Immunization and Vaccine-Preventable Diseases — MCQs
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Dukoral is:
Which day is not included in the pre-exposure prophylaxis dose schedule for the rabies vaccine?
What is the schedule of intradermal rabies vaccine?
Minimum threshold level of herd immunity for Pertussis is?
India started 2-dose vaccination strategy for measles, in -
To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:
Antiserum is available for passive immunization against ?
Vaccines are available against which types of meningococcus?
According to the immunization schedule, how many doses of influenza vaccine should children under 9 years of age receiving the vaccine for the first time typically receive?
At what age is the BCG vaccination administered in India?
Immunization and Vaccine-Preventable Diseases Indian Medical PG Practice Questions and MCQs
Question 461: Dukoral is:
- A. Oral cholera vaccine (Correct Answer)
- B. Oral rotavirus vaccine
- C. Oral typhoid vaccine
- D. Ready to use therapeutic food
Explanation: ***Oral cholera vaccine*** - Dukoral is a **killed oral whole-cell vaccine** against *Vibrio cholerae* O1 and O139, often combined with a recombinant B subunit of cholera toxin. - It provides protection against **cholera**, an acute diarrheal illness caused by bacterial infection of the small intestine. *Oral rotavirus vaccine* - Oral rotavirus vaccines (e.g., Rotarix, RotaTeq) provide protection against **rotavirus**, the most common cause of severe diarrhea in infants and young children. - These vaccines are usually given in multiple doses to infants and are distinct from cholera vaccines. *Oral typhoid vaccine* - An oral typhoid vaccine, such as Ty21a, is used for the prevention of **typhoid fever**, caused by *Salmonella Typhi*. - It is a **live attenuated vaccine** administered in several doses over a week, differing significantly from Dukoral's mechanism and target. *Ready to use therapeutic food* - **Ready-to-use therapeutic food (RUTF)** is a high-energy, micronutrient-rich paste used for the treatment of **severe acute malnutrition (SAM)**, especially in children. - It is a nutritional intervention, not a vaccine, and helps in weight gain and recovery for malnourished individuals.
Question 462: Which day is not included in the pre-exposure prophylaxis dose schedule for the rabies vaccine?
- A. Day 0
- B. Day 7
- C. Day 28
- D. Day 3 (Correct Answer)
Explanation: ***Day 3*** - The standard pre-exposure prophylaxis (PrEP) schedule for rabies vaccine typically involves three doses given on **Day 0, Day 7, and Day 21 or 28**. - A dose on Day 3 is **not part of the standard recommended PrEP schedule**. *Day 0* - This is the **initial dose** in the pre-exposure prophylaxis series for rabies. - It marks the beginning of the vaccination schedule to build immunity. *Day 7* - This is the **second dose** in the pre-exposure prophylaxis series for rabies. - It follows the initial dose and is crucial for developing a robust immune response. *Day 28* - This dose, along with Day 21, can be the **final dose** in the pre-exposure prophylaxis series for rabies, depending on the specific regimen used. - It completes the primary vaccination course to ensure long-lasting protection.
Question 463: What is the schedule of intradermal rabies vaccine?
- A. 2-2-0-1-0-1
- B. 8-4-4-1-0-1
- C. 2-2-2-0-1-1
- D. 2-0-2-0-1-1 (Correct Answer)
Explanation: ***2-0-2-0-1-1*** - This schedule represents the **Thai Red Cross (TRC) regimen** for intradermal rabies vaccination that was standard at the time of this exam (2013). - The numbers indicate the number of vaccine doses administered at different sites: **2 doses on day 0** (bilateral deltoids), **0 doses on day 3**, **2 doses on day 7** (bilateral deltoids), **0 doses on day 14**, **1 dose on day 28**, and **1 dose on day 90**. - This was the **answer expected for NEET 2013** based on the guidelines prevalent at that time. - **Note:** Current WHO guidelines (post-2013) recommend the updated 2-2-2-0-1-1 schedule (4-site ID regimen) which includes doses on days 0, 3, 7, and 28. *2-2-0-1-0-1* - This schedule is **not a recognized** intradermal rabies vaccination protocol. - Does not match any standard WHO-approved regimen for intradermal administration. *2-2-2-0-1-1* - While this may appear incorrect for the 2013 exam context, this schedule actually represents the **current updated Thai Red Cross (4-site ID) regimen** recommended by WHO in recent guidelines. - This regimen provides doses on **days 0, 3, 7, 28, and 90**, which is now the preferred intradermal schedule. - However, for the NEET 2013 exam, the older 2-0-2-0-1-1 schedule was the expected answer. *8-4-4-1-0-1* - This schedule is **not a standard regimen** and involves an impractically high number of doses. - No recognized intradermal rabies protocol uses this many doses on initial days. - Would be **unnecessary and impractical** for effective post-exposure prophylaxis.
