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Trop Med > Vaccines and Refugees > Flashcards

Vaccines and Refugees Flashcards

1
Q

Which vaccines can you not give in immunocompromised patients?

A

Yellow fever
MMR
Polio (oral)
BCG
Influenza (one type)
Typhoid - oral only
Rotavirus

You mustn’t prescribe BCG incase they rip.

Any live vaccine. Can give varicella if CD4 <200.

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2
Q

Which routine immunisations are always given?

A

*Tetanus/diphtheria/ pertussis
* Measles (mumps/rubella)
* Polio
* Pneumococcal

Sometimes:
* Varicella
* Influenza (separate lecture)
* HPV
* Zoster

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3
Q

What type of vaccine produces B and T cell response?

A

Conjugate vaccines

(polysaccharide - only B cell, most discontinued)

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4
Q

When do you give booster in T/D/P for travellers?

A

Booster: 10 yrs with Tdap for travelers

5 year rule for long termers

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5
Q

How many doses of measles vaccine do you need to be protected? How spread out?

A

2

28 days

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6
Q

Varicella vaccine - how many?

A

2 doses spaced by 4-8 weeks

Not in UK - just wait and get chicken pox :)

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7
Q

What is Shringex?

A

Zoster vaccine

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8
Q

Who gets Shringex?

A

*All immunocompetent persons aged ≥ 50 years.

*Under 18 yo and immunocompromised - HIV (any CD4) but delay until CD4 >200 and virologically suppressed.

– Zoster vaccine is not indicated for the prevention of chickenpox, and varicella vaccine is not indicated for the prevention of shingles.

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9
Q

How long do you wait after an episode of herpes zoster before vaccine?

A

Wait 1 yr if recent Zoster episode

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10
Q

What types of polio can you?

A

WPV1
VDPV - vaccine derived polio vaccine (which is a type 2)

Other strains are extinct

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11
Q

Who should be vaccinated against pneumococcal?

A

> =65 years who have not previously received
a pneumococcal conjugate vaccine should receive a
pneumococcal conjugate vaccine - PCV20

Adults >18 with HIV, certain underlying medical conditions - RESP DISEASE- or other risk factors who have not previously received a pneumococcal conjugate
vaccine should receive either PCV20 or PCV15.

If give PCV15, need to follow with PCV23.

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12
Q

How many doses of the PCV20 do you need?

A

1 and 1 only!

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13
Q

What are the 3 vaccines would pretty much always be recommended?

A

Hepatitis A
Typhoid
Hepatitis B

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14
Q

How many months does Hep A

A

2 doses 1 month apart
Booster: after 6-18 months, offers long-term protection

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15
Q

What types of typhoid vaccine exist?

A

Live oral and killed injectable

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16
Q

How many hepatitis B vaccines is there usually in a series?

A

3

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17
Q

How do you administer the oral typhoid vaccine?

A

4 x 1 capsule at 2 day intervals

18
Q

Yellow Fever vaccine - how many days in advance should you give if travelling to a country that requires it?

A

Must be given >10 days before entry

19
Q

Who do you not give the YF vaccine to?

A
  • Autoimmune thymus dysfunction is risk factor
  • primary immunodeficiencies
    – Transplantation
    – immunomodulatory drugs
20
Q

Cholera vaccine - who do you give it to?

A

Indicated only in aid and refugee workers

21
Q

Cholera vaccine also protects you from?

A

Efficacy against ETEC is 50% with duration of
efficacy of 3 months

22
Q

Which meningococcal is vaccinated against in the primary series?

A

A,C,Y,W135

Booster at 5 yrs

23
Q

Who should get Men B vaccine?

A

Asplenism
Sickle cell
Complement deficiency
Men B outbreak
Permissive use in adolescents 16-18yr

24
Q

Why vaccinate with rabies?

A

PrEP dramatically simplifies the PEP (post-exposure prophylaxis)
schedule to 2 injections spaced by 3 days and eliminates the need for RIG
(rabies immune globulin), which may be expensive and is often very difficult to access abroad.

PrEP may provide some protection if PEP is delayed or an unrecognized
exposure to rabies has occurred.

25
Q

What do you give if not vaccinated and get bitten by a dog? and what if vaccinated?

A

RIG plus
4 x 1 ml IM vaccine
doses over 14 days
–Days 0, 3, 7,14

Vaccinated
2 injections spaced by 3 days

26
Q

Who would you advise to get a JE vaccine?

A

Going to rural area in Endemic country or outbreak
For >4 weeks
During the JE season

27
Q

How many doses are there in a JE vaccine?

A

2 (0, 28 days)

28
Q

Who would you vaccinate against dengue?

A

People who have had dengue previously

29
Q

Vaccine induced allergy?

A

*Egg - yellow fever, measles, mumps, flu - can have vaccine If have egg allergy
* Neomycin - measles, mumps, rubella,
varicella
* Streptomycin – OPV
* PEG—COVID vaccines

30
Q

If Breastfeeding, cannot give 1 vaccine?

A

Yellow Fever

31
Q

What do you need to have herd immunity within a community?

A

> 95% of people are immune

32
Q

What do you do if a refugee doesn’t have vaccination records? And children?

A

Vaccinate all adult immigrants without
immunization records using one dose of
MMR

Vaccinate all immigrant children with missing
or uncertain vaccination records using age-
appropriate vaccination for measles, mumps
and rubella.

33
Q

Varicella vaccine and refugees - do you vaccinate?

A

Vaccinate all immigrant children < 13 years
of age with varicella vaccine without prior
serologic testing.

Screen all immigrants and refugees from
tropical countries ≥ 13 years of age for
serum varicella antibodies, and vaccinate
those found to be susceptible

34
Q

What to do for refugees without vaccine records for DTP and polio?

A

Vaccinate all adult immigrants without immunization records using a primary series of tetanus, diphtheria and inactivated polio vaccine (three doses)

35
Q

Why would you vaccinate someone who has previously been infected with Hep B?

A

Prevent reactivation later in life

36
Q

Most common infections in refugees from Africa?

A

Children - malaria
Adults - Latent TB
Both schistosomiasis and strongy is common

37
Q

Most common infections in refugees from Asia?

A

Children - malaria
Hep B and Hep C, latent and active TB adults
Strongy

38
Q

Most common infections in refugees from Latin America?

A

Chagas
NCC
Latent TB

39
Q

Which imms do you not give in pregancy?

A

MMR
Varicella
Typhoid
Influenza
HPV

40
Q

Which imms do you not give in HIV?

A

MMR
Varicella
Typhoid

Trop Med (49 decks)

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