Pharmacology
Immunoglobulins and Vaccines
Question 176 of 180
Regarding the UK routine childhood immunisation schedule which of the following vaccines is NOT given at 4 months:
Answer:
At 4 months the following vaccines are given:- Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (3rd dose)
- Meningococcal group B (2nd dose)
United Kingdom Immunisation Schedule
Microbiology / Principles / Principles of Immunisation / Pharmacology / Immunoglobulins and Vaccines
Last Updated: 30th March 2023
Routine Immunisation Schedule
| Vaccine | Schedule |
|---|---|
| Diphtheria, tetanus, polio | 2, 3, 4 months, preschool and 14 years |
| Pertussis | 2, 3, 4 months and preschool |
| Hib | 2, 3, 4 and 12 months |
| Pneumococcal | 3 and 12 months |
| Rotavirus | 2 and 3 months |
| MenB | 2, 4 and 12 months |
| MMR | 12 months and preschool |
| MenC | 12 months |
| MenACWY | 14 years |
| Hepatitis B | 2, 3 and 4 months |
- At 2 months the following vaccines are given:
- Diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B
- Rotavirus gastroenteritis
- Meningococcal group B
- At 3 months the following vaccines are given:
- Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (2nd dose)
- Pneumococcal (13 serotypes)
- Rotavirus (2nd dose)
- At 4 months the following vaccines are given:
- Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B (3rd dose)
- Meningococcal group B (2nd dose)
- At 12 months the following vaccines are given:
- Hib (4th dose) and Meningococcal group C
- Pneumococcal (13 serotypes) (2nd dose)
- Measles, mumps and rubella
- Meningococcal group B (3rd dose)
- In preschool children (aged 3 years 4 months old) the following vaccines are given:
- Diphtheria, tetanus, pertussis and polio (4th dose)
- Measles, mumps and rubella (2nd dose)
- In boys and girls aged 12 - 13 the HPV vaccine is offered.
- At 14 years (school year 9) the following vaccines are given:
- Meningococcal groups A, C, W and Y disease
- Tetanus, diphtheria and polio
- At 65 years, the pneumococcal (23 serotypes) vaccine is offered.
- In patients aged 65 years and older, the influenza vaccine is offered annually.
- At 70 years, the shingles vaccine is offered.
| Age | Diseases Protected Against | Vaccine Given |
|---|---|---|
| 2 months |
|
|
| 3 months |
|
|
| 4 months |
|
|
| One year |
|
|
| Eligible Paediatric Age Group |
|
|
| Three years four months old (preschool) |
|
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| Boys and girls aged 12 to 13 years |
|
|
| Fourteen years old (school year 9) |
|
|
| 65 years old | Pneumococcal (23 serotypes) | Pneumococcal polysaccharide vaccine (PPV) |
| 65 years of age and older | Influenza (each year from September) | Inactivated influenza vaccine |
| 70 to 79 years of age | Shingles | Shingles |
Selective Immunisation Schedules
- BCG vaccine should be given to infants in areas of the country with TB incidence ≥ 40/100,000, or to infants with a parent or grandparent born in a high incidence country.
- Influenza vaccine should be given to pregnant women during flu season at any stage of pregnancy, and to at risk children from 6 months to 17 years of age.
- Pertussis vaccine should be given to pregnant women from 16 weeks gestation.
- Hepatitis B vaccine should be given to babies born to hepatitis B infected mothers at birth, four weeks and 12 months old.
Additional vaccines may be required for individuals with underlying medical conditions.
https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule
Occupational Vaccinations
Healthcare workers are additionally strongly advised to have:
- Hepatitis B vaccine
- BCG vaccine
- Varicella vaccine (if non-immune)
- Influenza vaccine (annually)
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
