Teenage Immunisation

Question 1

Why do we give booster vaccinations to adolescents?

Answer 1

• Vaccines enable the prevention of certain diseases, such as HPV, diphtheria, pertussis, tetanus, and meningococcal
• Booster vaccinations provide additional immune responses, thus strengthening or restoring the immune ‘memory’ that underlies this immunity

Question 2

How can HPV cause cervical cancer?

Answer 2

• Infects squamous lining of the cervix through physical contact (such as during sex)
• In high-risk cases, integrates into epithelial genome
• Prevents action of p53 and other cell cycle checks; predisposed to neoplasm and cancer

Question 3

What factors make teenagers more likely than children to get vaccine-preventable diseases

Answer 3

• Increased sexual contact/living in close quarters
• Waning immunity/low vaccine uptake rate

Question 4

Which vaccines are given at which year levels for adolescents in Australia?

Answer 4

• Year 7: DTPa and HPV (gardasil)
• Year 10: Menigococcal ACWY and B

Question 5

How fast does HPV usually go away? What happens if it doesn’t?

Answer 5

• Usually gone within 12 months (both high/low risk)
• If still there, more likely cancer

Question 6

Which kinds of HPV cause genital warts most commonly?

Answer 6

6 and 11.

Question 7

Which kinds of HPV cause cervical cancer most commonly? What are some others?

Answer 7

• 16 and 18 most commonly
• 31, 33, 45, 52, 58 can also cause

Question 8

In which kinds of patients is meningococcal most common? Which has worst progonsis?

Answer 8

• Most common groups are young children (1-5) and adolescents/young people (15-24)
• Worst prognosis in really old/young people

Question 9

Meningococcal infection aetiology

Answer 9

• Exists asymptomatically in the nasopharynx of 10% of the population
• In response to compromised barrier (smoking, endothelial damage, immune compromise, can enter the bloodstream
• Here, it releases endotoxins, leading to a systemic inflammatory response, and can infect the brain, causing meningitis

Question 10

Clinical manifestations of meningococcal infection

Answer 10

• Meningitis (non-blanching rash, nausea/vomiting, neck stiffness, headache, photo/phonophobia)
• Sepsis (hypotension, fever, dyspnoea, altered mental status, mottled appearance)
• Can also present with severe myalgia

Question 11

Complications of meningococcal infection

Answer 11

• Brain damage (meningitis)
• Hearing loss (bacteria reaches cochlea)
• Limb loss (sepsis -> necrosis)
• Death

Question 12

How quickly can meningococcal infection kill? What proportion of people die?

Answer 12

• Can kill within hours
• Approximately 10% of people die w/ treatment

Question 13

By what % have vaccines reduced meningococcal MenC since 2003?

Answer 13

99%