Vaccines

Question 1

What vaccines are given at 2 months

Answer 1

2 months

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B), rotavirus and Men B

Question 2

What vaccines are given at 3 months

Answer 2

3 months

‘6-1 vaccine’, rotavirus and pneumococcal

Question 3

What vaccines are given at 4 months

Answer 3

4 months

‘6-1 vaccine, pneumococcal and Men B

Question 4

What vaccines are given at 12-13 months

Answer 4

12-13 months

Hib + Men C, MMR and Men B, pneumococcal

Question 5

What vaccine is given regularly between ages 2-8yrs?

Answer 5

Flu vaccine (annual)

Question 6

What vaccines are given at 3-4yrs?

Answer 6

3-4 years ‘4-in-1 pre-school booster’ (diphtheria, tetanus, whooping cough and polio) and MMR

Question 7

What vaccine is given at 12-13 years?

Answer 7

HPV vaccination for girls and boys

Question 8

What vaccine is given 13-18 years

Answer 8

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio), Men ACWY

Question 9

Which vaccines are given as inactivated organisms

Answer 9

Pertussis

Polio (IPV)

Question 10

Which vaccines are given as live attenuated organisms?

Answer 10

Measles 
Mumps
Rubella
BCG
Oral polio (OPV)
Rotavirus

Question 11

Which vaccines are given as secreted products?

Answer 11

Tetanus

Diphtheria

Question 12

Which vaccines are given as recombinant components?

Answer 12

Hep B

HPV

Question 13

Which vaccine is given as constituents of the cell wall?

Answer 13

Hemophilus Influenzae B
Pneumococcus
Meningococcus

Question 14

Why are boosters given?

Answer 14

The reason for needing boosters is that the first response in children often only produces an IgM response and the immunoglobulins from this may persist for months or years but after this they won’t be protected. A booster will stimulate a much larger IgG response allowing lifelong immunity.

Question 15

What is Diphtheria?

Answer 15

Caused by a bacterium called Corynebacterium diphtheria which is spread via aerosol droplets. Has a fatality rate of 10% but is very rare in developed countries.

Question 16

How does diphtheria present?

Answer 16

Causes local pharyngitis with enlarged lymph nodes and swelling which may put pressure on the throat. Systemically the toxins produced affect the heart CNS and adrenal tissues. It can lead to paralysis and cardiac failure.

Question 17

What is tetanus?

Answer 17

Infection caused by the anaerobic Clostridium Tetani. The spores are present in soil and manure and enter the body via breaks in the skin. Neonatal infection occurs via infection of the umbilical stump. Incubation period is 4-21 days but is not spread from person to person.

Question 18

How does tetanus present?

Answer 18

Features:
Locked jaw, facial spasms, neck stiffness and difficulty swallowing. Also, fever, sweating, tachycardia and elevated BP. Common in adults over 65.

Question 19

What is polio?

Answer 19

Highly infectious viral infection affecting mainly children under 5 years of age. Spread via faecal-oral route. Virus replicated in GI tract and then drains to cervical and mesenteric lymph nodes. In 5% the virus then enters the blood stream and into the nervous system. Can lead to irreversible paralysis.

Question 20

What is haemophilus influenza B?

Answer 20

Commensal in nose and throat that is passed on via coughing and sneezing. Can cause meningitis, epiglottitis, pneumonia, pericarditis, septic arthritis, osteomyelitis and cellulitis.

Question 21

What can strep pneumoniae cause in children?

Answer 21

Carried as a commensal in the throat and spread via respiratory droplets. An encapsulated gram-negative bacterium with the capsule providing a large amount of its virulence. In children can cause pneumonia, sepsis, meningitis, pharyngitis, otitis media, conjunctivitis and sinusitis.

Question 22

Why do we vaccinate against rubella?

Answer 22

Reasons for vaccinating against rubella is due to protecting pregnant women as congenital rubella is devastating.

Question 23

How does mumps present?

Answer 23

Presents with malaise, myopathy, cervical lymphadenopathy, and parotid swelling (which causes earache and pain on eating). Starts unilateral and becomes bilateral in 70% of cases.

Question 24

What are the complications of mumps infections?

Answer 24

Complications – meningoencephalitis, orchitis (uncommon in prepubertal boys but 25% of pubertal), pancreatitis and unilateral deafness.

Question 25

What causes mumps

Answer 25

Caused by an RNA paramyxovirus and more common in winter and spring. Spread by droplets, and people are infective 7 days before and 9 days after parotid swelling starts. Incubation period can be 14-21 days.

Question 26

How is mumps managed?

Answer 26

Management – rest, paracetamol for high fever/discomfort. Notifiable disease.

Question 27

List some common vaccine side effects?

Answer 27

Mild infective symptoms especially if live attenuated
Soreness at sight of injection
Rare side effects – convulsion and anaphylaxis (but not these are rarer than the complications of the natural infection)

Question 28

What contraindications are there for the MMR?

Answer 28

Immunosuppression for live attenuated vaccines
Confirmed previous anaphylactic reaction to vaccines, neomycin, or gelatine
Pregnant
Note NOT egg or penicillin allergies