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Adolescence > Vaccines for Teenagers > Flashcards

Vaccines for Teenagers Flashcards

1
Q

what is a vaccine

A

biological product used to induce an immune response against an infectious agent

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2
Q

vaccines utilise the ability of the human immune system to _____ to & _______ encounters with pathogens

A

respond to & remember

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3
Q

vaccination programs mainly target infants and children under _ yo

A

5yo

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4
Q

although children under 5 have the least robust immune system, they need vaccinations as they have the highest ____ from infectious diseases

A

burden

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5
Q

vaccinations avert millions of ___ annually

A

deaths

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6
Q

smallpox was eradicated after successful vaccination programs, and hence ______ ______ was stopped

A

routine vaccination

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7
Q

what was the most common cause of bacterial meningitis prior to its vaccine

A

haemophilus influenzae type b (Hib)

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8
Q

since Hib vaccine, incidence has declined dramatically with majority of cases in….

A

children aged less than 5 years

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9
Q

with polio, vaccination has led to elimination of how many wild-type poliovirus strains worldwide

A

2 of 3

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10
Q

detection of wild poliovirus type 1 (WPV1) in another country (besides Pakistan and Afghanistan) demonstrates what ……………….., unless……….

A

the need for maintaining high vaccination levels within population or else see continuous risk of spread of disease, unless virus is eradicated

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11
Q

how many polio strains are in australia currently

A

none, polio-free

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12
Q

what is the cure for polio

A

no cure
- can only be prevented by immunisation

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13
Q

unless diseases are _______, it is important to maintain high vaccination rates (esp for highly infectious diseases)

A

eradicated

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14
Q

can see increase in ____ in countries with low vaccination rates

A

outbreaks

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15
Q

rationale behind teenage vaccination

A

there are some serious infectious diseases that are more prevalent amongst adolescents that are vaccine-preventable

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16
Q

regarding teenage vaccination, adolescents have unique risks related to (3) broad factors which are common in this age group

A
  • biological
  • behavioural
  • environmental
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17
Q

contributors to increased risk of vaccine preventable disease in adolescents (3 - 2 behavioural, 1 biological)

A
  • social behaviours involving close contact
  • waning immunity from childhood vaccinations
  • low vaccine uptake among adolescents
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18
Q

what assists in reducing risk of VPD in adolescents regarding low vaccine uptake among adolescents

A
  • adolescents school programs result in relatively high vaccination uptake
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19
Q

does adolescents school vaccination programs make them on par with childhood vaccination uptake

A
  • no
  • remains more than 10% lower than that achieved for childhood vaccinations
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20
Q

contributing factors to why there might be low vaccine uptake among adolescents

A
  • less info and education about adolescent vaccination in public health campaign, among HCPs, parents, adolescents
  • newer concept compared to early childhood vaccinations
  • lack of clarity regarding ownership of adolescent vaccination decisions
  • lack of regular preventative primary healthcare visits with GP
  • structural barriers: lack of easily accessible platforms to administer vaccinations during routine primary care visits
  • exposure to misinformation on social media
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21
Q

how long has vaccination in adolescents been routinely integrated into healthcare

A

last 2 decades

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22
Q

who recommends and funds childhood vaccinations

A

Australian National Immunisation Program (NIP)

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23
Q

NIP also recommends and funds vaccinations for teenagers against which diseases:

A
  • diptheria (DTP)
  • tetanus (DTP)
  • pertussis (DTP)
  • human papillomavirus (HPV)
  • meningococcal disease (strains A, C, W, Y)
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24
Q

teenage vaccinations occur at what ages

A

12-13 years (Year 7-8 or age equivalent)
14-16 years (Year 10 or age equivalent)

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25
Q

which vaccinations are given at 12-13 years

A

dTpa booster
HPV vaccine

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26
Q

why are boosters needed

A
  • boosts waning immunity from childhood vaccinations
  • ensures high levels of protection are maintained over a long period of time
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27
Q

why is HPV vaccine recommended at 12-13 years

A
  • most effective if administered in early teen years, before age of sexual activity
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28
Q

what vaccines are given at 14-16 years

A
  • 4vMenCV (meningococcal ACWY)
  • meningococcal B
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29
Q

why are vaccines given at 14-16years

A

senior high school years, age of increased risk
peak ages of meningococcal disease

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30
Q

why is dTpa booster given

A
  • dTpa given in early childhood
  • its immunity is starting to wane by 12-13years
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31
Q

what other vaccinations are recommended to teenagers (2)

