WEEK 3 - UK Vaccination Strategy

Question 1

What is the UK Vaccination Programme

Answer 1

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

Question 2

Whats the difference between viable and non-viable vaccines

Answer 2

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)

Question 3

List the 5 Vaccines (lecture focused on) and what they protect against

Answer 3

1. DTaP - Diphtheria, Tetanus and Pertussis
2. Hib - Menangitis
3. PCV - Pneumococcal Infections
4. MenC - Meningitis
5. MMR - Measles, Mumps and Rubella

Question 4

DTaP Vaccine

What it protects against, whats in the vaccine, ages given at

Answer 4

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

Question 5

Hib (Haemophilus influenzae type b) Vaccine

What it protects against, whats in the vaccine, ages given at

Answer 5

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

Question 6

What are the signs and symptoms of meningitis

Answer 6

• 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)

Question 7

PCV (Pneumococcal Conjugated Vaccine)

What it protects against, whats in the vaccine, ages given at

Answer 7

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

Question 8

MenC Vaccine

What it protects against, whats in the vaccine, ages given at

Answer 8

Protects against meningitis

Given as a single injection at ages 1 and 14 years old

Question 9

Polio and its Vaccine

Answer 9

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

Question 10

MMR Vaccine

What it protects against, whats in the vaccine, ages given at

Answer 10

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

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)