Session 6 Flashcards
Define herd immunity
The resistance to the spread of a contagious disease within a population that results if a sufficiently high proportion of individuals are immune to the disease, especially through vaccination.
Who is more at risk of disease?
Infants who are too young to receive their vaccine, older adults, patients on immunosuppressive treatments.
How do vaccines work?
Immunity may be active or passive • Active immunity is produced by the host’s immune system, usually
life-long, acquired either by exposure of the illness or vaccination to
it. It involves serum antibodies, cellular response (controlled by T
lymphocytes) or a combination (eg, T cells stimulating B cells to
produce antibodies). Vaccines aim to provide similar immunity to
having had the illness but without the effects and risks of illness. • Vaccines may be inactivated (killed), attenuated live organisms or
modified toxins
Vaccine development – how do we know that they work and are safe?
Measuring effectiveness
• Antibodies (measurement of correlate of protection but does it measure
whether the vaccine works) • Epidemiological assessment
Safety
• Animal trials
• Human trials (prequalification)
• Post marketing surveillance (Urabe Mumps strain caused encephalitis) Efficacy monitoring – are the biologicals in the vaccine correct?
• National Institute of Biological Standards and Control
How is there a return on investment into vaccines?
Saving in healthcare costs, lost wages and productivity due to illness
• Immunisation is one of the most cost-effective ways to save lives,
improve health and ensure long-term prosperity • If you add the benefit of living healthier and longer lives then the
benefit rises to 44 $ • The overall economic benefit of vaccines 2011 – 2020 is 1.5 trillion $
What are the vaccine benefits?
• Prevents illness and reduces burden on healthcare system (Polio
disability for example) • Not being ill means that children’s cognitive skills improve quicker • The physical strength of children develops quicker • School performance is improved
Immunological value •Hib reduced the rate of disease in adults – presumably because children don’t carry •Pneumococcal – reduction of disease in older adults •Meningococcal – similar reduction in carriage of C disease Anti-microbial resistance •Pneumococcal vaccination has led to a significant reduction in antibiotic resistant pneumococcal infections – if given in low and middle income countries it would save 11.4 million days of antibiotic usage!
Savings on medical expenditures, such as hospital treatment, health workers and ambulance costs, frees up health resources to implement immunisation programmes and improve general health care. Increasing parents’ productive time: childhood infectious diseases place stress on families by forcing one of the major wage earners – usually the mother or grandmother – to stay with a sick child in hospital. Household benefits: long-term, families struggle to cope with caring for children left disabled by infectious diseases. In Bangladesh, for example, few schools specialise in the care of disabled children and therefore many mothers of disabled children are unable to work, imposing a considerable strain on family finances.
Who governs vaccines in the UK?
• JCVI – Joint Committee on Vaccination and Immunisation - is an
independent expert advisory committee of the United Kingdom
Department of Health. • The Green Book - has the latest information on vaccines and
vaccination procedures, for vaccine preventable infectious diseases
in the UK.
UK immunisation schedule
Go over
common reasons for common obstacles to achieving good vaccination rates
1
definition of sepsis children
Systemic inflammatory response syndrome -At least 2 of: • Temp. high or low • Heart rate high • Breathing rate high • WCC high or low
Sepsis - SIRS + Suspected / Proven Infection
Severe Sepsis - Sepsis + Organ dysfunction = septic shock • Cardiovascular or • Respiratory or • 2 or more other organs
stage after severe sepsis is death
which components of the blood gas result could indicate the severity of sepsis
3
Be able to explain the difference between the hypovolaemic and septic shock
4
changes in the body as a result of sepsis
5
Understand the challenges in recognition and treatment of sepsis in children
6
SEPSIS 6 Steps in paediatric context
7
