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Part B 29 Immunization

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OET Practice Reading Test (One Reading Passage

Only)
The evidence in favour of immunisation - a world without smallpox -
a world without polio.

IF YOU PREFER, PRINT THIS DOCUMENT AND HAVE IT NEXT TO YOU WHILE
DOING THE QUIZ.

1. It is an extraordinary paradox that, despite abundant evidence of the success of


immunisation, its necessity is still queried. In the last 12 months, feature articles in
leading Australian newspapers have openly questioned the need for immunisation.
Such articles cause unnecessary concern to parents & and medical practitioners alike
and may reduce the numbers of infants being immunised. The most important issue
today is the failure to apply immunisation universally to control or eliminate disease.

2. How can we produce convincing evidence of the current benefits of immunisation?


There are three major methods of evaluation: challenge studies and epidemiological
studies, which were once sufficient to support the common use of vaccines; and
controlled trials, in which both efficacy and safety have been demonstrated to the
satisfaction of national control authorities.

3. Two hundred years ago, Edward Jenner tested the belief that inoculation with
cowpox fluid would protect individuals against smallpox. He subsequently challenged
his cowpox vaccinees with smallpox fluid and convincingly confirmed the belief.
Jenner thus started the practice of vaccination and preventive medicine. In 1958, the
World Health Organization began a smallpox eradication campaign (modified in 1967
to deal with those areas when smallpox remained endemic). The success of this
campaign in 1977, both medically and financially, conclusively demonstrated the
benefits of well planned and organised immunisation campaigns.
4. In 1988, the World Health Assembly decided to attempt the global eradication of
poliomyelitis. Poliomyelitis has been eradicated from Australia the United Kingdom,
the Americas and many other countries, but the risk of reintroduction by wild viruses
persists. This has been demonstrated twice in 15 years in Holland, where two severe
outbreaks of paralytic poliomyelitis occurred among members of a religious sect who
refused vaccination. On both occasions, wild virus was reintroduced to the United
States and Canada by visiting members of this sect. Universal immunisation with
poliomyelitis vaccine is the only way to stop transmission of the virus and achieve
complete eradication.

5. What of other vaccine preventable viral diseases, such as measles, mumps and
rubella? At an immunisation conference in Washington, in 1978, Albert Sabin said
that eradication of these diseases was achievable with present day vaccines if there
was universal vaccination. He stated that: "The questions are no longer scientific or
medical - they are educational, social and financial. The current evidence for control
of these viral diseases is convincing but eradication will take a few more years. The
eradication of hepatitis B, however, may take several generations because of the
existence of the carrier state in some previously infected individuals.
6. What evidence is there for the success of vaccination against the previously common
bacterial diseases, diptheria, tetanus and pertussis. Diptheria and tetanus are types
of disease which have responded to vaccination and vaccines have lead to the almost
complete prevention of death in adequately vaccinated individuals. Pertussis is a
different type of disease, and the vaccine does not provide absolute protection.
Nevertheless, the epidemiological evidence for efficacy of the pertussis vaccine is
now, overwhelming, and there is no evidence that the modern vaccines are
associated with a disorder called neurological sequelae. However, whole cell
pertussis vaccine induces more reactions than diptheria-tetanus vaccines.

7. In the last five years vaccination against Haemophilus influenzae type b (Hib) has
been introduced to many countries in the developed world. In Finland, where the
initial efficacy studies were undertaken, there are now no reported cases of invasive
Hib infection. The numbers of reported cases are also falling in Britain and the United
States as a consequence of immunisation. There is no doubt that infant vaccination
with Hib vaccines, if conscientiously carried out, could eliminate this disease from
Australia within five years.

8. Despite the available evidence, a vocal minority is attempting to dissuade parents


from protecting their young children by immunisation, objecting that the injection of
foreign material is unnatural and, therefore, more dangerous than natural infection.
No medical procedure is entirely without risk, and occasional severe adverse
reactions to immunisation do occur. However, the incidence of death or permanent
disability from the infectious diseases of childhood is far in excess of the very
occasional severe reaction to immunisation. What anti-immunisation proponents do
not acknowledge is that, in any infectious disease, the human host is invaded by a
foreign and "unnatural" virulent pathogen which produces many toxic products and
destroys or damages many host cells. The result may be irreparable damage to the
host or death.

9. Advocates of natural immunisation propose that allowing wild infection to occur in a


healthy host engenders stronger immunity. Not infrequently, quite healthy
unimmunised children die from vaccine preventable diseases. Such advocacy is
mischievous and, in view of our knowledge of the efficacy of immunisation,
inexcusable.

