WEEK 3 - UK Vaccination Strategy Flashcards
What is the UK Vaccination Programme
Its the routine immunistaion schedule of various vaccines, what they protect against and the age its given at
- The youngest age that vaccines are adminstered at is 8 weeks
- not administered to newborns as they have antibodies from mother which could interfere with vaccine
AIM:
- protect population by inducing herd immunity (min. 80% protection against disease is required)
- Effectiveness of vaccine and uptake of vaccine contributes to herd immunity and protection
- Compliance (i.e. parents allowing child to receive vaccien) influences herd immunity
Whats the difference between viable and non-viable vaccines
Viable / Live-attenuated
- Better at eliciting mucosal protection
- ↑ risk of infection (vaccine can revert + infect immunocompromised)
- Not commonly used
Non-viable / Inactivated (killed)
- More commonly used due to improved safety
- Usually administered more than once as they don’t elicit good immune responses (like viable vaccines)
List the 5 Vaccines (lecture focused on) and what they protect against
- DTaP - Diphtheria, Tetanus and Pertussis
- Hib - Menangitis
- PCV - Pneumococcal Infections
- MenC - Meningitis
- MMR - Measles, Mumps and Rubella (viable / live attenuated)
DTaP Vaccine
What it protects against, whats in the vaccine, ages given at
Protects against Diphtheria, Tetanus and Pertussis (whooping cough)
Whats in the Vaccine:
Diphtheria toxoid
- cell-free diptheria toxoid (been made non-toxigenic BUT still immunologically protective)
- triggers antibody response = protection
Tetanus toxoid
- cell-free tetanus toxoid (from Clostridium tetani)
- triggers antibody response
- c. tetani occurs in wounds, germinates + produces spores which prodcue toxin
- can be administered prophlactically to adults with deep, dirty wounds
Pertussis
- acellular pertussis components are used not whole cell or live organism
- protects against colonisation
- Its a triple vaccine given in 1 dose / injection
- Given at ages: 8, 12 and 16 weeks AND at 3 years 4 months
- Non-viable / Inactivated vaccine
Hib (Haemophilus influenzae type b) Vaccine
What it protects against, whats in the vaccine, ages given at
Protects against Meningitis and Haemophilus influenzae type b infection
Whats in the Vaccine:
- Capsular polysaccharides from Hib bacteria
- its non-immunogeneic therefore is conjugated to a diptheria toxoid / protein to make vaccine more effective / immunogenic
- Given at ages: 8, 12 and 16 weeks AND at 1 year
- as younger children are more at risk - Non-viable / Inactivated vaccine
What are the signs and symptoms of meningitis
- Non-blanching rash
- Fever
- Nausea and vomitting
- Severe headache
- Stiff neck
- Convulsions / seizures
- Severe muscle pain
Babies / toddler specific signs
- Bulging fontanelle (sign of pressure around brain)
- Irritability
- Unusual crying
- Refusing food
- Drowsy, floppy or unresponsive
NOTES:
- Fatality rate = 5%
- Danger from infection decreases with age (higher risk in younger children)
PCV (Pneumococcal Conjugated Vaccine)
What it protects against, whats in the vaccine, ages given at
Protects against pneumococcal infections e.g. pneumonia, septicaemia, meningitis
- 7 valent vaccine
Whats in the Vaccine:
- Parts of polysaccharide coat from 7 serotypes of pneumococcus bacteria have been conjugated to protein
- its non-immunogeneic therefore is conjugated to make more effective / immunogenic
- as polysaccharide vaccines do NOT stimulate long-lasting antibody response in young children
- Given at 12 weeks AND a booster at 1 year
- children < 2 have increased risk
- Non-viable / Inactivated vaccine
NOTE ALTERNATIVE is PPV
(PPV = polysaccharide pneumococcal vaccine)
- Protect against same species of bacteria but have different composition
- 23-valents
- Given to older people (>65) to prevent against pneumonia
