Immunisations

Question 1

Why should children be immunised?

Answer 1

induction of active immunity

herd immunity => pathogen elimination

Question 2

What are the different types of vaccines?

Answer 2

Live attenuated = antigenic but not pathogenic e.g. MMR

Inactivated = no pathogenic capacity e.g. influenza, diptheria, pertussis, HBV, meningococcus, pneumococcus, haemophilus
(may contain adjuncts e.g. aluminium hydroxide/phosphate)

toxoid = toxin antigens = without the toxic effects e.g. tetanus

Question 3

What vaccinations are given at 2 months?

Answer 3

6 in 1: diphtheria, tetanus, pertussis, polio, Hib, hep b

PCV
rotavirus (oral)
men B

Question 4

What vaccinations are given at 3 months?

Answer 4

6 in 1: diphtheria, tetanus, pertussis, polio, Hib, hep b

rotavirus (oral)

Question 5

What vaccinations are given at 4 months?

Answer 5

6 in 1: diphtheria, tetanus, pertussis, polio, Hib, hep b

PCV
men B

Question 6

What vaccinations are given at 12 months?

Answer 6

Hib 
Men C
MMR
PCV (booster)
MenB (booster)

Question 7

What vaccinations are given at 2 years?

Answer 7

influenza

Question 8

What vaccinations are given at 3 years?

Answer 8

influenza
DTaP/IPV = 4 in 1: diphtheria, tetanus, polio, pertussis
MMR

Question 9

What are the characteristic signs/symptoms of measles and what are the complications?

Answer 9

viral illness
cold-like symptoms
red eyes and sensitivity to light
high temperature (fever)
greyish white spots in the mouth and throat
after a few days, a red brown spotty rash will appear

Complications:

• pneumonia
• encephalitis
• death

Question 10

What are the characteristic signs/symptoms of mumps and what are the complications?

Answer 10

viral self-limiting illness
painful swelling of parotids
headache 
joint pains 
fever 

complications:

• meningitis
• swelling of testicles/ovaries
• encephalitis
• pancreatitis

Question 11

What are the characteristic signs/symptoms of rubella and what are the complications?

Answer 11

viral infection
red pink rash 
swollen glands
fever 
cold symptoms 
aching and painful joints 

pregnancy complications 
congenital rubella syndrome 
cataracts 
deafness
heart abnormalities
brain damage

Question 12

What are the characteristic signs/symptoms of diphtheria and what are the complications?

Answer 12

bacterial infection 
fever 
sore throat
inflammation of the lungs 
grey white membrane in throat 

complications:

• myocarditis
• nervous system effects - peripheral neuropathy
• paralysis of the diaphragm
• neurogenic bladder
• severe bleeding problems
• kidney failure
• respiratory failure

Question 13

What are the signs/symptoms of tetanus?

Answer 13

bacterial infection causing prolonged contraction of skeletal muscle fibres
flesh wound contaminated
muscle stiffness and spasm of the jaw
dysphagia

Question 14

What are the signs/symptoms of whooping cough?

Answer 14

bacterial - lungs and airways (highly contagious) 
- cough 
- runny nose 
- fever 
- vomiting 
vaccinate pregnant women 28-38 weeks

Question 15

What are the characteristic signs/symptoms of polio and what are the complications?

Answer 15

virus 
fever 
headache
vomiting and diarrhoea
neck stiffness
pains in the limbs 

complications:

• muscle weakness
• legs, head, neck, diaphragm
• post polio syndrome

Question 16

What are the complications of haemophilus influenzae b infection?

Answer 16

bacterial infection

• meningitis
• septicaemia
• pneumonia
• pericarditis
• epiglottis
• septic arthritis
• cellulitis
• osteomyelitis

Question 17

What are the characteristic signs/symptoms of pneumococcal disease and what are the complications?

Answer 17

bacterial infection 
- fever
- aches and pains
- headache 
complications:
- bronchitis
- otitis media
- sinusitis
- bacteraemia
- septicaemia
- osteomyelitis
- septic arthritis
- pneumonia
- meningitis
- under 2 years/>65 / weakened immune system

Question 18

What does rotavirus cause and what are the complications?

Answer 18

gastroenteritis

complication= dehydration

Question 19

What are the risks associated with meningococcal C infection?

Answer 19

bacterial infection

• meningitis
• septicaemia

Question 20

What are the signs/symptoms of hep b infection?

Answer 20

tiredness
myalgia
pyrexia 38 or above 
general sense of feeling unwell
loss of appetite
nausea
diarrhoea
abdominal pain 
jaundice 
dark urine and pale faeces

Question 21

What are the additional vaccines that can be given?

Answer 21

influenza vaccine - given annually until 9 yrs
DTaP, MenACWY = 13-18 yrs
HPV - 2 doses =12-13 yrs girls and boys aged 12-13 eligible 2019/20 yr
BCG - high incidence area or 1st/2nd degree relative from high incidence country
chicken pox - children who are susceptible and in contact of immunocompromised (should be given same day as MMR, otherwise you have to wait 4 weeks

Question 22

What are the normal side effects of vaccinations?

Answer 22

pain, erythema, local oedema, mild fever = all common and normal

before having men B = advised to have 2 doses of paracetamol due to high incidence of fever

Question 23

What are the rare complications of immunisations?

Answer 23

anaphylaxis

egg allergy

Question 24

When should you delay vaccinations?

Answer 24

pyrexia
worsening neuro (e.g. epilepsy)
febrile convulsions <72 hours ago

Question 25

What systemic adverse reactions are common?

Answer 25

fever, malaise, myalgia, irritability, headache and loss of appetite
timing of the reaction can vary depending on the vaccination
e.g. tetanus - fever a few hours later where measles it can occur 7-10 days later