immunisations

Question 1

primary vs secondary prevention of communicable disease

Answer 1

primary = pre-exposure, routine, travel, occupational vaccines

secondary = alter course of infection/disease to prevent or limit consequences - immunoglobulin - hep B, rabies, varicella zoster

Question 2

active immunity

Answer 2

immune response to bacterial/viral antigens via production of antibodies

antibody-antigen immune complex alerts other immune cells (B+T cells)

Question 3

how are antibodies produced?

Answer 3

B cells - triggered to produce antibodies when encounter foreign antigen
(humoral immune system)

(T cells = cell mediated, CD4, CD8, irchestrate response by binding to other cells + sending out signals)

Question 4

what is passive immunity?

Answer 4

transfer of pre-formed antibodies (immunoglobulins)

or anti-toxins - diptheria

Question 5

methods of passive immunity?

Answer 5

mother to unborn babt - via placenta, lasts up to a year, only some

from another person or animal - antibodies from blood donors

Question 6

advantages of passive immunity

Answer 6

rapid action
post-exposure
can attenuate illness
outbreak control
can be used if contraindication to active vaccination

Question 7

disadvantages of passive immunity

Answer 7

short term protection
short time window
blood derived
hypersensitivity reaction 
expensive

Question 8

active vs passive immunity

Answer 8

active

• natural infection
• artificial immunisation

passive

• natural transplacental transfer
• artificial human IgG

Question 9

types of vaccines

Answer 9

live virus vaccines

inactivated vaccines - killed organisms, subunit, conjugate

Question 10

live virus vaccine examples

Answer 10

attenuated organism, replicates in host

OPV, measles, mumps, rubella, varicella, rotavirus, flu

Question 11

types of inactivated vaccines

Answer 11

suspension of killed organisms - pertussis, typhoid

subunit vaccines - toxoids or polysaccahrides

conjugate vaccines

Question 12

conjugate vaccines

Answer 12

inactivated vaccines where polysaccharide attached to immunogenic protein

–> Hib, MenC

Question 13

which vaccines should be avoided in egg allergies

Answer 13

yellow fever

flu

Question 14

contraindications to vaccines

Answer 14

confirmed anaphylaxis to previous dose or vaccine component
live vaccines if immunoupressed, steroids, pregnancy
egg allergy
sever latex allergy

acute or evolving illness - defer till resolved/stable

Question 15

selective childhood vaccination for children in at-risk groups

Answer 15

flue (annual) - 2yrs +
pneummoccal polysaccharide vaccine - 2yrs +
BCG - from birth - 16

hep B all ages

Question 16

adult vaccination programmes

Answer 16

pneumooccal polysacharride vaccine - 65yrs
shingles - 70yrs
seasonal flu - adults aged 65+, pregnant women, at risk groups

various selective - hep B, travel, occupational

Question 17

how to notify public health

Answer 17

phone as soon as reasonably practicable

notification in writing within 3 days

Question 18

examples of live attenuated vaccines

Answer 18

BCG
MMR
yellow fever

Question 19

examples of inactivated vaccines

Answer 19

rabies
hep A
influenza (intramuscular)

Question 20

examples of toxoid vaccines

Answer 20

(inactivated toxin)

tetanus
diptheria
pertussis

Question 21

whats the difference between subunit + conjugate vaccines?

Answer 21

subunit = only part of the pathogen is used to generate an immunogenic response

conjugate = links the poorly immunogeic bacterial polysaccharide outer coats to proteins to make them more immunogenic