Immunisations

Question 1

Go through the immunisation schedule (sorry!!!)

Answer 1

Birth - HepB

2 months - HepB, DTPa, Hib, IPV (inactivated polio), Pneumococcal conjugate, Rotavirus

4 months - HepB, DTPa, Hib, IPV (inactivated polio), Pneumococcal conjugate, Rotavirus

6 months - HepB, DTPa, Hib, IPV (inactivated polio), Pneumococcal conjugate, Rotavirus

12 months - Hib, MMR, Meningococcal C

18 months - VZV

4 years - DTPa, IPV, MMR

10-13 years - HepB, VZV
12-13 years - HPV
10-17 years - DTPa

Question 2

Name 3 diseases that vaccination has been very successful in reducing the global incidence of

Answer 2

Smallpox, polio, measles, Hib

Question 3

How is diptheria spread? What effects does it cause?

Answer 3

Spread by droplets. Forms a pseudomembrane over palate that can obstruct airway. Mediated by a toxin that also can cause cardiac arrhythmias

Question 4

Name 2 complications of pertussis. How do you treat it?

Answer 4

Hypoxia and encephalopathy. Treat with macrolide (clarithromycin) - only reduces symptoms in first few days but reduces infectivity

Question 5

Name 3 diseases Hib can cause. How to treat?

Answer 5

Periorbital cellulitis, epiglottitis, meningitis. Mx - 3rd gen ceph

Question 6

What does tetanus cause?

Answer 6

Generalised muscle contraction

Question 7

What agent causes mumps? How is it spread? Name 2 symptoms

Answer 7

Paramyxovirus. Spread by droplets. Causes neck swelling, lymphadenopathy, orchitis (in males)

Question 8

What agent causes polio? How is it spread? What does it cause?

Answer 8

An enterovirus, spread feco-orally. Infects anterior horn cells, causing paralysis

Question 9

Name 3 common and 3 uncommon side effects of vaccines (autism ain’t one)

Answer 9

Common - local inflammation, mild fever/upset/muscle aches, small lump at site, fainting
Uncommon - convulsion or limp baby (vasovagal reaction), anaphylaxis, intussusception (specific to rotavirus vaccine)

Question 10

What 3 vaccines are live vaccines? Give a SE of each vaccine

Answer 10

MMR - fever and rash
Varicella - vesicles at injection site
Rotavirus - diarrhoea

Question 11

Name 3 absolute C/I to live vaccines

Answer 11

Immunosuppression
Pregnancy
Previous live vaccine or Ig

Question 12

Is it OK to give a live vaccine to the contacts of an immunosuppressed child? Why/why not?

Answer 12

Yes - very low chance of transmission of a live vaccine

Question 13

Name 2 absolute and 2 relative C/I to vaccines

Answer 13

Absolute - unexplained encephalopathy (post-pertussis vaccine), anaphylaxis
Relative - evolving neurological illness, fever > 38.5