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M301 > W14 Vaccines and UK Vaccination Schedule (CW) > Flashcards

W14 Vaccines and UK Vaccination Schedule (CW) Flashcards

1
Q

What is a Vaccination?

A
  • Simple, safe effective way of protecting population against harmful disease prior to contact with them
  • Use of body’s natural defences to build resistance to infectious diseases
  • Improve immune system strength and function
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2
Q

Why do we vaccinate? (6)

A
  • Protect people against serious infectious disease
  • If not immunised themselves then reliance on others to be immunised
  • Always some of the population left unprotected for medical reasons
  • i.e. CI for certain vaccines
  • Decreased/lower vaccination rate = increased risk of disease outbreaks
  • Only stop vaccination when disease eradicated
  • Build herd immunity
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3
Q

What is Smallpox?

A
  • One of the deadliest disease to humans
  • The only disease to have been eradicated – glabal public health milestone
  • Symptoms – Fever, vomiting, mouth sores, fluid filled lesions on boyd
  • Could cause death within 2 weeks of infection
  • Survivors left with permanent life changing problems – Blindness, infertility
  • Highly infectious
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4
Q

How do vaccines work?

A
  • Teach immune system to create antibodies to fight disease
  • When exposed to the disease immune system will be able to fight and contain
  • Recognise virus or bacteria
  • Generate antibodies
  • Immune memory against the disease
  • Vaccines do not cause the illness
  • Active immunity
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5
Q

What is active immunity?

A
  • Long term
  • Use of inactivated or attenuated live organisms or their products
  • Protective effect
  • Cell-mediated immunity and serum antibodies (antibody-mediated)
  • Immune mechanism permanently sensitised
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6
Q

What is passive immunity?

A
  • Short term
  • Placental passage of antibodies and passage through colostrum and breast milk
  • Also, through injection of immunoglobulin
    -HNIG
    -Specific immunoglobulins
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7
Q

What is herd immunity?
What could it be influenced by? (3)

A
  • Also termed population immunity
  • Enough people immunised to prevent spread and protect those who are vulnerable
  • Vaccination preferred method over allowing disease to spread – saves lives
  • Example – Covid19 immunisation
  • % to achieve herd immunity varies between disease
  • Only applies to diseases spread by person to person contact
  • May be influenced by:
  • environmental factors
  • immune status of patient
  • virulence of disease
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8
Q

What is the Joint Committee on Vaccination and Immunisation (JCVI) ?

A
  • Advises UK health departments on immunisation
  • Independent group
  • 3 meetings a year – can see meeting inutes & agendas online
  • Take into account:
    -Need for and impact of vaccines
    -Quality of vaccines
    -Best strategies for immunisation
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9
Q

What is The Green Book?

A
  • a.k.a “Immunisation against infection disease”
  • DoH guideline for UK immunisation
  • Developed and updated as result of recommendations from Joint committee on
    Vaccination (JCVI)
  • 1st released in 2006
  • Monthly updates every year
  • Split into 2 parts
  • Part 1 – Principles, practices & procedures
  • Part 2 – The diseases, vaccinations & vaccines

12 chapters covering various aspects of
vaccines and vaccination/immunisation

2023 – Now expanded to include:
* Covid19
* Human Papilloma Virus (HPV)
* Respiratory Syncytial Virus
(RSV)
* Rotavirus
* Shingles
* Monkeypox

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10
Q

Consent to vaccinate:
How can consent be gained? (2)
Age for consent?

A
  • Must ALWAYS be obtained before immunisation
  • May be written or verbal
  • Must be given freely, voluntarily and without coercion
  • Appropriately informed patient with mental capacity to consent
  • Child under 16 – someone with parental responsibility unless….
  • they understand risk/benefit (‘Gillick-competent’)
  • At age 16 can consent for themselves
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11
Q

Consent regarding parental responsibility:
Do the parents/carer need to be present throughout?

A

the time of immunisation
* Children can be bought for immunisation by a person without parental responsibility as long as:
-Person with parental responsibility has consented in advance
-Person with parental responsibility has arranged for other person to provide the necessary consent i.e. they asked that person to take the child to appointment, consider information and agree consent as appropriate.

