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Child Health > Immunization > Flashcards

Immunization Flashcards

1
Q

What are the contradictions to vaccines?

A

• Confirmed anaphylaxis reaction to previous dose of same antigen or vaccine component
• Live vaccines:
– Immunosuppression (primary, radiotx, high-dose steroids/other drugs, HIV)
– Pregnancy
• Egg allergy (yellow fever, flu)
• Severe latex allergy
• Acute or evolving illness – defer till resolved/ stabilised

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2
Q

What is herd immunity?

A

Protect unvaccinated individuals, through having sufficiently large proportion of population vaccinated
Vaccinated individuals stop transmission of organism
Proportion required to be immune derived mathematically, based on:
Transmissibility and infectiousness of organism
Social mixing btw people in population

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3
Q

Why is herd immunity not useful for tetanus?

A

As the spores for tetanus would be present in the environment

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4
Q

What if the herd immunity is increased for more than 90%?

A

less than 1% of the individuals will be affected

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5
Q

What is the basic reproduction number?

A

everybody is susceptible and ?

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6
Q

What is effective reproduction number?

A

idk findout

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7
Q

What is crucial to identify the number of new cases formed?

A

basic reproduction number

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8
Q

What is the Population immunity for disease eradication is dependent on?

A

Ro

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9
Q

How many diseases are vaccinated for free in kids?

A

15 diseases

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10
Q

What is the purpose of routine vaccination schedule?

A
  • To provide early protection against infections that are most dangerous for the very young – e.g. whooping cough, pneumococcal, Hib, meningococcal
  • To ensure continued protection by providing subsequent immunisations and booster doses before reaching age when risk increases
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11
Q

How is the age at which the vaccine given determined?

A
  • age-specific risk of disease
  • risk of complications
  • ability to respond to the vaccine
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12
Q

How is the optimal age chosen for scheduling the vaccination?

A

compromise between risk of disease and level of protection (e.g. MMR)

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13
Q

What happens if a vaccine course in interrupted?

A

it should be resumed and completed

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14
Q

Why are certain vaccines not given before the age of 1?

A

as it mgith affect the immunoglobins

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15
Q

MMR effective response

A

1 yr/old

3 1/2 yr/old

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16
Q

What is the importance of immunological memory?

A

no need to restart the vaccine

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17
Q

Which vaccines are combined and why?

A

combined to increase the protective effect

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18
Q

16 month vaccine

A 
Hexavalent (DTaP/IPV/Hib/HepB)
Diphtheria
Tetanus
Pertussis
Polio
Haemophilus influenza type b
Hepatitis B
19
Q

What is the importance of public health notification?

A

Legal duty of medical practitioners to notify health board (i.e. Public Health) on clinical suspicion of specified diseases or a ‘health risk state’ posing significant public health risk
notification in writing (including electronic transmission) within 3 days
notification by phone as soon as reasonably practicable if ‘urgent’ (determined by practitioner – based on nature of the disease, ease of transmission, patient’s circumstances, and guidance issued by Scottish Ministers)

20
Q

which Diseases to be notified by registered medical practitioners, based on REASONABLE CLINICAL SUSPICION Should not await laboratory confirmation

A 
Anthrax
*Botulism
Brucellosis
*Cholera
*Clinical syndrome due to E. coli O157 infection
*Diphtheria
*Haemolytic Uraemic Syndrome (HUS)
*Haemophilus influenzae type b (Hib)
*Measles
*Meningococcal disease
Mumps  
*Necrotizing fasciitis
Paratyphoid		
*Pertussis
Plague 
*Poliomyelitis
*Rabies
Rubella
*Severe Acute Respiratory Syndrome
(SARS)
*Smallpox 
Tetanus
Tuberculosis (respiratory or
non-respiratory) (see Note 2)
*Tularemia 
*Typhoid
*Viral haemorrhagic fevers
*West Nile fever
Yellow Fever
21
Q

By when should they be notified?

A

*8 within the same working day

follow/ within 3 days is still required

22
Q

red
green
black

A

notify the same day

23
Q

Which committee is responsible for providing the advice, and looks into the vaccination schedule?

A

Joint Committee on Vaccination and Immunisation – JCVI

24
Q

What are the feautres of diphteria?

A

URTI characterized by sore throat, low grade fever

White adherent membrane on the tonsils, pharynx, and/or nasal cavity

25
Q

what causes diphtheria?

A

Caused by aerobic gram-positive bacterium Corynebacterium diphtheriae

26
Q

Which vaccine covers diphthera?

A

diphtheria is now covered by the 6-in-1 vaccine, also including tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b (Hib)

27
Q

Which organism causes meningococcal disease?

A

Invasive infection due to Neisseria meningitidis

28
Q

What are the symtpons that persist in survivors?

A

10-15% of survivors can have persistent neurological defects including hearing loss, speech disorders, loss of limbs and paralysis.

29
Q

Features of meningococcal disease?

A

Meningococcal vaccines available for serogroups A, C, W, Y135 and now B

Spread by person-to-person contact through respiratory droplets of infected people (close contact)

Incubation period ~3-5 days

Colonisation of nasopharynx common (~10%) important reservoir for disease but not well understood

Two peaks in disease: <5yrs and 15-24yrs

30
Q

How did meningococcal diseas echange in 1990s?

A

Increasing numbers of cases

Rising proportion of group C infection

Age distribution shift to older teens/early twenties

Some evidence of clustering

31
Q

Which vaccine was introduceed to decreases meningococcal disease?

A

men C conjugate vaccine in 1999

32
Q

Is memngicoccal ba present in the body?

A

yupo in the

33
Q

Why is MEn W increasing in 2014-2015?

A

men ACWY

34
Q

How has Men W decreased?

A

compulsory Men ACWY vaccine before coming to uni

35
Q

How are new vaccines investigated?

A

phase I, II, and III

36
Q

Explain the 3 phases of vaccine investigation?

A

Phase I - is it safe (any major issues) ?
- is it immunogenic ?

Phase II - how reactogenic is it ?

     - what dose should be used ?
     - how does it compare with current vaccine(s) ?

Phase III - is it efficacious ?
- are there any rarer reactions / safety issues ?

37
Q

What are the economic cost of the disease?

A

visits to GP

hospitalisations

38
Q

What would economic costs of vaccination be?

A

vaccine costs
adverse events
opportunity costs

39
Q

Acceptibility of vaccines?

A

Decision to use or not is based on considering
balance of benefits and risks
Disease burden before vaccination vs known risk of vaccine
Benefit / risk ratio often hugely in favour of vaccine

40
Q

What is the uptake of immnisation dependent on?

A

perception of relative risks and benefits

41
Q

When is uptake measures?

A

diff times:
1 year
2 year -

42
Q

Benefits of immunization for an individual?

A

Reduce burden of disease
acute infection
death
long term complications

 Maintain underlying health
 heart disease
 asthma
 transplants
 cancer treatments
 diabetes
 eyesight
43
Q

What is the benefit of immunization for a society?

A

Reduce community transmission
-minimise spread of infection

Reduce healthcare utilisation

  • GP consultations
  • Outpatient clinics
  • Hospitalisations
  • Ongoing care

Tackle inequalties

Reduce societal burden:

  • time off work
  • education and learning
  • care settings
  • -quality of life
44
Q

What are th evarious challenegs faced by theimmuzation challenge?

A

reviews and changes (giving HPV for boys)

Flu

transfer the responsibility of vaccination from GPs to other services

tackle vaccine hesitancy

Child Health (13 decks)

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