A 14-year-old child who is up-to-date with their vaccine schedule stepped on a rusty nail at a riding school in France a year ago and was given a vaccination abroad following the injury. There is no written record of what was given, although the parents believe this was tetanus vaccine. The child has now presented for a school leaving booster, which of the following is/are true:

Correct Answer: D

Rationale: The correct answer is D: The child should have a further tetanus vaccination in 10 years' time. This is because tetanus vaccine is typically given as a series of vaccines to provide long-term immunity. Following a tetanus-prone injury, a person should receive a booster if it has been more than 5 years since their last dose. In this case, since the child's last tetanus vaccination was given a year ago, they should receive a booster now and then continue with routine boosters every 10 years. Option A is incorrect because boosters are necessary to maintain immunity over time. Option B is incorrect as the risk of side effects from a repeat tetanus vaccination is minimal compared to the risk of contracting tetanus from an untreated wound. Option C is incorrect because the vaccination given at the time of injury should not be discounted, but rather the child should receive a booster now to ensure continued protection. In an educational context, it is important to emphasize the importance of maintaining up-to-date vaccinations, especially for tetanus which can be life-threatening. Understanding the proper vaccination schedule and the need for boosters after certain intervals is crucial for preventing infectious diseases. This case highlights the significance of accurate record-keeping and the need for healthcare providers to make informed decisions based on the individual's vaccination history.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Cystic fibrosis. Patients with cystic fibrosis are at increased risk of developing severe complications if they contract influenza. Therefore, they should receive the seasonal influenza vaccine to protect themselves from potential harm. Option A) Class III obesity, although a risk factor for severe influenza outcomes, is not a direct indication for seasonal influenza vaccination. Option B) Stage 2 chronic renal disease is also not a specific indication for seasonal influenza vaccination unless there are other co-existing conditions that warrant it. Option C) Diabetes controlled by diet alone does not necessitate seasonal influenza vaccination unless there are additional risk factors present. From an educational perspective, it is crucial to understand the specific patient populations that benefit most from seasonal influenza vaccination. By targeting high-risk groups such as patients with cystic fibrosis, healthcare providers can effectively prevent severe influenza-related complications and reduce the burden on healthcare systems. This rationale underscores the importance of evidence-based practice and personalized healthcare decisions to optimize patient outcomes.

Correct Answer: C

Rationale: In managing contacts of measles, option C is correct because administering a dose of MMR to susceptible immunocompetent contacts not contraindicated for MMR within 3 days of exposure can provide protection. This is based on the concept of post-exposure prophylaxis to prevent the development of measles in exposed individuals. Option A is incorrect because although seeking advice from healthcare professionals is important, the specific action of administering MMR within 3 days is a more direct and time-sensitive measure. Option B is incorrect because HNIG (human normal immunoglobulin) is not indicated for all non-immune contacts of measles but only in specific vulnerable populations as mentioned. Option D is incorrect because the interval between HNIG and MMR is at least 6 months, not 3 months as stated. From an educational standpoint, understanding the correct management of contacts of measles is crucial for healthcare professionals involved in infection control to prevent the spread of the disease and protect vulnerable populations. Timely and appropriate interventions can help mitigate the risk of measles transmission and its potential complications in susceptible individuals.

Correct Answer: D

Rationale: The correct answer is D) They are thiomersal-free. Acellular pertussis vaccines like Infanrix and Pediacel do not contain thiomersal, which is a mercury-based preservative. This is important for infection control as thiomersal has been a subject of safety concerns. Option A) They are conjugated vaccines is incorrect because acellular pertussis vaccines are not conjugated vaccines. Option B) They offer equal or better protection than the whole-cell pertussis vaccine is incorrect as whole-cell pertussis vaccines are generally considered to provide stronger immunity. Option C) They are only given as part of the combined products of aP/IPV/Hib) or DTaP/IPV or dTaP/IPV) is incorrect as acellular pertussis vaccines can also be given individually. In an educational context, it is crucial for healthcare professionals to understand the components of vaccines used in their practice to provide accurate information to patients and make informed decisions regarding vaccination strategies. Knowing the characteristics of different vaccines also helps in optimizing vaccination schedules and ensuring effective infection control practices.