Immunisations Flashcards
what vaccinations do we give at birth?
hepatitis b as soon after birth as possible
what vaccinations do we give at 2 months?
- hepb-dtpa-hib-IPV (hep b, pertussis, diptheria, tetanus, haemophillis b, inactivated polio)
- P13V (pneumoccal vaccine 13 valent)
- rotavirus
what vaccinations do we give at 4 months?
- hepb-dtpa-hib-IPV (hep b, pertussis, diptheria, tetanus, haemophillis b, inactivated polio)
- P13V (pneumoccal vaccine 13 valent)
- rotavirus
same as 2 months
what vaccinations do we give at 6 months?
- hepb-dtpa-hib-IPV (hep b, pertussis, diptheria, tetanus, haemophillis b, inactivated polio)
- P13V (pneumoccal vaccine 13 valent)
- rotavirus (depends on state)
same as 2 months
what vaccinations do we give at 12 months/1 yr?
- meningococcal C+ HIB
2. MMR (measles, mumps, rubella
what vaccinations do we give at 18 months?
- dtpa
2. MMRV
what vaccinations do we give at 4 years?
- dtpa + IPV (inactivated polio vaccination)
what are the vaccinations given at school?
- VZV (varicella)
- HPV (gardasil)
- DTPA
what are some vaccinations that we need to consider in Aboriginal and Torres Strait Islander patients?
- influenza annually
- hep a vaccine- 2 doses (in high risk areas for babies)
- pneumococcal vaccine 23 valent for adolescents to adults
what type of vaccine is diptheria and tetanus?
toxioid vaccine
what type of vaccine are Hib/menC/pneumoccocal vaccines?
polysaccharide protein conjugate vaccines
what type of vaccine is MMR and VZV
attenuated live viruses
what temperatures do we need to store vaccines?
2-8 degrees
name some adverse effects of immunisation?
fainting/loc
anaphylaxis
febrile convulsions
intussusception
which paeds groups do we recommend an annual influenza vaccination?
- children receiving immunosuppressive therapy
- children with chronic heart conditions
- children with chronic suppurative lung diseases
- children with other chronic illnesses e.g. CKD, diabetes etc
what are some common SE of immunisation?
transient like illness- fever, rash, muscle aches, headache
localised reaction- lump/swelling/pain
what are some contraindications to vaccination?
- immunodeficiency- contraindication to live attenuated virus vaccines
- previous anaphylactic shock to immunisation
- current evolving neurological disease
- relative contraindication- don’t immunise a febrile acutely unwell child; wait until the fever passes first
can a patient with an egg allergy safely receive immunisations?
generally yes unless they are anaphylactic to egg.
mild reactions like rash is fine.
If anaphylactic, may require vaccination with an immunology doctor or allergy specialist.
egg containing vaccines- influenza/yellow fever/Q fever
how many doses are there of the HPV vaccine, and at what time points should they be administered?
3 doses
0 months, 2nd month, 6th month
who should be given VZIG?
High-risk susceptible contacts where vaccination is not indicated, such as neonates, pregnancy and immunosuppressed persons, should be offered VZIG within 72 hours of exposure. If vaccination is not contraindicated, it should follow at least 5 months later.
how might we manage an unimmunised pregnant woman who has been exposed to varicella?
Susceptible pregnant women who have been exposed during pregnancy should seek specialist obstetric advice. Susceptibility can be assessed by serological testing for varicella immunoglobin G (IgG). The woman may be offered VZIG and antivirals (famciclovir, valaciclovir or aciclovir), especially where delivery is imminent.
Where chickenpox develops in pregnancy, specialist medical review within 24 hours of rash onset is indicated to consider treatment options.
which virus has been successfully eradicated globally by immunisation?
small pox
why do we get an increasing incidence of pertussis even though we have a vaccine for it?
pertussis
the immunogenicity of the vaccine isn’t strong–> immunity wanes overtime
why do we see a fluctuating course of cases of measles in australia despite robust immunisation schedule
people travel and may bring measles back with them
how is polio spread?
faecal oral route
spreads to the anterior horn cells
what might a white reflex (not red reflex) indicate in a newborn
congenital rubella (rubella acquired in-utero)
what are some complications of congenital rubella
intellectual disability congenital cataracts deafness heart defects small stature/ stunted growth
what type of meningococcal vaccine are available in Aus?
Men-C is the most available
Men-B also available but super expensive
how might we manage meningococcal infection?
ceftriaxone or benzylpenicillin
contact tracing
why can’t we give the travel vaccination of meningococcocal to a young infant?
because they are not polysaccharide conjugate vaccines
infants cannot get immunity from capsulated organisms like HIB and N.meningitidis
which vaccination doesn’t work from a herd immunity perspective?
tetanus
because you don’t get it from other people
what percentage of the population need to be vaccinated to achieve herd immunity
> 90%
Describe what hypotonic hyporesponsive episode refers to?
generally seen in babies post receiving a vaccine, sort of like a vasovagal reaction
baby becomes floppy/unresponsive/may have convulsion
it is self limiting but baby may need to be monitored overnight
what is a particular rare reaction for rotavirus vaccine?
intussusception
a young patient comes in with a lump on their arm, post vaccination. what is it and what do you need to exclude?
- a lump can be a normal vaccination response
2. exclude abscess
what are the live vaccines on the vaccination schedule?
MMR and VZV
Sally is 12 months and due for immunisation. Her brother Tom (4yrs) was recently diagnosed with ALL and receiving chemotherapy?
Don’t give live vaccines to Tom but you should also withhold vaccinations as his immune system won’t mount a response to it.
Give Sally the live vaccines MMR/HIB/MenC. Household contacts of a patient with immunosuppression should get their live vaccines.
Wait for at least 6 months post chemo to vaccinate Tom