- Polysaccharide is used as adults can elicit better immune response against this in comparison to conjugated
MenC Vaccine
What it protects against, whats in the vaccine, ages given at
Protects against meningitis
Given as a single injection at ages 1 and 14 years old
Polio and its Vaccine
Polio -
- can be a trivial disease in most cases but can lead to paralysis, nerve damage etc. for some (severe)
In UK SALK vaccine is used ~ IPV (inactivated polio vaccine)
- polio is almost eradicated
- IM vaccine
- introduction of vaccine in 1950s caused reduction in death and paralysis rate
MMR Vaccine
What it protects against, whats in the vaccine, ages given at
Protects against Measles, Mumps and Rubella
Measles:
- Caused by paramyxovirus
- Symptoms: fever, malaise, cough, conjunctivitis, spots on mucous membrane
- Transmission: airborne / droplets
- Complications: pneumonia, otitis media, diarrohea, convulsions, encephalitis (inflamation of brain), SSPE (very severe, fatal, rare), death
- Elicits IgG antibodies
Mumps:
- Caused by paramyxovirus
- Symptoms: bilateral or unilateral neck glan swelling
- Transmission: airborne
- Complications: neurological (inc. meningitis, encephalitis), ovary or testes inflammation (lead to infertility), kidney inflam., deafness
Rubella:
- Caused by togavirus
- Symptoms: fever, malaise, conjunctivitis
- Transmission:
- Complications: encephalitis, thrombocytopaenia, eye defects, deaf,
- severe if rubella acquired in pregnant women causing CRS
- Its a triple vaccine given in 1 dose / injection
- Given at ages: 1 and 14 years old
- given to all genders (orignally was only given to females) - Viable / Activated vaccine
NOTE:
- had a decline in uptake of vaccine due to published articles linking vaccine to autism developemnt in children (FALSE)
Measles - Role of HPT
EBL Question
- Is a notifiable disease as its highly infectious (R0 = 18)
- higher R0 = more infectious it is - Measle cases must be notifed to HPT so they can idenitfy potential exposed individuals, asess vaccination status of population + promote catch-up campains
- HPT collect data on measle cases, source of infection, demographics, vaccine history etc. (surveillance)
- HPT provide guidance to healthcare facilites on infection prevention, management + control on transmission of disease
HPT = health protection team
What has caused an increase in measles cases
EBL
- Vaccine uptake has declined
- Vaccine hesitancy due to autism causation speculation (not true)
- Vaccine misinformation (e.g. causes sudden infant death, immune dysfunction)
- Global travel has increased
- Covid-19 pandemic (disrupted routine immunisation schedules)
- Weak health infrastructure (e.g. in war-torn countries, low-income regions)
= poor access to vaccines
What are the potential complications of measles
EBL
- Otits media
- Pneumonia
- Encephalitis (inflammation of brain)
- Convulsions / seizures
- Diarrhoea leading to dehydration
- Malnutrition
- Blindenss (vit. A deficiency)
- Premature death
- Hospitilisation
- Respiratory complications
What are the risks of measles exposure in naturally-acquired immunity, non-vaccinated and pregnant individuals
Naturally-acquired immunity:
- To determine if have long-lasting immunity if havent received MMR vaccine but may have been exposed to measles = BLOOD TEST
- Blood test to check for IgG antibodies against measles
Non-vaccinated:
- Risk of complications
- If immunocompromised = more susceptible
Non-vaccinated and pregnant individuals:
- Have ↑ risk of severe complications
- e.g. still birth, miscarriage
Explain how feverPAIN score is used to support decision-making in sore throat and reduce antimicrobial resistance
EBL
Prevents overuse of antibitoitcs
- Should only be given antibitoitcs if have score of 4 to 5
- May be given backup Rx if have score of 2-3
- Score of 0 to 1 does NOT require antibioitcs
