Vaccines for Teenagers Flashcards
1
Q
what is a vaccine
A
biological product used to induce an immune response against an infectious agent
2
Q
vaccines utilise the ability of the human immune system to _____ to & _______ encounters with pathogens
A
respond to & remember
3
Q
vaccination programs mainly target infants and children under _ yo
A
5yo
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
5
Q
vaccinations avert millions of ___ annually
A
deaths
6
Q
smallpox was eradicated after successful vaccination programs, and hence ______ ______ was stopped
A
routine vaccination
7
Q
what was the most common cause of bacterial meningitis prior to its vaccine
A
haemophilus influenzae type b (Hib)
8
Q
since Hib vaccine, incidence has declined dramatically with majority of cases in….
A
children aged less than 5 years
9
Q
with polio, vaccination has led to elimination of how many wild-type poliovirus strains worldwide
A
2 of 3
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
11
Q
how many polio strains are in australia currently
A
none, polio-free
12
Q
what is the cure for polio
A
no cure
- can only be prevented by immunisation
13
Q
unless diseases are _______, it is important to maintain high vaccination rates (esp for highly infectious diseases)
A
eradicated
14
Q
can see increase in ____ in countries with low vaccination rates
A
outbreaks
15
Q
rationale behind teenage vaccination
A
there are some serious infectious diseases that are more prevalent amongst adolescents that are vaccine-preventable
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
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
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
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
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
21
Q
how long has vaccination in adolescents been routinely integrated into healthcare
A
last 2 decades
22
Q
who recommends and funds childhood vaccinations
A
Australian National Immunisation Program (NIP)
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)
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)
25
which vaccinations are given at 12-13 years
dTpa booster
HPV vaccine
26
why are boosters needed
- boosts waning immunity from childhood vaccinations
- ensures high levels of protection are maintained over a long period of time
27
why is HPV vaccine recommended at 12-13 years
- most effective if administered in early teen years, before age of sexual activity
28
what vaccines are given at 14-16 years
- 4vMenCV (meningococcal ACWY)
- meningococcal B
29
why are vaccines given at 14-16years
senior high school years, age of increased risk
peak ages of meningococcal disease
30
why is dTpa booster given
- dTpa given in early childhood
- its immunity is starting to wane by 12-13years
31
what other vaccinations are recommended to teenagers (2)
- covid vaccine (>age 5)
- annual flu vaccine (>6 months)
32
what is the most common sexually transmitted infection globally
anogenital HPV
33
what is the peak prevalence of HPV
- in first decade after sexual activity
- typically between ages 15-25 in most western countries
(thus important to ensure vaccination occurs before this age)
34
estimated at least % of sexually active individuals exposed to HPV once in their lifetime
80%
35
why do some experts believe that virtually all sexually active adults have been infected by HPV
- because most HPV infections are transient & can come and go in the interval between HPV testing
36
different types of HPV virus considered ____ risk and others ___ risk
- low
- high
37
how long does it take for most HPV infections to resolve, what type does this also include
-12 months
- including those with carcinogenic HPV genotypes
38
which type of HPV, if they persist beyond 12 months, increase likelihood of precancerous or cancerous lesions
carcinogenic HPV infections
39
different HPV types have ability to ______ ___________ _____ ______ and are associated with different diseases
- infect different body sites
40
symptoms HPV can cause (2)
- cutaneous (skin) warts
- anogenital lesions
41
cutaneous warts occur in which HPV types
HPV types: 1, 2, 3, 4, 7, 10
42
list 4 types of cutaneous warts that HPV can cause
- plantar warts
- common warts
- flat warts
- butcher's warts
43
types (2) anogenital lesions caused by HPV
- benign genital warts
- carcinoma of the vagina, vulva, cervix, anus, or penis
44
anogenital lesion of benign genital warts is caused by which HPV types
HPV type 6 and 11
45
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
HPV 16
45
anogenital lesion of carcinoma of the vagina, vulva, cervix, anus, or penis is caused by how many HPV types
~15 HPV types are associated with cancer; known as high risk of as carcinogenic
45
what else can HPV 16 infect and been associated with which cancer
- infect oral mucosa
- associated with oropharyngeal cancer
46
cervical cancer is the ___ most common cancer in females
4th
47
virtually all cases of cervical cancer are attributable to ?