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12
Q

Childhood immunisations

A

8 weeks
* DTaP/IPV/Hib/HepB
* MenB
* Rotavirus

12 weeks
* DTaP/IPV/Hib/HepB
* Pneumococcal
* Rotavirus

16 weeks
* DTaP/IPV/Hib/HepB
* MenB

12 months
* Hib/MenC
* MMR
* MenB
* Pneumococcal

2 and 3 years+
* Annual flu vaccine

Pre-school (3yrs 4mths – 5yrs)
* dTaP/IPV
* MMR

Boys & Girls 12-13yrs
* HPV

14 years
* MenACWY
* Td/IPV

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13
Q

DTaP/IPV/Hib/HepB
What is diphtheria

A

Diphtheria
* Droplet & contact infection
* URTi & sometimes skin
* Diptheria toxin produced by Corynebacterium diptheriae/ulcerans
* Membrane-forming exudate – membranous pharyngitis
* Enlarged lymph nodes – ‘bull neck’
* Incubation period 2-5 days
* Very rare in the UK – may not be spotted by clinicians

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14
Q

DTaP/IPV/Hib/HepB
Diphtheria vaccine: how is it administered?

A
  • Vaccine made from cell-free purified toxin
  • Extracted from C. diptheriae
  • Vaccine has higher dose of toxoid for under 10s than over 10s
  • IM administration into upper arm or thigh
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15
Q

DTaP/IPV/Hib/HepB
What is Tetanus?

A
  • Induced by tetanus toxin released by:
    -Clostridium tetani
  • Spores present in soil & manure
  • Enter the body through puncture wound, burn or scratch
  • Symptoms - muscular rigidity + contractions…lockjaw
  • Incubation period 4-21 days
  • Can never be eradicated
  • Fatal in 10-90% of cases
  • 1984-2017 – 293 cases of tetanus in UK
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16
Q

DTaP/IPV/Hib/HepB
What is included in the tetanus vaccine?

A
  • Vaccine made from cell-free purified toxin extracted from C. tetani
  • Primary imms. contain 40IU tetanus toxoid
  • Boosters contain minimum 20IU
  • Inactivated vaccine
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17
Q

When should we advise an anti-tetanus jab?

A
  • Higher risk when wound is:
  • deep
  • dirty with soil/manure
  • Clean wound ASAP
  • Partial/no vaccination or unsure – need booster
  • Full vaccination (five doses) - no need
  • Vaccine contains inactive tetanus toxoid
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18
Q

DTaP/IPV/Hib/HepB
What is pertussis?

A

=Whooping cough
* Highly infectious – caused by Bordetella pertussis
* Droplet infection
* Insidious onset catarrhal stage – most infectious stage
* irritating cough – gradually becomes paroxysmal (whoop) – lasts 2-3 months
-apnoea (esp. in young infants)
-Bronchopneumonia
-post-tussive vomiting / cerebral hypoxia

  • Incubation period 6-20 days
  • 1950s – > 120,000 cases/yr, presently ~ 1,000 cases/yr
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19
Q

DTaP/IPV/Hib/HepB
What is the vaccine for Pertussis (whooping cough)?

A
  • Acellular vaccine
  • Changed in 2004 from whole cell to acellular
  • Highly purified components of B. pertussis
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20
Q

DTaP/IPV/Hib/HepB
What is poliomyelitis?

A

individual
* GI tract invasion by polio virus serotypes(1-3)
* Replication in the gut
* High affinity for nervous tissue
* Spread in the bloodstream to susceptible tissues or by axonal transport to the CNS
* Can be asymptomatic or:
* fever / aseptic meningitis / paralysis
* Headache / GI disturbance / malaise / stiffness of the neck and back

  • Incubation period 3-21 days
  • infectious immediately before and 1-2 weeks after onset of paralytic disease
  • 1950s – 8,000 cases/yr paralytic strain
  • no indigenous outbreak since late 1970s
  • only 677 cases worldwide by 2003
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21
Q

DTaP/IPV/Hib/HepB
What are the components for the polio vaccine?

