Immunity

Question 1

What is herd immunity?

Answer 1

2Vaccinated individuals are also less likely to be a source of infection to others. This reduces the risk of unvaccinated individuals being exposed to infection. This means that individuals who cannot be vaccinated will still benefit from the routine vaccination programme. This concept is called population (or ‘herd’) immunity.

Question 2

What is the primary aim of vaccination?

Answer 2

To protect the individual who receives the vaccine.

Question 3

What are the advantages of vaccinations?

Answer 3

1) Vaccinations are quick, safe and extremely effective
2) Once a child has been vaccinated against a disease, their body can fight it off better
3) If a child isn’t vaccinated, they’re at higher risk of catching – and becoming very ill from – the illness (which might even be life-threatening)
4) The greater number of children vaccinated, the more children in the community will be protected against an illness.

Question 4

Reasons parents may not arrange vaccination

Answer 4

1) Fear about ‘damage’ from the vaccination or allergies.
2) Indicated safeguarding concern if parents are persistently failing to engage with their baby’s health promotion programmes.
3) Not feeling that their child is at risk.
4) Not knowing about the vaccination or not being invited- particularly if English is not understood.
5) Concern that vaccinations can ‘overload’ or weaken the baby’s immune system.
6) Not liking to see their child in pain from an injection

Question 5

What is safety-netting?

Answer 5

Explain uncertainty to the patient. If the diagnosis is uncertain, this should be communicated to the patient so that they are aware to re-consult if necessary.

Question 6

How do you safety-net?

Answer 6

• Highlight things to look out for. If there is a recognised risk of deterioration or complications developing, then the safety-net advice should include the specific clinical features that the patient should look out for. Patient information leaflets can be valuable in supporting this. It can be beneficial to gain an understanding of what the patient’s thoughts and concerns are around their symptoms, in order to avoid a potential mismatch of doctor and patient agenda.
• Signpost further help. Give the patient specific guidance on how and where to seek further help if required. This may be as simple as booking a return appointment.
• Map out a timeline. Where the likely time course of illness is anticipated, safety-net advice should include this information. However, it should be made clear that if a patient has concerns, they should not delay seeking further medical advice. Providing a realistic time frame may prevent unnecessary consulting for similar future symptoms, thus empowering and educating patients.
• Check the patient has understood. Ask the patient to repeat what you have agreed, so that you are able to check their understanding.
• Keep accurate and detailed records. The safety-netting advice given should be documented within the patient’s consultation notes.

Question 7

What is the red book?

Answer 7

The Personal Child Health Record (PCHR), also known as ‘The Red Book’ is given out to all parents at the time of the baby’s birth, and is a record of health and development. It is another example of population health policy in the community.
It contains information about growth, including growth charts, and vaccinations. The parent keeps the record; it is not kept at the hospital or GP Surgery. An electronic version is currently being trialled.