HPV infection
48
50% of cervical cancers caused by HPV are attributable to which type
HPV 16
49
20% of cervical cancers caused by HPV are attributable to which type
HPV 18
50
HPV types 16 and 18 also cause __% of ____ cancers
90% of anal cancers
51
globally, australia has had the greatest reduction in incidence of which HPV symptom
who is this greatest reduction amongst
- genital warts
- young women eligible for school-based vaccination (12-13yo and eligible for catchup program until age 26)
52
how has genital warts been reduced in young unvaccinated heterosexual males in early years
herd effect
53
why is the full impact of HPV vaccination on rates of HPV-associated cancers yet to be seen
due to the long latency period between HPV infection and progression to cancer
54
what is invasive meningococcal disease (IMD)
- uncommon but life-threatening infection causes by meningococcus
55
what can IMD cause (2)
- bacterial meningitis
- septicaemia
56
how many serogroups of meningococcus & which cause most cases of IMD in Aus
- 15
- 5: A, B, C, W, Y
57
at what age can IMD occur
- at any age
58
what is the peak age distribution for IMD occurrence
- bimodal pattern (2 distinct peaks)
- mainly young children under 5 yrs of age esp infants
- amongst adolescents / young adults aged 15-24yo
59
clinical manifestations of IMD
quite varied
- transient fever and bacteraemia to fulminant disease and death occurring within hours of onset of clinical symptoms
60
typical symptoms of IMD are often non-specific (esp early on) and can include sudden onset of
- fever, rash, headache, severe myalgia (classic sign), joint pain, nausea, vomiting, neck stiffness, photophobia, altered mental status in previously healthy person
61
IMD can progress _________
rapidly
62
transition from health to severe disease with _____ and / or ___ in a matter of hours
septicaemia
meningitis
63
even with treatment, what is the mortality rate of IMD and who is this highest amongst (2)
- 5-10%
- infants and older adults (probs 45yrs and above)
64
_______ morbidity in survivors, __-__% develop complications and sequelae
- significant
- 20-40%
65
complications and sequelae morbidity from IMD include
- skin necrosis
- gangrene (death of tissue) of limbs requiring extensive skin grafting
- scarring
- amputation
- deafness
- other neurological deficits
66
do we get HPV vaccine for each HPV type the same way we do for different meningococcal strains and why
no
HPV vaccines cover multiple types simultaneously
more than 200 known HPV types
67
in the last few years which serogroup for meningococcal is the primary cause of IMD across Aus
serogroup B (MenB)
68
what has caused the decrease after peaks of specific serogroups in meningococcal cause of IMD
serogroup-targeting meningococcal vaccination
69
MenW cases more common in _________
higher case ____ rate than disease by other serogroups
- adults aged 45 or above
- fatality
70
MenY, like Men_, is more common in older adults(45yrs or above)
MenW
71
Men_ is major cause of IMD for infants and young children, adolescents, young adults
MenB
72
in 2019 MenACWY vaccine introduced in NIP for adolescence which replaced what
MenC vaccine for children at 12 months
73
from 2018, SA has had state-funded MenB vaccine for....
infants and adolescence
74
MenB is funded by NIP since 2020 for
- ATSI infants & people of all ages w medical conditions that increase their risk of IMD
75
current meningococcal vaccinations in Aus for: infants and children under 2 years; adolescents 15-19yrs, special risk groups, private provider
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
catch up on NIP vaccines missed in childhood is offered to
- all people under 20 years of age
- people aged under 26years who missed HPV vaccination
- refugees and humanitarian entrants of any age
77
infectious diseases account for ~__% of all deaths recorded globally
40%
78
it is important to confirm ATSI in vaccinations, why?
- extra vaccinations often recommended
- as these patients experience higher burden of disease compared to non-Indigenous Australians
79
from 2024 in SA what will be routinely offered at Year 7 and Year 10 vaccination
Year 7
- dTpa booster
- HPV
Year 10
- meningococcal ACWY
- meningococcal B
80
what do students who cannot receive vaccinations from school immunisation team visit do to receive these vaccinations eg/ home schooled or did not attend
- 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
benefit of HPV is most effective if vaccination is done when
before first sexual contact
82
HPV vaccination is cost-effective method to reduce impact of HPV as both an
- STI (causing anogenital warts)
- risk factor for development of certain adult cancers
83
why are adolescents and young adults at increased risk from meningococcal disease
- 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
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...........
contributes overall protection of more vulnerable patients
ie/ herd immunity
85
if a young person's parents did not consent for a childhood vaccination during their childhood, can anything be done about this?
- 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
what if an under 16yr old wants medical vaccinations but their caregiver does not consent
young person may consent to the treatment if 2 medical practitioners agree the young person understands the nature and risks of the treatment