A
  • Inactivated vaccine
  • Made from polio virus strains Mahoney, MEF-1 and Saukett
  • Strains grown in Vero cell culture – isolated kidney epithelial cells of African green monkeys
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22
Q

DTaP/IPV/Hib/HepB
What is Haemophilus influenzae type B? (Hep B)

A
  • Droplet or close contact infection – carried in the nose & throat with no symptoms
  • Haemophilus influenzae - serious invasive disease, especially in young children
  • Invasive disease caused by encapsulated strain – 6 serotypes (a-f)
  • Type b most prevalent before vaccination introduced
  • Presents as:
  • meningitis +/- bacteraemia (60%) – (fatality rate 4-5%)
  • epiglottitis (15%)
  • bacteraemia (~ 10%)
  • septic arthritis / osteomyelitis /cellulitis / pneumonia / pericarditis
  • Non-capsulated strains of H. influenzae linked with otitis media & chronic bronchitis
  • Before immunization introduced
  • 1 in every 600 children developed some form of invasive Hib before age 5
  • 1998 – 21 cases vs 803 in 1991 (conjugate vaccine introduced 1992)
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23
Q

DTaP/IPV/Hib/HepB
What the components of the Hep B vaccine?

A
  • Vaccine made from capsular polysaccharide extracted from Hib cultures
  • Linked to protein
  • Conjugated with tetanus or diptheria toxoid
  • Increases immunogenicity in young children
  • Attenuated response with DTaP/Hib compared to DTwP/Hib
  • IM vaccine
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24
Q

DTaP/IPV/Hib/HepB
What is Hepatitis B?
How is it transmitted?

A

=Liver infection caused by hepatitis B Virus
* Sub-clinical or a flu-like illness
* Jaundice in 10% of younger children & 30-50% of adults
* Acute infection – fulminant hepatic necrosis – fatal
* Anorexia, nausea, right upper abdominal ache, mild fever, malaise
* Darkened urine, light coloured faeces

Transmitted by parenteral exposure to infected blood or body fluids:
* Vaginal/anal intercourse
* Blood-blood contact through needle sharing, needlestick injuries
* Perinatal transfer from mum to child
* Bite by infected person (rare)
* Blood transfusion infection – rare as blood screened prior to donation today

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25
Q

DTaP/IPV/Hib/HepB
Hep B (info only?)

A
  • Incubation period 40-160 days
  • Current infection detected by HBsAg in serum
  • Chronic Hep B = HBsAg in serum for 6 months+
  • 250 million
  • people worldwide are chronically infected
  • UK low prevalence
  • Vaccine given combined in childhood
  • Contains HBsAg prepared from yeast cells using recombinant DNA technology
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26
Q

DTaP/IPV/Hib/HepB
What are the common side effects? (4)
Rare SE? (5)

A
  • Mild fever
  • Irritability, crying, restlessness, drowsiness
  • vomiting +/or diarrhoea
  • Local effect at inj. site – redness, heat, itching

Serious but rare
* Febrile convulsions
* High fever
* Child floppy and less responsive
* Unusual, high-pitched cry
* Extensive swelling of vaccinated limb

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27
Q

What does DTaP/IPV/Hib/HepB stand for?

A

Diphtheria / Tetanus / acellular Pertussis / Inactivated Poliovirus / Haemophilus influenzae type b/Hepatitis B

28
Q

What is rotavirus?

A
  • RNA virus contained within a protein capsule
  • Strains classed on outer layer proteins VP7 (G)& VP4 (P)
  • Highly contagious:
  • Faecal-oral and respiratory transmission
  • Good hygiene can help prevent spread
  • only require 10-100 virus particles to become infectious – can render
    hygiene measures ineffective
  • Common cause of gastroenteritis
  • Recovery within a few days
  • 1 in 5 need to see GP
  • 1 in 10 of these will be hospitalised with complications such as dehydration
  • Rare deaths: 3 to 4/yr in E&W
29
Q

Rotavirus:
What are the components of the vaccine?
Doses?