A
  • covid vaccine (>age 5)
  • annual flu vaccine (>6 months)
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32
Q

what is the most common sexually transmitted infection globally

A

anogenital HPV

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33
Q

what is the peak prevalence of HPV

A
  • in first decade after sexual activity
  • typically between ages 15-25 in most western countries
    (thus important to ensure vaccination occurs before this age)
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34
Q

estimated at least % of sexually active individuals exposed to HPV once in their lifetime

A

80%

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35
Q

why do some experts believe that virtually all sexually active adults have been infected by HPV

A
  • because most HPV infections are transient & can come and go in the interval between HPV testing
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36
Q

different types of HPV virus considered ____ risk and others ___ risk

A
  • low
  • high
37
Q

how long does it take for most HPV infections to resolve, what type does this also include

A

-12 months
- including those with carcinogenic HPV genotypes

38
Q

which type of HPV, if they persist beyond 12 months, increase likelihood of precancerous or cancerous lesions

A

carcinogenic HPV infections

39
Q

different HPV types have ability to ______ ___________ _____ ______ and are associated with different diseases

A
  • infect different body sites
40
Q

symptoms HPV can cause (2)

A
  • cutaneous (skin) warts
  • anogenital lesions
41
Q

cutaneous warts occur in which HPV types

A

HPV types: 1, 2, 3, 4, 7, 10

42
Q

list 4 types of cutaneous warts that HPV can cause

A
  • plantar warts
  • common warts
  • flat warts
  • butcher’s warts
43
Q

types (2) anogenital lesions caused by HPV

A
  • benign genital warts
  • carcinoma of the vagina, vulva, cervix, anus, or penis
44
Q

anogenital lesion of benign genital warts is caused by which HPV types

A

HPV type 6 and 11

45
Q

anogenital lesion of carcinoma of the vagina, vulva, cervix, anus, or penis - which HPV type is the most common and has highest risk of progression to cancer

A

HPV 16

45
Q

anogenital lesion of carcinoma of the vagina, vulva, cervix, anus, or penis is caused by how many HPV types

A

~15 HPV types are associated with cancer; known as high risk of as carcinogenic

45
Q

what else can HPV 16 infect and been associated with which cancer

A
  • infect oral mucosa
  • associated with oropharyngeal cancer
46
Q

cervical cancer is the ___ most common cancer in females

A

4th

47
Q

virtually all cases of cervical cancer are attributable to ?

A

HPV infection

48
Q

50% of cervical cancers caused by HPV are attributable to which type

A

HPV 16

49
Q

20% of cervical cancers caused by HPV are attributable to which type

A

HPV 18

50
Q

HPV types 16 and 18 also cause __% of ____ cancers

A

90% of anal cancers

51
Q

globally, australia has had the greatest reduction in incidence of which HPV symptom

who is this greatest reduction amongst

A
  • genital warts
  • young women eligible for school-based vaccination (12-13yo and eligible for catchup program until age 26)
52
Q

how has genital warts been reduced in young unvaccinated heterosexual males in early years

A

herd effect

53
Q

why is the full impact of HPV vaccination on rates of HPV-associated cancers yet to be seen

A

due to the long latency period between HPV infection and progression to cancer

54
Q

what is invasive meningococcal disease (IMD)

A
  • uncommon but life-threatening infection causes by meningococcus
55
Q

what can IMD cause (2)

A
  • bacterial meningitis
  • septicaemia
56
Q

how many serogroups of meningococcus & which cause most cases of IMD in Aus

A
  • 15
  • 5: A, B, C, W, Y
57
Q

at what age can IMD occur

A
  • at any age
58
Q

what is the peak age distribution for IMD occurrence

A
  • bimodal pattern (2 distinct peaks)
  • mainly young children under 5 yrs of age esp infants
  • amongst adolescents / young adults aged 15-24yo
59
Q

clinical manifestations of IMD

A

quite varied
- transient fever and bacteraemia to fulminant disease and death occurring within hours of onset of clinical symptoms

60
Q

typical symptoms of IMD are often non-specific (esp early on) and can include sudden onset of

A
  • fever, rash, headache, severe myalgia (classic sign), joint pain, nausea, vomiting, neck stiffness, photophobia, altered mental status in previously healthy person
61
Q

IMD can progress _________

A

rapidly

62
Q

transition from health to severe disease with _____ and / or ___ in a matter of hours

A

septicaemia
meningitis

63
Q

even with treatment, what is the mortality rate of IMD and who is this highest amongst (2)

