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Year 3 - Public Health > Vaccination: The Principles > Flashcards

Vaccination: The Principles Flashcards

1
Q

why do we use vaccines

A
  • can prevent the spread of infectious disease
  • creates herd immunity to reduce the spread of infectious disease
  • protects people who cann be vaccinated such as young babies and those who have compromised immune systems
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2
Q

How do vaccines work

A

Vaccines safely deliver an immunogen which is a specific type of antigen that elicits an immune response, to train the immune system to recognize the pathogen when it is encountered naturally.

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3
Q

How can vaccines be delivered

A
  • infection into the muscle
  • infection under the skin
  • oral route
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4
Q

Why do vaccines require more than one dose

A
  • build a complete immunity
  • give a booster dose when the immunity wears off
  • immunize people against viruses causing disease that may be differnet from season to season for example the yearly flu vaccine
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5
Q

What are vaccine preventable diseases

A
  • Infectious disease for which an effective preventivie vaccine exists
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6
Q

What is a vaccine preventable death

A
  • this happens if a person acquires a vaccine-preventable disease and dies from it, the death is considered a vaccine-preventable death
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7
Q

Name the most common and preventable serious vaccine preventable diseases

A
  • Diphtheria
  • haemophilus influenzae serotype B infection
  • hepatitis B
  • measles
  • meningitis
  • mumps
  • pertussis
  • poliomyelitis
  • rubella
  • tetanus
  • tuberculosis
  • yellow fever
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8
Q

How do vaccines work

A

Herd immunity

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9
Q

describe how herd immunity works

A
  • Vaccinations protects unvaccinated people as well as vaccinated because with fewer infected people in the populaiton there will be les sopportunity for susceptible people to be infected
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10
Q

What is the obejctive of vaccination

A
  • eradicate the infection throughout by herd immunity
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11
Q

What is the reproductive number

A
  • The number of secondary cases infected by one index case in a susceptible population on average
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12
Q

What does the R number increase with

A
  • population density, longer infectivity, respriatory spread
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13
Q

To reach herd immunity how much of the population has to be vaccianted

A

75%-90% of the population

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14
Q

Name the types of vaccines

A
  • Attenuated live virus
  • whole inactivated virus
  • protein subunit
  • recombinant
  • peptides
  • replicating or non replicating viral vectors
  • nucleic acid
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15
Q

What are the advatnages and disadvantages of attenuated live virus

A

Advantage
- induces the same response as natural infection

Disadvantge
- not recommended for pregnant women and immunocompromised persons

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16
Q

Name some examples of attenuated live virus vaccines

A
  • measles
  • rubella
  • mumps
  • yellow fever
  • smallpox
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17
Q

What are the advantages and disadvantages of whole inactivated virus

A

Advantages
- induces strong antibody response

Disadvantages
- requires large quantities of virus

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18
Q

Name some examples of whole inactivated virus vaccines

A
  • influenza
  • rabies
  • hepatitis A
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19
Q

What are the advantages and disadvantages of protein subunit vaccines

A

Advantages
- may have fewer side effects than whole virus (redness, swelling at injection site)

Disadvantages

  • May be poorly immunogenic
  • complex process
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20
Q

Name some examples of protein subunit vaccines

A
  • Influenza
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21
Q

What are the advantages and disadvantages of recombinant vaccines

A

Advantage
- no need to produce the whole virus

Disadvantage

  • may be poorly immunogenic
  • high cost
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22
Q

What are the examples of recombinant vaccines

A
  • Hepatitis B
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23
Q

What are the advantages and disadvantages of peptides

A

Advantages
- rapid development

Disadvantage

  • poorly immunogenic
  • high cost
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24
Q

what are the examples of peptides

A
  • COVID-19 vaccines in development
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25
Q

What are the advantages and disadvantages of replicating or non replicating viral vectors

A

Advantages
- rapid development

Disadvantage

  • prior exposure to vector virus
  • may reduce immunogenicity
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26
Q

What are the exampels of replicating or non replicating viral vectors

A
  • Ebola
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27
Q

What are the advantages and disadvantages of nucelic acid

A

Advantages

  • strong cell immunity
  • rapid development

Disadvantages
- relatively low antibody response

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28
Q

What are the examples of nucleic acid

A
  • covid-19 vaccines in development
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29
Q

How are viruses given as a vaccine

A
  • selective, modified, or completely inactivated so it will not cause disease
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30
Q

How are protein based vaccines given

A

= A protein is extracted from the virus ( alive or inactivated) they are then purified and injected as a vaccine

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31
Q

How do viral vector vaccines work

A
  • The gene for a pathogen protein is inserted into a different virus that can infect someone without causing disease
  • The safe virus serves as a ‘platform’ or ‘vector’ to deliver the protein that triggers an immune response
  • The safe virus is then injected as a vaccine
  • Somereplicate (reproduce) in the body and some do not
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32
Q