A
  • Rotarix vaccine used in the UK
  • Oral live attenuated vaccine
  • Derived from virus initially isolated from 15-month old child – attenuated by serial cell culture
    passage
  • 1.5ml dose at 8 weeks and 12 weeks of age – complete cours eneeded before 16 weeks of age
  • Orally administered vaccine
30
Q

What are the SE of the rotavirus vaccine?

A
  • Diarrhoea
  • Fatigue
  • Fever
  • Reduced appetite
  • Vomiting
  • Abdo pain
31
Q

What is Pneumococcal disease?

A
  • Infections caused by Strep. Pneumoniae – Gram +ve , multiple serotypes
  • Carried in the nasopharynx
  • Droplet or close contact infection
  • Incubation period 1-3 days
  • Invasive disease can cause pneumonia / bacteraemia / meningitis / peritonitis
    -Mortality rate 10 – 20%
  • Mild infection causes sinusitis or otitis media
  • Increasing anti-microbial resistance levels (~2.5% to penicillin and 11.2% to erythromycin in E+W)
  • Most common in < 5 yrs and > 65yrs – vaccinate in these groups
32
Q

Pneumococcal
SE?

A

2 types of vaccine:
* Conjugate
* Polysaccharide

  • Variance in number of serotypes
  • 10-23
  • Prevenar13 given at 12 weeks and 12 months of age – 0.5ml dose given IM
  • Side effects – Local injection site effects, low grade fever
33
Q

What is Meningococcal disease?

A
  • Caused by systemic bacterial infection by Neisseria meningitidis
  • 12 Meningococcal capsular group = A, B,C , E , H, I, K, L ,W, X, Y, Z
  • B, C, W & Y most common causes of invasive disease in the UK
  • Nasopharyngeal colonisation
  • Droplet or direct contact infection
  • meningitis and septicaemia
  • prodromal symptoms - malaise / pyrexia / vomiting
  • headache / photophobia /drowsiness / confusion / pain / rash
  • mortality 7-8%
  • incidence most common in infants
  • Cases have decreased by > 97% in vaccinated population
34
Q

What are the meningococcal vaccines? (4)

A

1 &2: Hib/MenC Conjugate Vaccine
* 12 months old
3: Quadrivalent ACWY conjugate vaccine
* Age 14
4: Men B protein vaccine
* 8 weeks, 16 weeks, 12 months

All given IM to upper arm/thigh

35
Q

SE of meningococal vaccine?

A
  • local effects at inj. Site
  • Fever
  • Irritability
  • Crying
  • Drowsiness (esp in infants + toddlers)
36
Q

MMR:
What is measles?

A

Measles
* Acute viral illness – morbillivirus of paramyxovirus family
* Droplet transmission
* Fever, malaise, coryza, conjunctivitis, cough
* Koplik spots
* Macropapular rash on head, trunk and limbs
* Incubation period around 10 days
* Infectious from beginning of prodromal phase until 4 days after rash appears
* Complications (1 in 15 cases) – otitis media, bronchitis, pneumonia, convulsions, encephalitis (1 in 5,000 cases), SSPE (subacute sclerosing panencephalitis)
* Lab confirmation of suspected cases needed

37
Q

What features are strongly suggestive of measles? (3)

A

Rash for at least 3 days
Fever for at least one day and
At least one of the following- cough, coryza or conjunctivitis

38
Q

MMR:
What is Mumps?

A
  • Acute viral illness
  • Droplet transmission
  • Parotid swelling (unilateral or bilateral)
  • Fever, headache, malaise, muscle aches a few days before parotid swelling appears
  • May be asymptomatic

Complications
* Pancreatitis, oophoritis, orchitis, deafness
* Neurological complications – meningitis & encephalitis

  • Incubation period 14-25 days
  • Infectious for several days before parotid swelling and for several days after
  • Progressive decline after MM vaccine introduced in 1998 but…
  • Cases rising since 1999
  • Most cases in people too old to have been given offered MMR
39
Q

MMR:
What is Rubella?
What are the complications?

