Principls of Immunisation Flashcards

1
Q

what are the 3 aims of immunisation?

A

prevent onset of disease (primary prevention)
interrupt transmission
Alter course of infection/disease to prevent or limit consequences (secondary prevention)

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2
Q

which type of disease does immunisation control?

A

communicable diseases

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3
Q

what do vaccines do?

A

teach the immune system to recognise bacteria and viruses before the individual encounters them as potential pathogens so allowing the body to fight against the pathogen

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4
Q

name 3 immunological mechanisms

A

active immunity
passive immunity
herd immunity

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5
Q

what are antigens usually made of?

A

proteins or polysaccharides (sugars)

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6
Q

what are antibodies made of?

A

proteins

very specific to individual antigens

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7
Q

how are B cells produced?

A

humoral immune system

  • mature in the bone marrow
  • triggered to produce antibody when they encounter foreign antigen
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8
Q

how are T cells produced?

A

cell-mediated immune system

  • mature in Thymus
  • CD4 and CD8 cells
  • orchestrate response of immune system by binding to other cells and sending out signals
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9
Q

what is passive immunity?

A

transfer of pre-formed antibodies (immunoglobulins)

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10
Q

through what 2 methods can passive immunity be acquired?

A
mother to unborn baby via placenta
- lasts up to 1 year
- doesn't protect against all antigens
from another person or animal
- antibodies from blood donors
- human normal Ig
- specific Ig
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11
Q

what 2 components of the immune system are present in passive immunity and what do they protect against>

A

human immunoglobulin
- hep B, rabies, varicella zoster etc
anti-toxin
- diphtheria, botulinum etc

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12
Q

what are the advantages of passive immunity?

A
rapid action
post-exposure
can attenuate illness
outbreak control
can be used if live vaccine is contraindicated
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13
Q

what are the disadvantages of passive immunity?

A
short term protection
short time window
blood derived
hypersensitivity reactions
expensive
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14
Q

natural vs artificial passive immunity?

A
natural = transplacental transfer
artificial = human IgG
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15
Q

natural vs artificial active immunity?

A
natural = natural infection
artificial = artificial immunisation
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16
Q

mechanism of vaccines?

A

induce cell mediated immunity responses and serum antibodies

different vaccines induce different speed and sustainability of response

17
Q

what are live vaccines?

A

attenuated organism, replicates in host

  • OPV
  • MMR
  • varicella
  • rotavirus
  • flu
18
Q

what are inactivated vaccines?

A

suspensions of killed organism
- pertussis (whooping cough)
- typhoid
OR
subunit vaccines
- toxoids (e.g diphtheria, tetanus, pertussis)
- polysaccharides (e.g pneumococcal, typhoid)
OR
conjugate vaccines
- polysaccharide attached to immunogenic proteins
- Hib, MenC

19
Q

what are 5 contraindications to vaccines?

A

confirmed anaphylaxis to previous dose of same vaccine
immunosuppression or pregnancy (if live vaccine)
egg allergy
severe latex allergy
acute or evolving illness (wait until resolved)

20
Q

what is herd immunity?

A

unvaccinated individuals are protected through having sufficiently large population of population vaccinated

21
Q

what is the proportion of the population required to be immune based on?

A

transmissibility and infectiousness of organism

social mixing in population

22
Q

give 3 examples of herd immunity?

A

measles = 90%
umps = 75-86%
smallpox = 80-85%
requires that there is no reservoir of infection

23
Q

what is the Scottish immunisation programme?

A

programme of vaccination

24
Q

what is the purpose of the vaccine schedule in the UK?

A

to provide early protection against infections that are most dangerous for the very young (whooping cough, meningococcal, pneumococcal)
to ensure continued protection by providing subsequent immunisations and booster doses before reaching age when risk increases

25
how is the age at which vaccine is offered based on?
risk of disease level of protection risk of complications
26
are vaccines still given, even if older than recommended age?
yes
27
if a course of immunisation is interrupted, does it need to be restarted?
no | can usually be resumed and completed due to immunological memory
28
name 11 routine childhood vaccines
``` hexavalent meningococcal group B rotavirus pneumococcal Hib/meningococcal group C MMR influenza diphtheria, tetanus, pertussis and polio tetanus, diphtheria and polio booster meningococcal groups A, C, W and Y HPV ```
29
what selective childhood vaccines are given for at risk children?
flu pneumococcal polysaccharide vaccine BCG Hep B
30
name 4 adult programmes of vaccination
pneumococcal polysaccharide vaccine shingles (70 y/o) seasonal flu various selective programmes
31
when and how must public health be notified of a disease?
clinical suspicion of specific disease or health risk state - notification in writing within 3 days - notification by phone ASAP if urgent
32
what characterises diphtheria?
URTI sore throat low grade fever white adherent membrane on tonsils, pharynx and/or nasal cavity
33
what causes diphtheria?
aerobic gram-positive bacterium | corynebacterium diptheriae
34
what causes meningococcal disease?
invasive infection due to Neisseria meningitidis
35
how serious is meningococcal disease?
10-20% mortality in children
36
which types of meningococcal disease can be vaccinated against>
groups: - A - C - W - Y135 - B
37
how does meningococcal disease spread?
person-person contact through respiratory droplets incubation = 3-5 days colonisation of nasopharynx
38
what are the 3 phases of vaccine trials?
phase 1 = is it safe, is it immunogenic phase 2 = how reactogenic is it, what dose, how does it compare with current vaccines phase 3 = is it efficacious, are there any rarer reactions/safety issues?