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
what causes diphtheria?
Caused by aerobic gram-positive bacterium Corynebacterium diphtheriae
26
Which vaccine covers diphthera?
diphtheria is now covered by the 6-in-1 vaccine, also including tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b (Hib)
27
Which organism causes meningococcal disease?
Invasive infection due to Neisseria meningitidis
28
What are the symtpons that persist in survivors?
10-15% of survivors can have persistent neurological defects including hearing loss, speech disorders, loss of limbs and paralysis.
29
Features of meningococcal disease?
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
How did meningococcal diseas echange in 1990s?
Increasing numbers of cases Rising proportion of group C infection Age distribution shift to older teens/early twenties Some evidence of clustering
31
Which vaccine was introduceed to decreases meningococcal disease?
men C conjugate vaccine in 1999
32
Is memngicoccal ba present in the body?
yupo in the
33
Why is MEn W increasing in 2014-2015?
men ACWY
34
How has Men W decreased?
compulsory Men ACWY vaccine before coming to uni
35
How are new vaccines investigated?
phase I, II, and III
36
Explain the 3 phases of vaccine investigation?
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
What are the economic cost of the disease?
visits to GP | hospitalisations
38
What would economic costs of vaccination be?
vaccine costs adverse events opportunity costs
39
Acceptibility of vaccines?
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
What is the uptake of immnisation dependent on?
perception of relative risks and benefits
41
When is uptake measures?
diff times: 1 year 2 year -
42
Benefits of immunization for an individual?
Reduce burden of disease acute infection death long term complications ``` Maintain underlying health heart disease asthma transplants cancer treatments diabetes eyesight ```
43
What is the benefit of immunization for a society?
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
What are th evarious challenegs faced by theimmuzation challenge?
reviews and changes (giving HPV for boys) Flu transfer the responsibility of vaccination from GPs to other services tackle vaccine hesitancy