NHS vaccination schedule

Question 1

what is the most vulnerable time of life

Answer 1

1-28 days

Question 2

explain the Childs immune system in the first 2 months

Answer 2

1. antibody synthesis begins in foetus at 20 weeks
2. infants reliant on maternal Abs for first 2 months
   - can’t vaccinate before then
3. extra Ab production induced by oestrogen
4. IgGs cross placenta in last 10 weeks of pregnancy
5. breast milk transfers IgA
   - protects against lung and GI infections

Question 3

describe the Childs immune system in the first 12 months

Answer 3

1. adaptive immune system immature
2. many T cells but these are all naive- don’t respond well to antigen
3. risk with attenuated vaccines- can be virulent
   - so use toxoids, glycoconjugates, recombinant proteins and safe adjuvants
4. but weakly immunogenic, so needs booster immunisations

Question 4

what is transient hypogammaglobulineamia of infancy

Answer 4

delay in maturation of IgG synthesis when maternal Abs are falling

Question 5

outline the vaccines given at 8 weeks

Answer 5

1. DTaP/IPV/Hib/HepB- infanrix hexa
2. Men B
3. rotavirus

Question 6

outline the vaccines given at 12 weeks

Answer 6

1. DTaP/IPV/Hib/HepB- infanrix hexa- 2nd immunisation
2. Rotavirus- 2nd immunisation
3. PCV

Question 7

outline the vaccines given at 16 weeks

Answer 7

1. DTaP/IPV/Hib/HepB- infanrix hexa- 3rd immunisation
2. men B- 2nd immunisation

Question 8

describe the Childs immune system at 1 year

Answer 8

1. maturation of immune system
   - can cope with attenuated vaccines
   - T cells functional

Question 9

outline the vaccines given at 12 months

Answer 9

1. Hib/Men C
2. PCV- 3rd immynisation
3. Men B- 3rd immunisation
4. MMR (priorix)

Question 10

outline the vaccines given between 2-19 years

Answer 10

1. live attenuated influenza
2. MMR
3. DTaP/IPV (boostrix) 4 in 1
4. HPV
5. Td/IPV
6. men cwy

Question 11

what does Infanrix hexa protect against

Answer 11

4 bacterial infections
- diphtheria, tetanus, whooping cough (Bordetella pertussis), haemophilus influenzae type B (pneumonia and meningitis)
2 viral infections
- polio, hepatitis b

Question 12

what does Boostrix IPV 4 in 1 contain

Answer 12

1. diphtheria toxoid, tetanus toxoid, bordetella pertussis, poliovirus

Question 13

outline the vaccines given in the elderly

Answer 13

1. adjuvanted trivalent influenza vaccine
2. pneumococcal polysaccharide vaccine
3. varicella zoster vaccine

Question 14

describe the elderly immune system

Answer 14

1. T cells stop living after about 40 divisions
2. enhanced risk of respiratory infections
3. shingles due to latent chickenpox virus (varicella zoster)
   - sign of secondary immunodeficiency due to malignant B cells
4. B cell clones can outgrow and become malignant

Question 15

who is eligible for the shingles vaccine

Answer 15

1. zostavax is licensed for those aged over 50
2. offered free for anyone aged 70, 78 or 79

Question 16

outline the vaccines given to travellers

Answer 16

1. polio
2. yellow fever
3. hep A, B, E
4. tick borne encephalitis
5. rabies
6. cholera
7. tb
8. tetanus
9. typhoid
10. meningococcal meningitis