 3 conditions that the pneumococcus bacteria causes?

Pneumonia

Septicaemia

Meningitis

Who should get the hep B vaccine?

All new born children from 2018 (6-in-1)

Also given to:-
Children at high risk of exposure to HBV
Health care workers, PWID, MSM, prisoners, ch. liver disease, ch. kidney disease,
Given at 0, 1 month,2 months and 1 year

Who is the Varicella-zoster vaccine recommended to?

Patients who have a suppressed immune system e.g having cancer treatment or organ transplant

Children if in contact with those at risk of severe vzv

Health case workers if they’ve never had it before

What is human normal immunoglobulin?

A method of passive immunisation i.e injecting preparations made from the plasma of immune individuals with adequate levels of antibody to the disease for which protection is sought.

HNI is prepared from pools of at least 1000 donations of human plasma; it contains immunoglobulin G (IgG) and antibodies to hepatitis A, measles, mumps, rubella, varicella, and other viruses that are currently prevalent in the general population.

It is used in patients with immunoglobulin deficiencies

What are the 2 types of human immunoglobulin preparation available?

Human normal immunoglobulin

Disease-specific immunoglobulins.

What is an immunoglobulin?

Antibodies of human origin are usually termed immunoglobulins.

What is disease specific immunoglobulin?

Specific immunoglobulins are prepared by pooling the plasma of selected human donors with high levels of the specific antibody required. These are used following exposure ie when the patient has the infection. So for example... Rabies Ig is administered after an unimmunised individual has been bitten by an animal in or from a country where the risk of rabies is high or hep B Ig should be given to laboratory and other personnel who have been accidentally inoculated with hepatitis B virus, and in infants born to mothers who have become infected with this virus in pregnancy

What should you find out about a patient who needs vaccinations for travelling?

Health of Traveller – are they immunocompromised etc? Previous immunisation and prophylaxis Area to be visited and duration of visit Accommodation - hotels or hostels/camping/rough sleeping etc Activities Remote areas or cities Recent outbreaks where they are going

General measures that a patient who is going travelling should be given advice on (7)

``` Care with food/water Hand washing Sunburn / Sunstroke Altitude Road traffic accidents Safer sex Mosquitoes - bed nets, sprays, “cover up” ```

Common immunisations for travellers (6)

``` Tetanus Polio Typhoid Hepatitis A Yellow fever Cholera ```

Most common prophylaxis medication

Anti-malaria tablets | chemoprophylaxis

ABCD of malaria prevention

Awareness of risk Bite prevention - cover up at dawn and dusk, DEET spray, Permethrin-impregnated mosquito nets Chemoprophylaxis - malarone = most popular then doxycycline, mefloquine Diagnosis and treatment - know the signs of malaria, if they become ill - seek medical help

What are the components of the “6 in 1” childhood vaccination?

diphtheria, tetanus, Bordetalla pertussis, polio, Haemophilus influenzae, hepatitis B

There is no vaccine for which hepatitis infection?

Hep C