A
  • Mild viral disease – caused by togavirus
  • Droplet transmission
  • Mild prodromal stage
  • Fever, malaise, coryza, mild conjunctivitis
  • Transient erythematous rash & lymphadenopathy
  • Complications
  • Maternal infection – mental handicap, cataract, deafness, cardiac abnormalities,
    growth retardation, inflammation (brain, liver, lungs, bone marrow)
  • Infection in first 8-10 weeks = damage to 90% of surviving infants, multiple defects
  • Congenital Rubella Syndrome (CRS)
  • Thrombocytopenia, encephalitis, arthritis
  • Incubation 14-21 days – rash usually appears 14-17 days after exposure
40
Q

What are the components of the MMR vaccine?

A
  • Live-attenuated vaccine of MMR strains
  • MMRVaxPRO or Priorix
  • 0.5ml dose at 12 months and 3yrs 4 months
  • IM to upper arm or thigh
41
Q

What are the SE of the MMR vaccine?

A
  • 1st dose
  • Malaise, fever, rash
  • Febrile convulsions
  • Parotid swelling
  • Thrombocytopenia
  • Muscle aches, arthritis
  • Side effects less common with second dose
42
Q

MMR and Autism link?
(for info

A
  • 1998 Andrew Wakefield & 12 colleagues
  • Lancet paper
  • Suggestion that MMR may cause behavioural regression and pervasice development disorder in children
  • Small sample size – 12, uncontrolled study
  • Huge publicity worldwide
  • Caused vaccination rates to drop due to parental concern
  • Retraction by majority of the authors
  • Funded by lawyers engaged with lawsuits by parents against vaccine companies
  • Complete retraction by the Lancet in 2010
  • Fraudulent data, falsified results and ethical violations
43
Q

What is Flu/Influenza?

Complications?

A
  • Acute viral infection of respiratory tract
  • 3 types – A, B, C
  • A &B are responsible for most clinical illness
  • Highly infectious, DROPLET TRANSMISSION
  • 1-3 day incubation period
  • Children have same symptoms as adults
  • Fever, chills, headache, joint and muscle aches, fatigue
  • More unpleasant for children

Complications:
* otitis media
* bronchitis
* pneumonia
* tonsillitis
* meningitis
* encephalitis

44
Q

Flu symptoms? (FACTS)

A

Fever
Aches- sudden, unexplained
Chills- unexplained
Tiredness- sudden, extreme
Sudden Symptoms- severe, come on without warning

45
Q

Features of the Flu Vaccine?

A
  • WHO monitors epidemiology for flu worldwide
  • Recommends which strains should be included in vaccine for winter ahead
  • UK vaccines currently quadrivalent – 2 Flu A and 2 Flu B strains
  • Most vaccines made from virus grown in hens eggs – CI in pats with egg allergies
  • Some grown in insect cells
  • Moving towards trivalent vaccines as Yamagata strain low detection in the UK
  • Children receive nasal vaccine from Age 2
  • 0.1ml dose in each nostril
  • Live-attenuated vaccine
  • Full immunity within 14 days of vaccination
46
Q

SE of flu vaccine?

A
  • Rhinorrhoea/nasal congestion
  • Reduced appetite
  • Weakness
  • Headache
47
Q

What are the treatments for Post-immunisation pyrexia?

A
  • Non-pharmacological treatment preferred first

Paracetamol 120mg/5ml Susp
* 2.5ml (60mg) for 1 dose
* Repeat after 4-6 hours if needed
* Max 2 doses in -3 months, 4 doses in 4months

  • Ibuprofen 100mg/5ml Susp
  • 2.5ml (50mg)for 1 dose
  • Repeat after 6 hours id needed
  • Seek medical help if fever persists
48
Q

What is Human Papillomavirus (HPV)?