10. National control authorities will not license the use of any vaccine until extensive
safety, immunogenicity and efficacy studies have been carried out. As an example,
the hepatitis A vaccine was demonstrated to have an efficacy of approximately 95%
in a controlled trial of about 40000 subjects before it was recently licensed. No
comparable data exist to support the use of any alternative homoeopathic
"immunisation" procedures because they have never been subjected to any
scientifically acceptable study. Claims of efficacy for these procedures are only
possible because herd immunity resulting from standard immunisation provides
some indirect protection to the unimmunised. Medical practitioners who misguidedly
yield to parental requests to administer such preparations could be charged with
malpractice and be liable for damages should the child subsequently suffer disability
from a vaccine preventable disease. The facts speak for themselves. Smallpox has
been eradicated. Poliomyelitis has been eliminated from many countries and could
be eradicated by the World Health Organization campaign. Invasive Haemophilus
infection has been eliminated from Finland by the use of Hib vaccines. In Australia
the reductions in mortality cannot fail to impress: 91% reduction from measles
(since immunisation was introduced in 1970); 99% from tetanus and pertussis and
100% from diphtheria and poliomyelitis. In the United States there has been a 80%
- 100% reduction in the incidence of vaccine preventable diseases since
immunisation was introduced.

�JOURNAL OF AUSTRALIA � Vol 160 18 April 1994


THE MEDICAL�

1.
(Points: 10) The author of the article thinks that arguments against world immunisation

a. are causing doctors and parents to worry unnecessarily


b. are necessary for the success of immunisation
c. have reduced the numbers of infants and youth being immunised
d. fail to address today's most important issues
Save Answer

2.
(Points: 10) Two hundred years ago, Edward Jenner

a. proved that injecting people with smallpox would vaccinate them against cowpox
b. injected smallpox into people after inoculating them with a cowpox vaccine
c. mixed cowpox and smallpox vaccines together and tested people
d. changed his vaccine from cowpox to smallpox
Save Answer

3.
(Points: 10) According to the article, the potential of well planned and organised
immunisation campaigns

a. is limited to the World Health Organisation


b. is the responsibility of Edward Jenner
c. was only possible with the eradication of smallpox
d. was successfully demonstrated with the smallpox eradication program
Save Answer
4.
(Points: 10) Which statement is FALSE?

a. Albert Sabin claims that with world wide immunisation it is possible to eradicate rubella,
measles and mumps
b. There is little evidence that Hepatitis B could be eradicated
c. Since some people may be carriers of the Hepatitis B virus, it cannot be eradicated quickly
d. There is convincing evidence that world immunisation of many viral diseases will be
effective
Save Answer

5.
(Points: 10) Evidence for the effectiveness of vaccination against bacterial diseases

a. is not convincing in terms of diptheria and tetanus


b. shows that the vaccine for pertussis causes neurological sequelae
c. indicates that the vaccine for pertussis is also effective
d. none of the above
Save Answer

6.
(Points: 10) Which statement is TRUE?

a. Initial studies in Finland reported no cases of Hib infection


b. Hib was eliminated from Australia within five years
c. Many people are falling ill in Britain and the United States as a consequence of Hib
d. The vaccination against Hib has been effective in Britain, the United States, Finland and
Australia
Save Answer

7.
(Points: 10) According to the author,
a. immunisation is dangerous because of the injection of foreign material into the body
b. vaccination is completely safe, effective and contains no element of risk
c. a virus is foreign material but a vaccine is a natural product
d. foreign vaccine material is generally less harmful than a foreign virus entering the body
Save Answer

8.
(Points: 10) Natural ‘immunisation’

a. procedures have a success rate comparable with standard immunisation success rates
b. procedures have been tested extensively and scientifically
c. procedures have appeared to be successful because other people in the community had
been immunised
d. procedures should be allowed in the community when requested by parents
Save Answer

9.
(Points: 10) Which statement is FALSE?

a. No one in Australia now contracts poliomyelitis or diptheria


b. The World Health Campaign may completely eliminate poliomyelitis from the world
c. In the last 25 years in Australia, the number of deaths from measles has dropped by 91%
d. The use of immunisation in the United States has had an enormous effect on the presence
of diseases which vaccination could prevent
Save Answer

10.
(Points: 10) Where effective campaigns for immunisation are carried out

a. vaccination rates have fallen


b. they are effective in reducing incidence of the disease
c. the diseases have returned soon after
d. medical practitioners are reluctant to vaccinate
Save Answer
1.

