Week 10_immunisations Flashcards
List 3 important effects of vaccines.
- individual protection
- herd immunity
- Reduction in morbidity and mortality from vaccine preventable infectious diseased and eventually certain cancers (cervical and liver)
Define herd immunity
Resistance of a group to invasion and spread of an infectious agent, based on the immunity of a high proportion of individual members of the group
List types of vaccines
- Live vaccines (attenuated, similar to non-disease causing organism)
- Killed/inactivated vaccines (heat, formalin, radiation)
- Acellular vaccines (capsule, flagella, part of the protein cell wall, subunit vaccines). Take component of virus or organism to create immune response. the part/mechanism that is disease causing is not present.
- Toxoid: Act as adjuvant to create immune response so that toxin of bacteria will be attacked in case of infection. Bacteria may multiply and spread, but if they’ve had vaccine, toxins will be inhibited. Does not alter immunity or spread.
- Adjuvants/conjugates: Agents added to increase immune response to vaccine.
Discuss immune responses to different types of vaccines:
Live:
- robust response
- has potential to cause disease so not to be used with immunocompromised
- lifetime immunity with 1 or 2 doses
Killed/inactivated:
- Less robust immune response
- no ability to cause disease
- Fewer adverse events or side effects
- required multiple doses and may require booster
- waning immunity
Acellular/toxoid/subunit:
- less robust immune response
- May require adjuvants or conjugates
- requires multiple doses and may require booster.
- Waning immunity
We are immunised for many diseases. How is the idea that our vaccine schedule means our body is being exposed to too many antigens, flawed?
The argument that vaccines expose us to too mnay Ags is flawed b/c back before vaccines, people were still exposed anyway, except that these diseases killed people they knew and the disease was still seen often. Now, disease hardly seen.
List the one ABSOLUTE contraindication to vaccination
Absolute contraindication to vaccination:
Anaphylactic response to vaccine or component
List relative contraindications
- immunocompromised (live vaccines)
- pregant or may be pregnant (live)
- recent (<4 weeks) (live)
- recent )=(,7mos) blood or blood products eg. immune globulin (11mons)
- GBS (influenza)
Should you vaccinate in the case of poorly documented vaccination history?
yes.
What are the 4 categories of adverse events?
- vaccine product related reaction
- Vaccine quality related reaction
- immunisation error related reaction
- immunisation anxiety related reaction
- coincidental event
What is the cold chain?
System of transporting and storing vaccines within the safe temperature range of +2 to +8C.
What are the stages in the chain?
Begins from time vaccine leaves manufacturer, continues through to the state or territory vaccine distribution centres and ends when the vaccine is administered.
What is the temperature to be aimed for? What is the acceptable range?
+2-+8C. Can reach +12C for a max of 15mins. Effects of temperature are CUMULATIVE and will destroy vaccines.
Which environmental exposures are capable of destroying vaccines?
- frozen
- allowed to get warm (<12C for < 15mins)
- Exposed to direct sunlight or UV light, including fluorescent light
What is the main requirement for a vaccine fridge?
A stable, uniform, and controlled temperature b/w +2 and +8C.
Also important:
- size- big enough to store enough vaccines to meet facility’s needs.
- enough space to ensure circulation around back and sides of refrigerator as per manufacturer’s instructions.
- inbuilt temp monitor
- alarm system to notify of temp changes/open doors
- chart recording system placed at bottom of refrigerator.
- How and how often should thermometers be checked and maintained?
Max and min or twice daily; before refrigerator is used for first time and at end of each day.
- on receipt of vaccines
- following a power failure
- hourly during outreach clinics
