Vaccs

Question 1

What can HCP do to prevent and control spread of antibiotic resistance?

Answer 1

1. Infection prevention:
   - Ensure hygiene
   - Discuss infection prevention like vaccination with patient
2. Antimicrobial stewardship

Question 2

Explain how vaccines elicit an immune response and provide protection from disease

Answer 2

Expose immune system to the antigen to develop memory T and B cells against them. When the pathogen invades body, body mounts a rapid and strong response in eliminating the pathogen, hence preventing symptom onset

Question 3

Describe herd immunity

Answer 3

The concept where if a certain proportion of population is vaccinated, the whole population, including those who are not vaccinated or unable to acquire the immunity, will be protected from the disease, and preventing the spread of an outbreak

Question 4

List the vaccines in Singapore’s childhood immunisation schedule

Answer 4

1. BCG
2. Hep B
3. DTap
4. Tdap
5. IPV (Inactivated poliovirus)
6. Hib (H.influenzae type b)
7. PCV (Pneumococcal conjugate)
8. PPSV23 (Pneumococcal polysaccharide)
9. MMR
10. VAR (Varicella)
11. HPV
12. INF (Influenza)

Question 5

List the vaccines in Singapore’s adult immunisation schedule

Answer 5

1. Hep B
2. Tdap
3. PCV (Pneumococcal conjugate)
4. PPSV (Pneumococcal polysaccharide)
5. MMR
6. HPV
7. VAR (Varicella)
8. INF (Influenza)

Question 6

What are the three broad considerations when using vaccines?

Answer 6

1. Effectiveness
2. AE
3. CI and Precautions

Question 7

What factors can affect the effectiveness of vaccines?

Answer 7

1. Type of vaccine
2. Patient age and immune status
3. Site of vaccine administration
4. Cold chain problems

Question 8

Name some CI and precautions in vaccines

Answer 8

1. Reasons why patient cannot get vaccine at this time
2. Allergy
3. Currently ill
4. Pregnancy in live vaccines
5. Immunocompromised in live vaccines
6. Precaution: Bleeding risk (e.g. on warfarin/low plt count)

Question 9

Most vaccines can be administered simultaneously or within same day without altering efficacy and AE.

What are the two exceptions to this rule?

Answer 9

1. PCV and meningococcal conjugate vaccine in patients with functional/anatomical asplenia.
   - 4 weeks interval between administration
2. Live vaccines via IM/SC must space 28d apart

Question 10

List the components that make a vaccine and their function

Answer 10

1. Active component to elicit immune response
2. Adjuvants to enhance response
3. Antibiotics during manufacturing process to prevent bacterial contamination. Removed before vaccine is complete
4. Stabilisers to ensure shelf-life stability and efficacy
5. Preservative to prevent contamination, usually for multi-dose vaccine
6. Trace components like formaldehyde to deactivate virus and detoxify bacteria

Question 11

List and briefly describe the 5 type of vaccines

Answer 11

1. Live attenuated
2. Inactivated vaccine (i.e. whole, killed)
   - Pathogen killed before introduction to body
3. Subunit vaccine (protein/polysaccharide/conjugate)
   - Isolated part of pathogen
4. Toxoids
   - Inactivated toxins from pathogen
5. Recombinant vaccine
   - Produced with genetic engineering
   - May not contain actualy virus
   - Can contain modified strain of virus

Question 12

List the routes of transmission of common infectious disease and some vaccines available to prevent such infections

Answer 12

1. Respiratory (airborne/droplets)
   - Flu, BCG, H.influenzae, MMR, etc.
2. Food and Water
   - Hep A, typhoid, cholera, rotavirus
3. Vector-borne
   - Yellow fever, Japanese Encephalitis, Dengue
4. Blood & body fluids (sexual/mother-to-child)
   - Hep B, HPV
5. Contact (e.g. bites, cuts)
   - Tetanus, rabies, shingles