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Questions

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Pharmacology

Immunoglobulins and Vaccines

Question 56 of 180

Hepatitis B vaccine is given at which of the following intervals in the UK routine childhood immunisation schedule:

Answer:

Hepatitis B: 2, 3, 4 and 18 months

Routine Immunisation Programme

Age due Diseases Protected Against Vaccine Given
8 weeks old
  • Diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B
  • Meningococcal group B (MenB)
  • Rotavirus gastroenteritis
  • DTaP/IPV/Hib/HepB
  • MenB
  • Rotavirus
12 weeks old
  • Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  • MenB
  • Rotavirus
  • DTaP/IPV/Hib/HepB
  • MenB
  • Rotavirus
16 weeks old
  • Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  • Pneumococcal (13 serotypes)
  • DTaP/IPV/Hib/HepB
  • PCV
One year old
  • Pneumococcal
  • Measles, mumps, rubella and varicella
  • MenB
  • PCV
  • MMRV
  • MenB
18 months old
  • Born on or after 1 July 2024:
    • DTaP/IPV/Hib/HepB
    • Measles, mumps, rubella and varicella
  • Born on or before 30 June 2024:
    • No appointment
  • DTaP/IPV/Hib/HepB
  • MMRV
Eligible Paediatric Age Group
  • Influenza (each year from September)
  • Live attenuated influenza vaccine (LAIV)
Three years, four months old (preschool)
  • Born on or after 1 January 2025:
    • Diphtheria, tetanus, pertussis and polio
  • Born on or before 31 December 2024:
    • Diphtheria, tetanus, pertussis and polio.
    • Measles, mumps, rubella and varicella
  • DTaP/IPV
  • MMRV
Boys and girls aged 12 to 13 years
  • Cancers and genital warts caused by specific human papillomavirus
    (HPV) types
  • HPV
14 years old (school year 9)
  • Tetanus, diphtheria and polio
  • Meningococcal groups A, C, W and Y disease
  • Td/IPV
  • MenACWY
65 years old Pneumococcal (23 or 20 serotypes) Pneumococcal polysaccharide vaccine (PPV23) or Pneumococcal conjugate vaccine (PCV20)
65 years old and older Influenza (each year from September) Inactivated influenza vaccine
Individuals turning 65 from 1 Sept each year Shingles Shingles vaccine
70 to 79 years of age (and those severely immunosuppressed over 18 years of age) Shingles Shingles vaccine
75 years of age Respiratory syncytial virus (RSV) RSV vaccine

 

Vaccine Schedule
Diphtheria, tetanus, polio 2, 3, 4 and 18 months, preschool and 14 years
Pertussis 2, 3, 4, 18 months and preschool
Hib 2, 3, 4 and 18 months
Pneumococcal 4 and 12 months
Rotavirus 2 and 3 months
MenB 2, 3 and 12 months
MMRV 12, 18 months and preschool
MenACWY 14 years
Hepatitis B 2, 3, 4 and 18 months

 

Selective Immunisation Schedules

  • Hepatitis B vaccine should be given to babies born to women with hepatitis B infection (at birth, 4 weeks and 12 months old).
  • 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 (at 4 weeks old).
  • Influenza vaccine should be given to pregnant women at any stage of pregnancy during flu season, and to children in a clinical risk group each flu season.
  • Pertussis vaccine should be given to pregnant women from 16 weeks gestation.
  • RSV vaccine should be given to pregnant women from 28 weeks gestation.

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
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