Immunisation_Schedule_Flashcards

Question 1

What are the recommended immunisations at birth?

Answer 1

BCG if risk factors (e.g., tuberculosis in the family in the past 6 months).

Question 2

What are the recommended immunisations at 2 months?

Answer 2

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B), Oral rotavirus vaccine, Men B.

Question 3

What are the recommended immunisations at 3 months?

Answer 3

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B), Oral rotavirus vaccine, PCV.

Question 4

What are the recommended immunisations at 4 months?

Answer 4

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B), Men B.

Question 5

What are the recommended immunisations at 12-13 months?

Answer 5

Hib/Men C, MMR, PCV, Men B.

Question 6

What are the recommended immunisations for children aged 2-8 years?

Answer 6

Flu vaccine (annual).

Question 7

What are the recommended immunisations at 3-4 years?

Answer 7

‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio), MMR.

Question 8

What are the recommended immunisations at 12-13 years?

Answer 8

HPV vaccination.

Question 9

What are the recommended immunisations at 13-18 years?

Answer 9

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio), Men ACWY.

Question 10

Why has the meningitis ACWY vaccine replaced meningitis C for 13-18 year-olds?

Answer 10

Due to an increased incidence of meningitis W disease in recent years. The ACWY vaccine is also offered to new students (up to the age of 25 years) at university.

Question 11

What does Hib stand for?

Answer 11

Haemophilus influenzae B vaccine.

Question 12

What does PCV stand for?

Answer 12

Pneumococcal Conjugate Vaccine.

Question 13

What does Men B stand for?

Answer 13

Meningococcal B vaccine.

Question 14

What does Men C stand for?

Answer 14

Meningococcal C vaccine.

Question 15

What does Men ACWY stand for?

Answer 15

Meningococcal vaccine covering A, C, W and Y serotypes.

Question 16

What does MMR stand for?

Answer 16

Measles, Mumps, Rubella vaccine.

Question 17

What does HPV stand for?

Answer 17

Human Papilloma Vaccine.

Question 18

Why was the Men C vaccine discontinued at 3 months?

Answer 18

Due to the success of the Men C vaccination programme, there are almost no cases of Men C disease in babies or young children in the UK any longer. The dose of Men C vaccine at 12 weeks of age has been removed from the vaccination schedule.

Question 19

summarise the immunisation schedule

Answer 19

Immunisation schedule

The current UK immunisation schedule is as follows.

Age Recommended immunisations
At birth BCG if risk factors (see below)
2 months ‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B
3 months* ‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
PCV
4 months ‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Men B
12-13 months Hib/Men C
MMR
PCV
Men B
2-8 years Flu vaccine (annual)
3-4 years ‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio)
MMR
12-13 years HPV vaccination
13-18 years ‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)
Men ACWY

At birth the BCG vaccine should be given if the baby is deemed at risk of tuberculosis (e.g. Tuberculosis in the family in the past 6 months).

Meningitis ACWY vaccine

Note that the meningitis ACWY vaccine has replaced meningitis C for 13-18 year-olds. This is due to an increased incidence of meningitis W disease in recent years. The ACWY vaccine will also be offered to new students (up to the age of 25 years) at university. With respect to getting the vaccine, the NHS give the following advice to patients:

‘GP practices will automatically send letters inviting 17-and 18-year-olds in school year 13 to have the Men ACWY vaccine.

Students going to university or college for the first time as freshers, including overseas and mature students up to the age of 25, should contact their GP to have the Men ACWY vaccine, ideally before the start of the academic year’

Key
Hib = Haemophilus influenzae B vaccine
PCV = Pneumococcal Conjugate Vaccine
Men B = Meningococcal B vaccine
Men C = Meningococcal C vaccine
Men ACWY = Meningococcal vaccine covering A, C, W and Y serotypes
MMR = Measles, Mumps, Rubella vaccine
HPV = Human Papilloma Vaccine

*Meningitis C vaccine

This used to be given at 3 months but has now been discountinued. The NHS immunisation website states:

From July 1 2016, the Men C vaccine will be discontinued from the NHS childhood vaccination programme.

The success of the Men C vaccination programme means there are almost no cases of Men C disease in babies or young children on the UK any longer.

The dose of Men C vaccine that used to be offered to babies at 12 weeks of age has therefore been removed from the vaccination schedule.

All children will continue to be offered the Hib/Men C vaccine at one year of age, and the Men ACWY vaccine at 14 years of age to provide protection across all age groups.

Question 20

An 18 year-old with no significant medical history registers at a new GP practice when he moves to University. The practice reviews his immunisation history and sends him an invitation to have a vaccination. Which of the following vaccinations should he receive if he has not had it previously?