The author of the article thinks that arguments against world immunisation

Student Correct
Value Feedback
Response Answer
A. are causing 100% Yes, this is the correct answer
doctors and
parents to
worry
unnecessarily
B. are necessary 0%
for the
success of
immunisation
C. have reduced 0%
the numbers
of infants and
youth being
immunised
D. fail to 0%
address
today's most
important
issues
Score: 10/10

2.

Two hundred years ago, Edward Jenner

Student
Value Correct Answer Feedback
Response
A. proved 0%
that
injecting
people
with
smallpox
would
vaccinate
them
against
cowpox
B. injected 100%
smallpox
into people
after
inoculating
them with
a cowpox
vaccine
C. mixed 0% No, this is not the correct answer
cowpox
and
smallpox
vaccines
together
and tested
people
D. changed 0%
his vaccine
from
cowpox to
smallpox
Score: 0/10

3.

According to the article, the potential of well planned and organised immunisation
campaigns

Student Correct
Value Feedback
Response Answer
A. is limited to 0%
the World
Health
Organisation
B. is the 0%
responsibility
of Edward
Jenner
C. was only 0%
possible with
the
eradication
of smallpox
D. was 100% Yes, this is the correct answer
successfully
demonstrated
with the
smallpox
eradication
program
Score: 10/10

4.

Which statement is FALSE?

Student Correct
Value Feedback
Response Answer
A. Albert Sabin 0%
claims that
with world
wide
immunisation
it is possible
to eradicate
rubella,
measles and
mumps
B. There is little 100% Yes, this is the correct answer
evidence that
Hepatitis B
could be
eradicated
C. Since some 0%
people may
be carriers of
the Hepatitis
B virus, it
cannot be
eradicated
quickly
D. There is 0%
convincing
evidence that
world
immunisation
of many viral
diseases will
be effective
Score: 10/10

5.

Evidence for the effectiveness of vaccination against bacterial diseases

Student
Value Correct Answer Feedback
Response
A. is not 0%
convincing
in terms of
diptheria
and tetanus
B. shows that 0%
the vaccine
for pertussis
causes
neurological
sequelae
C. indicates 100% Yes, this is the correct answer
that the
vaccine for
pertussis is
also
effective
D. none of the 0%
above
Score: 10/10
6.

Which statement is TRUE?

Student
Value Correct Answer Feedback
Response
A. Initial 0%
studies in
Finland
reported no
cases of Hib
infection
B. Hib was 0%
eliminated
from
Australia
within five
years
C. Many 0%
people are
falling ill in
Britain and
the United
States as a
consequence
of Hib
D. The 100% Yes, this is the correct answer
vaccination
against Hib
has been
effective in
Britain, the
United
States,
Finland and
Australia
Score: 10/10

7.
According to the author,

Student Correct
Value Feedback
Response Answer
A. immunisation 0%
is dangerous
because of
the injection
of foreign
material into
the body
B. vaccination 0%
is completely
safe,
effective and
contains no
element of
risk
C. a virus is 0%
foreign
material but a
vaccine is a
natural
product
D. foreign 100% Yes, this is the correct answer
vaccine
material is
generally less
harmful than
a foreign
virus
entering the
body
Score: 10/10

8.

Natural ‘immunisation’

Student Correct
Value Feedback
Response Answer
A. procedures 0% No, this answer is incorrect
have a
success rate
comparable
with standard
immunisation
success rates
B. procedures 0%
have been
tested
extensively
and
scientifically
C. procedures 100%
have
appeared to
be successful
because other
people in the
community
had been
immunised
D. procedures 0%
should be
allowed in
the
community
when
requested by
parents
Score: 0/10

9.

Which statement is FALSE?

Student Correct
Value Feedback
Response Answer
A. No one in 100% Yes, this is the correct answer
Australia
now
contracts
poliomyelitis
or diptheria
B. The World 0%
Health
Campaign
may
completely
eliminate
poliomyelitis
from the
world
C. In the last 25 0%
years in
Australia, the
number of
deaths from
measles has
dropped by
91%
D. The use of 0%
immunisation
in the United
States has
had an
enormous
effect on the
presence of
diseases
which
vaccination
could prevent
Score: 10/10

10.

Where effective campaigns for immunisation are carried out

Student
Value Correct Answer Feedback
Response
A. vaccination 0%
rates have
fallen
B. they are 100% Yes, this is the correct answer
effective in
reducing
incidence of
the disease
C. the diseases 0%
have
returned
soon after
D. medical 0%
practitioners
are reluctant
to vaccinate
Score: 10/10

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