vaccines Flashcards
what is the main contraindication for live attenuated vaccines
immunosuppression
who is the chickenpox VZV vaccine offered to
- healthcare workers who are not immune
- contacts of an immunosuppressed family member e.g. child or a parent who is getting chemotherapy
what are the live attenuated vaccines
BCG
MMR
Influenza (intranasal)
Oral rotavirus
Oral polio
Yellow fever
Oral typhoid
VZV (shingles + chickenpox) - subcut
who is eligible for shingles vaccine
age 70 until 79
Toxoid (inactivated toxin) vaccines
tetanus
diphtheria
pertussis
Subunit and conjugate vaccines
pneumococcus (conjugate)
haemophilus (conjugate)
meningococcus (conjugate)
hepatitis B
HPV
Inactivated preparations vaccinations
Rabies
Influenza (IM)
Hep A
Valency of vaccines definition
the number of antigenic components or serotypes it can protect against
difference between monovalent and multivalent/polyvalent vaccines with examples
monovalent - works against one strain or subtype of a pathogen e.g. measles vaccine
multi/polyvalent - works against various strains or subtypes of pathogen e.g. influenza vaccine
over the course of 0 to 18 years, how many tetanus vaccinations do you get
FIVE
at 2 months, 3 months, 4 months, 3-5 years, and 13-18 years
Patient has wound injury
Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago
What is the treatment?
No vaccine
No tetanus immunoglobulin needed
Patient has wound injury
Patient has had a full course of tetanus vaccines, with the last dose OVER 10 years ago
What is the treatment?
If tetanus prone wound: give tetanus vaccine
If high risk wound: give tetanus vaccine AND tetanus immunoglobulin
Patient has wound injury
Patient is unsure of vaccination history in terms of tetanus.
What is the treatment?
Give tetanus vaccine regardless
If tetanus prone and high risk wound: give tetanus vaccine AND tetanus immunoglobulin
What are the 3 categories of tetanus types of wound
- clean wound - less than 6 hours old, no tissue damage
- tetanus prone wound - puncture type injury in contaminated environment, foreign bodies, compound fractures, sepsis, bites and scratches
- high-risk wound - heavy contamination with tetanus spores e.g. soil, manure. wounds or burns with extensive devitalised tissue, or need surgical intervention
there are 2 types of pneumococcal vaccine. which one is offered to who?
- pneumococcal conjugate vaccine (PCV) - given to children as part of routine imms (at 3 and 12-13 months)
- pneumococcal polysaccharide vaccine (PPV) - given to all over age 65, and chronic conditions e.g. COPD, splenectomy
Adults over age of 65 with risks usually require just one dose of pneumococcal polysaccharide vaccine (PPV). Which cohorts need a vaccine every 5 years?
Asplenia
Splenic dysfunction (including coeliac!)
Chronic kidney disease
who is influenza vaccine offered to
over 65 years old with:
- respiratory disease (including asthma inhaled steroids)
- heart disease (IHD, heart failure)
- CKD
- chronic liver disease
- chronic neuro disease e.g. stroke
- diabetes including diet controlled
- immunosupressed
- asplenia/splenic dysfunction
- pregnant women
or at risk individuals in care homes, carers, or healthcare staff
Which groups of adults over age of 65 require pneumococcal polysaccharide vaccine (PPV) (regardless of every year or 5 years)?
- asplenia/splenic dysfunction
- chronic resp disease e.g. COPD, CF (asthma only if ORAL steroids)
- chronic heart disease - controlled HTN does not count
- CKD
- chronic liver disease
- DM if needs medication
- immunosuppresion
- cochlear implants
- patients with CSF leaks
who is the BCG vaccine recommended for:
- infants (0-12 months) in UK where TB annual incidence is >40/100,000
- infants (0-12 months) who parent or grandparent was born in country where TB annual incidence is >40/100,000
- previously unvaccinated tuberculin-negative contacts of resp TB
- previously unvaccinated tuberculin-negative new entrants <16 years who lived or were born in country with annual TB incidence >40/100,000
- healthcare workers
- prison staff
- carehome workers
- ppl who work with homeless people
if an infant is older than 6 years but parent/grandparent is from a high incidence TB country, what needs to be done before deciding if they need BCG vaccine
tuberculin test
what does the BCG vaccine contain
live attenuated Mycobacterium bovis
Any person being considered for the BCG vaccine must first be given a tuberculin skin test. The only exceptions is what..?
children < 6 years old who have had no contact with tuberculosis
How is BCG vaccine given
Intradermally
Lateral aspect of L upper arm
What are the rules for BCG vaccines for timing of vaccination
Can be given at the same time as other live vaccines
If it is not, there should be a 4 week interval
6 contraindications to BCG vaccination
- previous BCG vaccination
- past history of tuberculosis
- HIV
- Pregnancy
- positive tuberculin test (Heaf or Mantoux)
- Age over 35
MMR vaccine
When are the doses given
12-15 months
3-4 months
What are the 5 contraindications to MMR
- Immunosuppresion
- Allergy to neomycin
- Children who received another live vaccine by injection within 4 weeks
- Pregnancy - avoid for at least 1 month after vaccination
- Immunoglobulin therapy within last 3 months
When should Men B vaccines be given?
2 months
4 months
12-13 months
Adverse effects of MMR vaccine after 1st dose - when do they occur and how long do they last for
Malaise
Fever
Rash
Typically occurs after 5-10 days, lasts around 2-3 days