A
  • 5-10%
  • infants and older adults (probs 45yrs and above)
64
Q

_______ morbidity in survivors, __-__% develop complications and sequelae

A
  • significant
  • 20-40%
65
Q

complications and sequelae morbidity from IMD include

A
  • skin necrosis
  • gangrene (death of tissue) of limbs requiring extensive skin grafting
  • scarring
  • amputation
  • deafness
  • other neurological deficits
66
Q

do we get HPV vaccine for each HPV type the same way we do for different meningococcal strains and why

A

no
HPV vaccines cover multiple types simultaneously
more than 200 known HPV types

67
Q

in the last few years which serogroup for meningococcal is the primary cause of IMD across Aus

A

serogroup B (MenB)

68
Q

what has caused the decrease after peaks of specific serogroups in meningococcal cause of IMD

A

serogroup-targeting meningococcal vaccination

69
Q

MenW cases more common in _________
higher case ____ rate than disease by other serogroups

A
  • adults aged 45 or above
  • fatality
70
Q

MenY, like Men_, is more common in older adults(45yrs or above)

A

MenW

71
Q

Men_ is major cause of IMD for infants and young children, adolescents, young adults

A

MenB

72
Q

in 2019 MenACWY vaccine introduced in NIP for adolescence which replaced what

A

MenC vaccine for children at 12 months

73
Q

from 2018, SA has had state-funded MenB vaccine for….

A

infants and adolescence

74
Q

MenB is funded by NIP since 2020 for

A
  • ATSI infants & people of all ages w medical conditions that increase their risk of IMD
75
Q

current meningococcal vaccinations in Aus for: infants and children under 2 years; adolescents 15-19yrs, special risk groups, private provider

A

All infants and children under 2 years:
- MenACWY vaccine at 12 months - funded by NIP
- MenB funded in SA only
Adolescents 15-19years:
- MenACWY vaccine - funded by NIP
- MenB funded in SA only
Special Risk Groups
- ATSI people
- eligible with medical conditions
- travellers
- lab workers who frequently handle meningococcal
- young adults who live with or are current smokers
Private purchase (if you want to reduce your risk IMD):
- MenACWY and MenB can be offered to anyone 6wks or older

76
Q

catch up on NIP vaccines missed in childhood is offered to

A
  • all people under 20 years of age
  • people aged under 26years who missed HPV vaccination
  • refugees and humanitarian entrants of any age
77
Q

infectious diseases account for ~__% of all deaths recorded globally

A

40%

78
Q

it is important to confirm ATSI in vaccinations, why?

A
  • extra vaccinations often recommended
  • as these patients experience higher burden of disease compared to non-Indigenous Australians
79
Q

from 2024 in SA what will be routinely offered at Year 7 and Year 10 vaccination

A

Year 7
- dTpa booster
- HPV
Year 10
- meningococcal ACWY
- meningococcal B

80
Q

what do students who cannot receive vaccinations from school immunisation team visit do to receive these vaccinations eg/ home schooled or did not attend

A
  • can catch up thru general practitioner or immunisation provider
  • ideally done as close to recommended time as possible
  • however, free catch-up childhood and school vaccinations still accessible until 20 years old
81
Q

benefit of HPV is most effective if vaccination is done when

A

before first sexual contact

82
Q

HPV vaccination is cost-effective method to reduce impact of HPV as both an

A
  • STI (causing anogenital warts)
  • risk factor for development of certain adult cancers
83
Q

why are adolescents and young adults at increased risk from meningococcal disease

A
  • this population has higher rate of carriage of bacteria of meningococcal (Neisseria Meningitidis) in nasopharynx
  • and participate more commonly in social behaviours with higher risk of transmission (eg/ close physical contact, kissing, living in residential colleges)
  • therefore, booster doses meningococcal ACWY and B vaccinations offered in Year 10
84
Q

although young people themselves may not generally be at increased risk of severe disease outcomes from infections (seasonal infections including influenza and covid-19) their participation in immunisation programs………..

A

contributes overall protection of more vulnerable patients
ie/ herd immunity

85
Q

if a young person’s parents did not consent for a childhood vaccination during their childhood, can anything be done about this?

A
  • they may wish to begin a catch-up course of recommended vaccinations during their teenage years
  • consent for medical vaccinations can be given by 16yr olds
86
Q

what if an under 16yr old wants medical vaccinations but their caregiver does not consent

A

young person may consent to the treatment if 2 medical practitioners agree the young person understands the nature and risks of the treatment

Adolescence (5 decks)

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