UK vaccination programme
Name a disease that the childhood UK vaccination program vaccinates against
Diphtheria, tetanus, pertussis, polio, haemophilus influenzae type B (Hib), hepatitis B, Meningococcal groups, Rotavirus, Measles, Mumps, Rubella, Human papillomavirus
Are global vaccination rates rising, stalling or falling?
Vaccine coverage has stalled or reversed amid persistent health inequalities and soaring levels of misinformation and hesitancy
Measles vaccination rates have fallen in 100 of 204 countries, while coverage for at least one dose against diphtheria, tetanus, whooping cough, measles, polio or tuberculosis has declined in 21 of 36 high-income countries – including France, Italy, Japan, the UK and the US.
Define Herd Immunity?
Herd immunity is when a high enough proportion of a population is immune to an infectious disease either through vaccination or previous infection that it indirectly protects individuals who are not immune
Is an unvaccinated child more likely to develop a serious infectious disease?
Yes
What did the world first vaccine immunise against
Smallpox (cowpox was given as the vaccine)
What disease does the MMR vaccine immunise against?
Measles, mumps and rubella
Is every child in the UK vaccinated?
No, parents have autonomy for their child's health and can refuse the vaccine.
In the last quarter, coverage in one-year-olds in England (excluding London) was at least 92% for all immunisations except rotavirus
Name a disease we have eradicated with vaccines?
Smallpox- only one that has been completely wiped out
Who needs to be contacted if the pt presents with a notifiable disease?
Public health England
Name a type of vaccine
Inactivated vaccines- involve giving a killed version of the pathogen. They cannot cause an infection and are safe for immunocompromised patients, although they may not have an adequate response
Subunit and conjugate vaccines- only contain parts of the organism used to stimulate an immune response. They also cannot cause infection and are safe for immunocompromised patients
Live attenuated vaccines- contain a weakened version of the pathogen. They are still capable of causing infection, particularly in immunocompromised patients
Toxin vaccines contain a toxin that is normally produced by a pathogen
mRNA
What age should children be given the HPV?
12-13 yo- 2 doses given 6 to 24 months apart
Ideally given to girls and boys before they become sexually active
In the UK, outbreaks of which disease have been in the press a lot lately?
Measles
Name the 2 types of Immunity
Active and Passive
Is a child being unvaccinated a safeguarding concern?
No, parent has autonomy for their child's health.
Could be a concern if parent is not engaging with healthcare at all, but parent is allowed to make decisions around vaccines for their child
How do mRNA vaccines work?
To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines. Instead, mRNA vaccines use mRNA created in a laboratory to teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. This immune response, which produces antibodies, is what helps protect us from getting sick from that germ in the future
Which type of Meningococcal is vaccinated against when a child is 1 year or younger?
A, B, C, W or Y
B- given at 8 weeks, 16 weeks and 1 year
Meningococcal groups A, C, W and Y are given at 14 years old
Despite offering the HPV vaccine to both boys and girls since 2019, certain London boroughs report uptake rates below 40%. What is the primary public health concern associated with this low vaccination coverage?
A. Development of HPV vaccine-resistant strains
B. Reduced aspiration to vaccinate other childhood immunizations
C. Increased future incidence of HPV-related cancers
D. Overuse of catch-up vaccination resources
C. Increased future incidence of HPV-related cancers
Which of the following is most likely to reduce the effectiveness of herd immunity in a population?
A. Improved cold chain storage of vaccines
B. Increased uptake of routine childhood vaccinations
C. Clustering of unvaccinated individuals in specific communities
D. Introduction of new vaccine boosters
E. Use of combination vaccines such as MMR
C- When unvaccinated individuals are clustered (e.g. in specific geographic or cultural groups), it increases the risk of local outbreaks, undermining the benefits of herd immunity even if overall coverage seems high.
Name one routine and one urgent notifiable disease
Acute encephalitis Routine
Acute flaccid paralysis (AFP) or Acute flaccid myelitis (AFM) Urgent
Acute infectious hepatitis (A/B/C) Urgent
Acute meningitis Urgent
Acute poliomyelitis Urgent
Anthrax Urgent
Botulism Urgent
Brucellosis Routine. Urgent if acquired in UK
Chickenpox (varicella) Routine
Cholera Urgent
Congenital syphilis Routine
COVID-19 Routine
Creutzfeldt-Jakob disease (CJD) Routine
Disseminated gonococcal infection (DGI) Routine
Diphtheria Urgent
Enteric fever (typhoid or paratyphoid fever) Urgent
Food poisoning Routine. Urgent if part of a cluster or outbreak
Haemolytic uraemic syndrome (HUS) Urgent
Infectious bloody diarrhoea Urgent
Influenza of zoonotic origin Urgent
Invasive group A streptococcal disease Urgent
Legionnaires’ disease Urgent
Leprosy Routine
Malaria Routine. Urgent if acquired in UK
Measles Urgent
Meningococcal septicaemia Urgent
Middle East respiratory syndrome (MERS) Urgent
Mpox (previously known as monkeypox) Urgent
Mumps Routine
Neonatal herpes Routine
Plague Urgent
Rabies Urgent
Rubella Routine
Severe Acute Respiratory Syndrome (SARS) Urgent
Scarlet fever Routine
Smallpox Urgent
Tetanus Routine. Urgent if associated with injecting drug use
Tuberculosis Routine. Urgent if healthcare worker, or suspected cluster or multi-drug resistant
Typhus Routine
Viral haemorrhagic fever (VHF) Urgent
Whooping cough Urgent if diagnosed in acute phase. Routine in later diagnosis
Yellow fever Routine. Urgent if acquired in UK
What journal did Andrew Wakefield publish his later disproven paper claiming the MMR vaccine causes autism in 1998?
Lancet- he performed a series of tests on 12 children with autism and chronic enterocolitis. He reported it appeared they started having features of autism after the MMR vaccine. This was very anecdotal evidence based on parents perceptions about when the issues started. This caused a very big media response that generated a lot of fear amongst parents and uncertainty amongst doctors
Name all the diseases the 6 in 1 vaccine (that baby receives at 8 and 12 weeks) protects against
Diphtheria, tetanus, pertussis, polio, haemophilus influenzae type B (Hib) and hepatitis B
Which UK innovation is aimed at enhancing vaccine access in low-resource settings by removing reliance on cold-chain storage?
A. UKHSA’s 100‑Days Mission
B. VMIC in Oxfordshire
C. Stablepharma’s “fridge-free” vaccine platform
D. Gavi funding cut initiatives
Stablepharma’s “fridge-free” vaccine platform
Explanation:
Stablepharma, based in Bath, is developing thermostable (fridge-free) vaccines like a tetanus-diphtheria booster, using sugar-glass technology to eliminate cold-chain
The basic reproduction number (R₀) of a novel virus is estimated to be 4. What is the minimum percentage of the population that must be immune to achieve herd immunity?
75%
Herd Immunity Threshold (HIT)= (1- 1/Ro)x100
=(1− 1/4 )×100=0.75×100=75%
Why do pts refuse Vaccines and what should as clinicians do about it?
Mistrust in vaccine safety, misinformation and conspiracy beliefs, religious/political beliefs, low perceived risk and access/barriers to vaccines
In what year did Edward Jenner develop the 1st vaccine?
1796