A
  • Double stranded DNA virus
  • Infects squamous epithelia in skin, upper resp. tract and anogenital tract
  • Approx. 100 types of HPV – ~40 infect genital tract
  • Most infections asymptomatic and self-limiting
  • Causes genital warts & anogenital cancers in men & women
  • Cervical cancer cause
  • Transmission through sexual contact with infected individual
  • Increased risk of exposure with increased number of sexual partners, new partner and sexual hx of partner
  • Condom use reduces transmission…does not eliminate
  • Can be transmitted from mum to baby
49
Q

Human Papillomavirus (HPV)
Cervical ca:

A
  • One of the commonest cancers amongst women worldwide 570k new cases & 311K
    deaths in 2018
  • Vaccination prevents infection and disease
  • Early detection of HPV infection and cervical abnormalities through cervical screening
  • UK screening programme
  • 1974-2004 – Mortality rate declined by 60% due to screening
  • Screening every 3 years for women aged 24.5-49
  • Screening every 5 years for women aged 50-64
  • Improved testing system in 2019
  • Peak incidence women aged 30-34
50
Q

HPV VACCINATION features:

A
  • 2008 review on impact of cost-effectiveness of HPV vaccination
  • JCVI recommended universal programme in girls aged 12-13 in schools plus catch up
    programme for girls aged 13-18
  • Started in September 2008
  • Cervavix used until 2012, then Gardasil since Sept 2012
  • Quadrivalent vaccine - 3 dose schedule
  • 0.5ml 1st dose then 0.5ml one month later then 3rd dose after at least 3 months
  • IM injection to upper arm
  • July 2018 - JCVI advised programme extended to include boys
  • September 2019 – Immunisation programme extended to include boys
51
Q

What are Notifiable diseases?

A
  • Diseases where we must notify local health
    authorities of suspected or confirmed cases
  • To help detect and monitor possible local or
    national outbreaks and epidemics
  • Statutory duty for Registered Medical
    Professionals
  • Online notification form to be completed
    immediately on suspecting a notifiable
    disease – DO NOT WAIT FOR LAB
    CONFIRMATION
  • Send form to local officer within 3 days or
    notify verbally within 24 hours by phone or
    secure email/fax
  • Local officer then passes notification on to
    UKHSA within 3 days (24hrs if urgent)
52
Q

What is Shingles?

A
  • Herpes Zoster
  • Caused by reactivation of latent varicella Zoster virus (VZV)
  • Primary VZV infection during childhood…….CHICKENPOX
  • VZV enters sensory nerves and travels nerve to sensory dorsal root ganglia
  • Permanent latent infection
  • Reactivation of latent virus leads to clinical manifestations of shingles

Reactivation due to suppressed immune system
* Immunosuppressant drugs
* HIV infection
* Malignancy
* Elderly age

53
Q

Shingles
Symptoms?
Complications?

A
  • First signs - Tingling sensation of skin and pain in affected area of skin, intense itching
  • Headache, photophobia, fever malaise
  • Vesicular rash within days/weeks in affected area – last 2-4 weeks
  • Persistent pain at site of rash after 4 weeks– post herpetic neuralgia
  • Higher incidence in elderly
  • Pain for more than 90 days after rash onset, can last up to 6 months
  • Commonly on chest and abdomen but also scalp, face, eyes & genitals

Complications
* Paresis
* Facial palsy
* Herpes zoster ophthalmicus
* Keratitis
* Corneal ulcer
* Retinits, optic neuritis +/-glaucoma

54
Q

Shingles (info)

A
  • Can’t catch shingles
  • Contact with fluid from active vesicles/lesions can transfer VSV
  • Can cause chickenpox
  • Immunocompromised/at risk individuals need post exposure management
  • No evidence that shingles can be acquired from an individual who has chickenpox but….you can get varicella infection
55
Q

Shingles vaccines: (2)

A

Shingrix
* From age 65
* Recombinant vaccine containing VZV glycoprotein E antigen
* 2 x 0.5ml doses 8 weeks apart
* Administer to deltoid in upper arm

Zostavax
* Age 70-79
* Live vaccine
* 1 x 0.65ml dose
* Shingrix now preferred since September 2023
* Also given to immunocompromised individuals due to disease or treatment

56
Q

SE of Shingles vaccines?

A

Side Effects
* Diarrhoea
* Fatigue
* Fever
* Headache
* Malaise
* Local site reaction
* Lymphadenopathy
* Chills

57
Q

What is Tuberculosis (TB)?

