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91

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Pharmacology

Immunoglobulins and Vaccines

Question 101 of 180

Haemophilus influenzae type b (Hib) vaccine is given at which of the following intervals in the UK routine childhood immunisation schedule:

Answer:

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

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
  • Diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B
  • Meningococcal group B (MenB)
  • Rotavirus gastroenteritis
  • DTaP/IPV/Hib/HepB
  • MenB
  • Rotavirus
3 months
  • Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  • Pneumococcal (13 serotypes)
  • Rotavirus
  • DTaP/IPV/Hib/HepB
  • Pneumococcal conjugate
    vaccine (PCV)
  • Rotavirus
4 months
  • Diphtheria, tetanus, pertussis, polio, Hib and hepatitis B
  • MenB
  • DTaP/IPV/Hib/HepB
  • MenB
One year
  • Hib and MenC
  • Pneumococcal
  • Measles, mumps and rubella
  • MenB
  • Hib/MenC
  • PCV booster
  • MMR
  • MenB booster
Eligible Paediatric Age Group
  • Influenza (each year from September)
  • Live attenuated influenza vaccine (LAIV)
Three years four months old (preschool)
  • Diphtheria, tetanus, pertussis and polio
  • Measles, mumps and rubella
  • DTaP/IPV
  • MMR
Boys and girls aged 12 to 13 years
  • Cancers and genital warts caused by specific human papillomavirus
    (HPV) types
  • HPV (two doses 6-24 months apart)
Fourteen 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 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

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