Immunisation and prophylaxis

Question 1

What are the different types of vaccine?

Answer 1

Live attenuated
Inactivated (killed)
Detoxified exotoxin
Subunit of micro-organism (purified microbial products or recombinant)

Question 2

What are examples of live attenuated vaccines?

Answer 2

MMR
BCG
VZV
Yellow fever
Smallpox
Typhoid
Polio
Rotavirus

Question 3

What are examples of inactivated (killed) vaccines?

Answer 3

Polio
Hep A
Cholera
Rabies
Japanese encephalitis
Tick-bourne encephalitis
Influenza

Question 4

What are examples of detoxified exotoxin vaccines?

Answer 4

Diphtheria

Tetanus

Question 5

How are detoxified exotoxin vaccines made?

Answer 5

Treat toxin with formalin = toxoid

Question 6

What are examples of subunit vaccines?

Answer 6

Pertussis
Haemophilus influenzae type B
Meningococcus (group C)
Pneumococcus
Typhoid
Anthrax
Hep B

Question 7

What is a recombinant vaccine example?

Answer 7

Hep B

Question 8

What is the 6 in 1 vaccine?

Answer 8

Infanrix hexa
D = diphtheria
T = tetanus
aP = Bordetella pertussis
IPV = inactivated polio virus
Hib = Haemophilus influenzae b
HBV = hep B

Question 9

What immunisations do children typically get at 2 months?

Answer 9

• 6-in-1 vaccine
• Pneumococcal conjugate
• Rotavirus
• Men B

Question 10

What immunisations do children typically get at 3 months?

Answer 10

• 6-in-1 vaccine

- Rotavirus

Question 11

What immunisations do children typically get at 4 months?

Answer 11

• 6-in-1 vaccine
• Pneumoccocal conjugate
• Men B

Question 12

How many doses of the 6-in-1 vaccine are given?

Answer 12

3

Question 13

What immunisations do children typically get at 1 year?

Answer 13

• Hib/Men C
• MMR
• Pneumococcal conjugate
• Men B

Question 14

What immunisations do children typically get at 2-8yrs?

Answer 14

• Influenza nasal

Question 15

What immunisations do children typically get at 3-5yrs?

Answer 15

• 4-in-1 booster (DTaP/IPV)

- MMR

Question 16

What immunisations do girls typically get at 12-13yrs?

Answer 16

HPV

Question 17

What immunisations do children typically get at 14yrs?

Answer 17

• 3-in-1 booster (dT/IPV)

- Men ACWY

Question 18

How much coverage does herd immunity typically get?

Answer 18

90-95%

Question 19

What vaccines are specifically given to special patient and occupational groups?

Answer 19

BCG
Flu
Pneumococcal
Hep B
VZV
HSV (shingles)

Question 20

Who is given BCG vaccine?

Answer 20

• Infants in areas of UK with high annual incidence
• Infants with parents/grandparents born in country with high annual incidence of TB
• Children screened at school for risk factors
• New immigrants
• Contact with resp TB patients
• Healthcare workers

Question 21

Who should you not give an influenza vaccine to?

Answer 21

Egg allergies

Question 22

What are the indications for flu vaccine?

Answer 22

>65yrs
Nursing home residents
Some health care workers
Immunodeficiency
Immunosuppression
Asplenia/hyposplenism
Chronic liver/renal/cardiac/lung disease
DM
Pregnant women
Coeliac disease

Question 23

What are the 2 different pneumococcal vaccines?

Answer 23

• Pneuomococcal conjugate polysaccharide vaccine = childhood immunisation
• Pneumococcal polysaccharide vaccine = those at increased risk of pneumococcal infection

Question 24

Who receives the hep B vaccination?

Answer 24

• All new born children from 2018 (6-in-1)
• Children at high risk exposure to HBV
• Health care workers, IVDU, MSM, prisoners

Question 25

Who receives the VZV (chickenpox) vaccine?

Answer 25

- Patients with suppressed immune systems - Children if risk severe VZV - Health care workers

Question 26

Who receives the shingles vaccine?

Answer 26

All elderly patients 70+

Question 27

What does human normal immunoglobulin contain?

Answer 27

Antibodies against hep A, rubella, measles

Question 28

When is human normal immunoglobulin used?

Answer 28

Immunoglobulin deficiencies | Treatment of some autoimmune disorders

Question 29

When is disease specific immunoglobulin used?

Answer 29

Post-exposure to disease e.g. hep B, rabies, tetanus anti-toxin

Question 30

What is the risk assessment for travel immunisation/prophylaxis?

Answer 30

``` Health of traveller Previous immunisations/prophylaxis Area visited Duration visit Accommodation Activities Remote areas Recent outbreaks ```

Question 31

What are general measures to advice for travel?

Answer 31

``` Care with food/water Hand washing Sunburn/stroke Altitude RTAs Safe sex Mosquitoes ```

Question 32

What are common immunisations for travellers?

Answer 32

``` Tetanus Polio Typhoid Hep A Yellow fever Cholera ```

Question 33

What are less common immunisations for travellers?

Answer 33

``` Meningococcus A, C, W, Y Rabies Diphtheria Japanese B encephalitis Tick borne encephalitis ```

Question 34

What are some travel prophylaxis?

Answer 34

Chemoprophylaxis against malaria Post-exposure prophylaxis e.g. ciprofloxacin for meningococcal disease HIV post-exposure prophylaxis Surgical antibiotic prophylaxis

Question 35

What is the ABCD of malaria prevention?

Answer 35

Awareness of risk Bite prevention Chemoprophylaxis Diagnosis and treatment

Question 36

What is the bite awareness for malaria prevention?

Answer 36

``` Cover-up dusk and dawn Insect repellent Mosquito coils Permethrin-impregnated mosquito nets Chemoprophylaxis against malaria ```

Question 37

What are the chemoprophylaxis options against malaria?

Answer 37

Malarone daily Doxyclcine daily Mefloquine weekly Chloroquine weekly + proquanil daily

Question 38

What are the side effects of mefloquine?

Answer 38

Psychosis | Nightmares

Question 39

What is malaria advice to travellers on return?

Answer 39

Any illness occurring within 1yr (esp. 3mo) might be malaria