A
  • Caused by infection with Mycobacterium tuberculosis
  • Can affect any part of the body
  • Most common is pulmonary TB – 55% of cases in the UK
  • Symptoms vary and depend on site of infection
  • Fever, loss of appetite, weight loss, night sweats, lack of energy
  • Cough, haemoptysis
  • Slowly progresses if left untreated – fatal
  • Nearly all UK cases acquired – droplet infection from infected person
  • Prolonged close contact – living in same house
  • Elimination, latent, active TB
58
Q

Tuberculosis (TB) - BCG Immunisation Programme

A
  • Introduced 1953
  • Multiple changes over years due to changing trends in TB epidemiology
  • Initially targeted at children of school-leaving age (Age 14 in those days)
  • Peak incidence was in young, working age adults
  • 1960s
  • UK born TB rates had declined
  • Most cases in migrants from high prevalence countries & family members
  • Selective neonatal immunisation introduced to protect infants born in the UK to parents from high
    prevalence countries
  • 1990s
  • BCG vaccination uptake in schools circa 70%
  • 2005 – BCG vaccination programme in schools stopped due to further decline of TB incidence
  • Now a risk based programme – neonatal programme still ongoing for children most at risk of exposure
59
Q

Tuberculosis (TB)- features of the BCG vaccine?

A
  • Bacillus Calmette-Guerin
  • Live attenuated strain deived from M. bovis
  • Intradermal administration to middle of left upper arm
  • Skin test prior to vaccination
  • Positive result = TB exposure
60
Q

What is Hepatitis A?

A
  • Liver infection caused by Hep A virus
  • Generally but more severe with age
  • Asymptomatic disease common in children
  • Jaundice in 70-80% of adult cases
  • Fatality rate low but greater in older people or those with liver disease
  • Transmitted by faecal-oral route through contaminated food or drink
  • Number of outbreaks in UK over recent decades amongst men engaging in sex with other men – 2016-17 doubled case numbers
  • 201 outbreak amongst drug users in Aberdeen
61
Q

Tuberculosis
Side effects of BCG vaccine?

A
  • Abdo pain
  • Reduced appetite
  • Muscle aches
  • Diarrhoea
  • Fatigue
  • Fever
  • Headache
  • Local skin reactions
62
Q

Hep A vaccines:

A

Monovalent vaccine
* Strains grown in human diploid cells
* Havrix & Avaxim
* Vaqta

Combined Hep & HepB vaccine
* Purified inavtivated HepA and ourified recombinant Hep B surface antigen
* Twinrix
* Ambirix

Combined Hep A & typhoid
* Purified inactivated Hep A & purified Vi capsulsar polysaccharide typhoid
* Viatim

63
Q

What is Covid-19
What are the symptoms?

A
  • Respiratory disease
  • Caused by SARS-CoV-2 virus
  • 4 major structural proteins – S,M,E,N
  • S protein main antigenic target – binds to ACE2 on host cells
  • Droplet transmission from person-person contact

Symptoms
* Headache
* Fatigue
* Cough
* Muscle aches

Complications – pneumonia, acute respiratory distress, organ failure, death, Long COVID
Natural immunity lasts up to 1 year after previous infection

64
Q

Covid-19
Vaccination:

A
  • Mild disease in children
  • More severe disease in elderly & immunocompromised

Vaccination
* Target S protein
* mRNA vaccines – Pfizer, Moderna
* Adenovirus vector – AZ, Janssen
* Recombinant S protein – Novavax
* AZ vaccine extensively used in orimary vaccination campaign but no as a booster – no longer
available in UK
* Pfizer and Moderna used for bulk of UK programme
* Initial mass vaccination programme
* Now only for those at risk of more severe complications from covid19
* Provides around 6 months protection

65
Q

Examples of Travel Vaccinations?
Websites to access info for them?

A
  • Cholera
  • Hep A & B
  • Japanese Encephalitis
  • Rabies
  • Tetanus
  • Tick-borne encephalitis
  • Typhoid
  • Yellow Fever
  • Travel Health Pro - NaTHNaC - Country List (travelhealthpro.org.uk)
  • NHS Fit for Travel - Destinations - Fit for Travel
    -Search for destination and will advise which vaccines are required for travel within that country

M301 (78 decks)

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