Question 464: Minimum threshold level of herd immunity for Pertussis is?
- A. 80%
- B. 70%
- C. 90% (Correct Answer)
- D. 50%
Explanation: ***90%*** - Pertussis, due to its **high R-naught (R0)**, requires a very high vaccination coverage to achieve herd immunity. - An estimated 92-94% vaccination coverage is often cited as necessary to prevent outbreaks. *80%* - While 80% might be sufficient for some less contagious diseases, it's **too low a threshold** for a highly transmissible infection like pertussis. - This level would likely still allow for significant localized outbreaks, especially in unvaccinated pockets. *70%* - A 70% threshold is generally considered **insufficient** for controlling the spread of highly contagious respiratory infections. - This level of immunity would mean a higher proportion of susceptible individuals, leading to a greater risk of widespread transmission. *50%* - A 50% herd immunity level is **grossly inadequate** for a disease like pertussis, which is one of the most contagious vaccine-preventable diseases. - This low level of immunity would offer minimal protection against widespread transmission and outbreaks.
Question 465: India started 2-dose vaccination strategy for measles, in -
- A. 2008
- B. 2009
- C. 2010 (Correct Answer)
- D. 2011
Explanation: ***2010*** - India implemented the **two-dose measles vaccination strategy** as part of its Universal Immunization Program starting in **2010**. - This decision was based on recommendations to improve immunity and reduce measles incidence, moving from a single-dose to a more effective **two-dose schedule**. *2008* - While important immunization initiatives were ongoing, the specific policy of a **two-dose measles vaccination strategy** had not yet been introduced in India during 2008. - At this time, the focus was primarily on ensuring high coverage of the **first dose** of measles vaccine. *2009* - The year 2009 saw continued efforts to strengthen the Universal Immunization Program, but the official launch of the **two-dose measles vaccination strategy** in India occurred later. - Discussions and planning for the transition were likely underway, but implementation began in the subsequent year. *2011* - By 2011, the **two-dose measles vaccination strategy** was already being implemented across India, having been introduced in 2010. - This year marked a period of expanding coverage and consolidation of the new 2-dose schedule rather than its initial introduction.
Question 466: To achieve neonatal tetanus elimination, the incidence of neonatal tetanus per 1000 live births should be reduced to less than:
- A. 0.1
- B. 0.5
- C. 1.0 (Correct Answer)
- D. 0.2
Explanation: ***1.0*** - The international target for **neonatal tetanus elimination (NTE)** as defined by WHO/UNICEF is an incidence rate of **less than 1 case per 1,000 live births per year** in every district of a country. - This is the globally recognized threshold for declaring that neonatal tetanus has been eliminated as a public health problem. - Countries achieving this target at the district level are considered to have achieved NTE. *0.1* - While 0.1 per 1,000 live births represents an extremely low incidence, this is not the WHO-defined threshold for **neonatal tetanus elimination**. - The elimination target is less stringent at <1 per 1,000 live births, making disease control achievable while still representing a major public health success. *0.2* - An incidence of 0.2 per 1,000 live births, though very low, is not the internationally recognized threshold for **neonatal tetanus elimination**. - The established WHO/UNICEF target is <1 per 1,000 live births in every district. *0.5* - An incidence of 0.5 per 1,000 live births indicates excellent control of neonatal tetanus but is not the specific cut-off value. - The WHO criterion for elimination is less than 1 case per 1,000 live births per year at the district level.
Question 467: Antiserum is available for passive immunization against ?