How do nucleic acid vaccines work

A
  • Instead of a virus, a protein antigen, or a virus expressing the protein, nucleic acid coding for the antigen is injected
  • DNA plasmid:enters nucleus, translated to mRNA for expression of protein
  • Or mRNA can be injected.More direct (no translation required) but less stable than DNA
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33
Q

What book has the latest information on vaccines and vaccination procedures for all the vaccine preventable infectious diseases that may occur in the UK

A

The green book

34
Q

Describe the UK immunisaiton programme

A

8 weeks

  • Diptheria, tetanus, pertusis, polio, Hib and hepatitis B
  • pneumococccal conjugate vaccine
  • meningococcal B
  • rotavirus

12 weeks

  • Diptheria, tetanus, pertusis, polio, Hib and hepatitis B
  • rotavirus

16 weeks

  • Diptheria, tetanus, pertusis, polio, Hib and hepatitis B
  • pneumococccal conjugate vaccine
  • meningococcal B

One year old

  • Hib/MenC booster
  • pneumococcal conjugate vaccine booster
  • meningococcal B booster
  • MMR

three years four months - Diptheria, tetanus, pertusis, polio
- MMR

12-13 years old
- HPV

14 years old

  • tetanus, diphtheria adn polio
  • Meningococcal ACWY

65 years old
- pneumococcal poolysaccharide vaccine

65 years of age and older
- inactivated influenza vaccine

70 years old
- shingles

35
Q

What is diphtheria caused by

A

• Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae.

36
Q

What happens in diphtheria

A

Diphtheria causes a thick covering in the back of the throat. It can lead to difficulty breathing, heart failure, paralysis, and even death

37
Q

What causes tetanus

A

Tetanus is a serious illness caused by Clostridium bacteria

- bacteria can enter the body through a deep cut

38
Q

Where does the tetanus bacteria live

A

soil, saliva, dust, and manure.

39
Q

What can tetanus cause to happen

A
  • infection can cause painful tightening of the muscles
40
Q

What is the vaccine used for in tetanus

A

Toxoid adsorbed onto an adjuvant

41
Q

what can cause pertussis

A
  • is a highly contagious respiratory disease.

* It is caused by the bacterium Bordetella pertussis.

42
Q

What happens in pertussis

A

• Pertussis is known for uncontrollable, violent coughing often makes it hard to breathe

43
Q

What causes meningitis

A

The bacterium Neisseria meningitidis, also
called meningococcus,
causes meningococcal meningitis.

44
Q

What does haemophilus influenza type B cause

A
  • responsible for severe pneumonia, meningitis and other invasive diseases
45
Q

How is haemophilus influenza type B transmitted

A

• Transmitted through the respiratory tract from infected to susceptible individuals

46
Q

What type of vaccine is haemophilus influenza type B

A

Hib vaccine as a polysaccharide conjugate vaccine, which is a type of inactivated bacterial vaccine.

47
Q

what is penumococic

A

• Pneumococci are a type of streptococcus bacteria. (Streptococcus Pneumonieae)

48
Q

How does pneumocci spread

A

• Spread through contact with people who are ill or by healthy people who carry the bacteria in the back of their nose.

49
Q

What are the vaccines for pneumoccocus

A
  • Pneumococcal conjugate vaccine or PCV13

* Pneumococcal polysaccharide vaccine or PPSV23

50
Q

What is the most common cause of diarrhoea

A
  • Rotavirus - this is the most common cause of severe diarrhoeal disease in young children throughout the world
51
Q

What are the four differnet type of vaccines for rotavirus

A

Four oral, live, attenuated rotavirus vaccines available internationally:
• RotarixTM (derived from a single common strain of human rotavirus);
• RotaTeqTM (a reassorted bovine- human rotavirus);
• RotavacTM (naturally occurring bovine-human reassortant neonatal G9P, also called 116E);
• RotaSiilTM (bovine-human reassortant with human G1, G2, G3 and G4 bovine UK G6P[5] backbone)

52
Q

What organ does hepatitis B attack

A
  • Hepatitis B is a viral infection that attacks the liver

* Can cause both acute and chronic disease

53
Q

How is hepatitis B transmitted

A
  • from mother to child during birth and delivery,

* through contact with blood or other body fluids

54
Q

What does MMR protect against

A
  • Measles
  • mumps
  • rubella
55
Q

When do you have the MMR vaccine dose

A
  • within a month of their first birthday

- 3 years and 4 months

56
Q

what type of vaccine is the MMR

A

live-attenuated (weakened) live virus vaccine

57
Q

Why is MMR not given until the age of 12-15 months

A
  • because passively acquired maternal antibodies would destory the live vaccine if given under 1 year
58
Q

what two HPV viruses cause cancer

A

16 and 18 = these cause cervical cancer

59
Q

What two HPV viruses cause gential warts

A

6 and 11 = these cause genital warts

60
Q

What happens in polio disease

A

The virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis

61
Q

What vaccine is used in polio disease

A

Killed virus absorbed onto adjuvants (oral live vaccine used in some countries)