Varicella
BCG
Influenza
Men ACWY
Men B

Answer 20

Men ACWY

The Meningitis ACWY vaccine is being rolled out over several years. All children should receive the vaccination in school year 9 or 10 (in place of the Men C booster). The catch-up program is currently being aimed at students starting University for the first time (aged 25 and under only) and should ideally be given a few weeks before they begin.

Question 21

Which vaccines do young people usually receive between the ages of 13 - 18 years?

Key
DTaP = Diphtheria, Tetanus, acellular Pertussis vaccine
IPV = Inactivated Polio Vaccine
Hib = Haemophilus influenzae B vaccine
PCV = Pneumococcal Conjugate Vaccine
Men C = Meningococcal C vaccine
MMR = Measles, Mumps, Rubella vaccine
DT = Diphtheria, Tetanus vaccine

Hib + Men C
Tetanus/diphtheria/polio + Hib
Tetanus/diphtheria/polio + Men ACWY
IPV + Hib
Tetanus/diphtheria/polio + Men C

Answer 21

Tetanus/diphtheria/polio + Men ACWY

13-18 years immunisations: DT + IPV + Men ACWY
Important for meLess important
The correct answer is Tetanus/diphtheria/polio + Men ACWY. According to the UK vaccination schedule, young people between the ages of 13-18 years usually receive a combined tetanus, diphtheria, and polio vaccine (Td/IPV) as a booster dose, and the quadrivalent meningococcal conjugate vaccine (MenACWY) which protects against four strains of meningococcal disease (A, C, W, and Y). The Td/IPV booster helps maintain immunity against these three diseases throughout adulthood. The MenACWY vaccine is given to this age group since adolescents have an increased risk of contracting meningococcal disease.

Hib + Men C is incorrect because Hib (Haemophilus influenzae type B) vaccine is not routinely administered to adolescents in the UK. It is given as part of the primary immunisation series in infancy. Additionally, Men C only covers one strain of meningococcus (C), whereas the Men ACWY vaccine provides broader protection against four strains.

Tetanus/diphtheria/polio + Hib is also incorrect because, as mentioned earlier, Hib vaccine is not typically given to adolescents in the UK. The tetanus/diphtheria/polio booster should be administered during this age range but not with Hib.

IPV + Hib is incorrect for similar reasons. IPV stands for Inactivated Polio Vaccine and it’s included in the combined Td/IPV booster that adolescents receive. However, again, Hib is not part of their routine vaccinations at this age.

Finally, Tetanus/diphtheria/polio + Men C is incorrect because although it includes the appropriate tetanus/diphtheria/polio booster, the Men C vaccine only covers one strain of meningococcal disease. The Men ACWY vaccine is recommended for this age group as it provides broader protection against four strains of meningococcus.

Question 22

An 18-year-old male presents to his local GP surgery. He is due to start university in two months time and has been told by his friends that he should ‘have a vaccine’ before he starts. He identifies himself as ‘White British’, has no past medical history of note and is due to study history at the University of Birmingham. Which one of the following vaccines should he be offered as part of routine NHS immunisation?

Meningitis ACWY
Hepatitis B vaccine
Human papilloma virus
BCG vaccine
Meningitis B

Answer 22

Meningitis ACWY

The NHS now recommends the meningitis ACWY for all new students due to an outbreak of meningitis W in the past few years.

Question 23

You see a 30-year-old lady for a postnatal check following an emergency caesarian section 8 weeks ago. She also has her baby booked in for his first set of routine immunisations today. She asks about the new Meningococcus B (MenB) vaccination and wants to know when it is given.

When is the routine MenB vaccine given?

At 2 and 4 months of age
At 2, 3 and 4 months of age
At 2, 3 and 12-13 months of age
At 2, 4 and 12-13 months
At 4 and 12-13 months of age

Answer 23

At 2, 4 and 12-13 months

The Men B vaccine is given at 2, 4 and 12-13 months.
Important for meLess important
The UK is the first country in the world to introduce a MenB vaccine into its routine vaccination schedule.

The MenB vaccine was introduced into the routine UK schedule on 1st September 2015. The vaccine is given at 2 and 4 months, with a booster at 12 months. Therefore, option 4 is the only correct answer. The MenC vaccine used to be given at 3 months but was stopped in 2016.

The MenB vaccine is also recommended for people with some long-term health conditions who are at greater risk of complications from meningococcal disease. This includes people with:

Asplenia or splenic dysfunction
Sickle cell anaemia
Coeliac disease
Complement disorders

The vaccine does not contain any live bacteria and therefore, cannot cause meningococcal disease.

Question 24

Contraindications to vaccination

Answer 24

 Acute febrile illness
 Egg allergy – influenza, yellow fever and tick-borne encephalitis (NB: MMR is usually safe but
can be given in hospital if egg allergic)
 Previous anaphylaxis to vaccine containing or constituent antigens/components
 Immunocompromised depends on cause.
o Short term – delay vaccines. o Care with live vaccines