Vaccine

Question 1

Splenectomy

Answer 1

At risk from encapsulated bacteria: pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus* infections

Vaccination if elective, should be done 2 weeks prior to operation -> Hib, meningitis A & C
annual influenza vaccination
pneumococcal vaccine every 5 years
Antibiotic prophylaxis with penicillin V

Question 2

HPV vaccination

Answer 2

HPV vaccination should be offered to men who have sex with men under the age of 45 to protect against anal, throat and penile cancers

Question 3

Live vaccines

Answer 3

BCG
measles, mumps, rubella (MMR)
influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid

Question 4

Inactivated vaccines

Answer 4

rabies
hepatitis A
influenza (intramuscular)

Question 5

Toxoid (inactivated toxin)

Answer 5

tetanus
diphtheria
pertussis

Question 6

Hepatitis B vaccine

Answer 6

around 10-15% of adults fail to respond or respond poorly to 3 doses of the vaccine. Risk factors include age over 40 years, obesity, smoking, alcohol excess and immunosuppression
testing for anti-HBs is only recommended for those at risk of occupational exposure (i.e. Healthcare workers) and patients with chronic kidney disease. In these patients anti-HBs levels should be checked 1-4 months after primary immunisation
Anti-HBs level (mIU/ml) >100 indicates adequate response.
10 - 100 - sub optimal response, should receive an additional vaccine dose.
<10 - non-responder and qill require further vaccine course (3 doses again)