62
Q

what does the oral polio vaccine contain

A

Oral polio vaccine (OPV) contains an attenuated (weakened) vaccine-virus

63
Q

what can happen with the oral polio vaccine

A
  • On rare occasions, if a population is seriously under-immunized, an excreted vaccine- virus can continue to circulate for an extended period of time.
  • In very rare instances, the vaccine-virus can genetically change into a form that can paralyse – this is what is known as a circulating vaccine-derived poliovirus (cVDPV)
64
Q

What does BCG stand for

A

Bacillus Calmette–Guérin (BCG) vaccine

65
Q

What is BCG used against

A
  • tuberculosis
66
Q

Who is the BCG recommended for

A

BCG vaccination is only recommended on the NHS for babies, children and adults under the age of 35 who are at risk of catching tuberculosis (TB)

67
Q

Which babies get the BCG vaccine

A

BCG vaccination is recommended for all babies up to 1 year old who:
• are born in areas of the UK where the rates of TB are high
• have a parent or grandparent who was born in a country where there’s a high rate of TB (high risk = incidence of TB >40/100,000)

68
Q

Define vaccine efficiacy

A

% reduction in disease incidence in a vaccinated group compared to an unvaccinated group under optimal conditions (eg RCT)

69
Q

How effective are vaccines

A 
All are 96% to 100% effective except:
 • Pertussis 75%
• Pneumococcus 60%
• Rotavirus 60%
• Influenza 75% 
• BCG 70%
70
Q

How long does the immunity of vaccines last

A
  • All give lifelong immunity except:
  • Influenza = 1 year
  • Pneumococcal = 5 years
71
Q

How many vaccines have herd immunity

A

Herd immunity applies to all these vaccines except:
• Tetanus - is caught from bacteria in the environment, not from other people who have the disease
• Influenza - High antigenic shift and drift
• TB–organisms constantly reintroduced
• Pertussis (Efficacy<80%)
• Rotavirus (Efficacy<80%)
• Pneumococcal (Efficacy<80%)

72
Q

What are the 4 main adverse events following immunisation

A

● programme-related ● vaccine-induced
● coincidental
● unknown.

73
Q

What can adverse effects following immunisation be caused by

A

AEFIs may be true adverse reactions that are intrinsic to the vaccine, or may be caused by the way it is administered or be related to an underlying condition in the recipient.
- can also be coincidental and would have occured regardless of vaccination

74
Q

Who should you avoid giving a vaccine in

A

●● history of a confirmed anaphylactic reaction to a previous dose of the vaccine
●● history of a confirmed anaphylactic reaction to a component of the vaccine
●● primary or acquired immunodeficiency
●● current or recent immunosuppressive or immunosuppressive biological therapy
●● infants born to a mother who received immunosuppressive biological therapy during pregnancy
●● those in contact with an individual with immunodeficiency, current recent immunosuppressive including biological therapy
●● pregnant women

75
Q

Name routine vaccination given in pregnancy

A
  • Pertusis vaccination is given in mothers who are 28 weeks + pregnancy
  • cases of pertusis are occuring in the first few weeks of life before the vaccine
  • influenza
76
Q

What vaccinations are given in young adults

A
  • Influenza - people with chronic illness
  • BCG
  • pneumococcal
  • varicella
  • Hepatitis A and B - people at higher risk only
77
Q

describe the influenza vaccine

A
  • Live attenuated strains of the three most endemic influenza viruses that year (killed virus in adults)
    • New versions of the vaccines are developed twice a year, as the influenza virus rapidly changes.
78
Q

Who should get the flu vaccination

A
  • Elderly people
  • Diabetics
  • Patients with chronic lung
  • Heart
  • Renal disease
  • Immunosuppressed patients
  • Healthcare personnel
79
Q

How effective is the infleunza vaccine

A

On average the efficacy of the vaccine against the targeted strains is about 75%.

80
Q

Name the adverse events that can follow immunisation

A
  • pain, swelling or redness at the site of injection. These occur commonly after immunisation and should be anticipated
  • local adverse reactions that generally start within a few hours of the injection and are usually mild and self-limiting.
  • these are often referred to as ‘hypersensitivity reactions’, they are not allergic in origin, but may be either due to high titres of antibody or a direct effect of the vaccine product,
  • Rash with MMR – common
  • Systemic adverse reactions which include fever, malaise, myalgia, irritability, headache and loss of appetite.
  • Limpness,cyanosis–Rare
  • Anaphylactic reactions to vaccines are extremely rare but have the potential to be fatal. – no deaths as a result of the reaction

Year 3 - Public Health (12 decks)

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