- A. Rabies (Correct Answer)
- B. Typhoid
- C. Mumps
- D. Measles
Explanation: ***Rabies*** - **Antiserum** (or rabies immune globulin, RIG) provides immediate **passive immunity** against rabies, neutralizing the virus before the body can mount an active immune response. - It is administered in conjunction with the **rabies vaccine** for post-exposure prophylaxis, especially in severe exposures. *Typhoid* - **Typhoid fever** is primarily prevented through vaccination (active immunization) and improved sanitation. - There is no routinely available antiserum for **passive immunization** against *Salmonella typhi* infection. *Measles* - **Measles** is prevented through active immunization with the MMR (measles, mumps, rubella) vaccine. - While immune globulin can be used for passive protection in exposed, immunocompromised individuals, it's not commonly referred to as "antiserum" in the same context as rabies. *Mumps* - **Mumps** is prevented by active immunization with the MMR vaccine. - Similar to measles, there is no commonly used specific antiserum for **passive immunity** against mumps in the clinical setting.
Question 468: Vaccines are available against which types of meningococcus?
- A. Type A
- B. Type B
- C. Type A, B, and C
- D. Type A, B, C, W, and Y (Correct Answer)
Explanation: ***Type A, B, C, W, and Y*** - Vaccines are currently available against **all five major meningococcal serogroups**: A, B, C, W-135, and Y. - **Meningococcal conjugate vaccines (MenACWY)** provide protection against serogroups A, C, W-135, and Y, and are widely used globally. - **Meningococcal B vaccines (MenB)** such as Bexsero and Trumenba specifically target serogroup B, which is a leading cause of meningococcal disease in developed countries. - Combined, these vaccines provide comprehensive coverage against the most epidemiologically important meningococcal serogroups worldwide. *Type A* - While vaccines against **meningococcus type A** do exist (as part of conjugate vaccines), this option is incomplete as it excludes the other important serogroups (B, C, W, Y) for which vaccines are also available. *Type B* - **Type B vaccines** are available and important, particularly in developed countries where serogroup B causes significant disease burden. - However, this option alone is insufficient because vaccines also effectively target other serogroups (A, C, W, Y). *Type A, B, and C* - This option is incomplete because it omits **serogroups W and Y**, for which conjugate vaccines (MenACWY) are readily available and widely used. - The question asks which types vaccines are *available* against, not which are most common, making this an incorrect answer.
Question 469: According to the immunization schedule, how many doses of influenza vaccine should children under 9 years of age receiving the vaccine for the first time typically receive?
- A. 2 doses at 4 weeks interval with a booster dose for high-risk children
- B. 2 doses at 4 weeks interval (Correct Answer)
- C. 3 doses at 4 weeks interval
- D. None of the options
Explanation: ***2 doses at 4 weeks interval*** - Children **under 9 years of age** receiving the influenza vaccine for the **first time** require **two doses** administered at least **4 weeks (28 days) apart**. - This two-dose priming schedule is essential to ensure adequate immune response and protection against circulating influenza strains. - This recommendation is consistent across **IAP (Indian Academy of Pediatrics)** and **CDC guidelines**. - Children 9 years and older, and younger children who have been previously vaccinated, require only **1 dose annually**. *3 doses at 4 weeks interval* - The standard protocol for influenza vaccination does **not involve three doses**. - A three-dose schedule is typically seen with vaccines like **Hepatitis B**, **DTaP**, or **Hib**, but not for influenza. *2 doses at 4 weeks interval with a booster dose for high-risk children* - While high-risk children (chronic lung disease, heart disease, immunocompromised) are priority groups for influenza vaccination, the schedule remains **two initial doses** for first-time recipients under 9 years. - There is **no additional booster dose** beyond the two-dose series within the same influenza season, even for high-risk children. - Subsequent years require only **1 dose annually**. *None of the options* - This is incorrect as the standard recommendation is clearly established in immunization guidelines. - The **two-dose schedule at 4-week intervals** for first-time recipients under 9 years is well-documented by IAP and international guidelines.
Question 470: At what age is the BCG vaccination administered in India?
- A. At birth (Correct Answer)
- B. 1 year
- C. 2 years
- D. 6 weeks
Explanation: ***At birth*** - In India, the **BCG vaccine** is routinely administered to infants **at birth** or as early as possible thereafter as per the **Universal Immunization Programme (UIP)**. - This early vaccination aims to provide protection against **severe forms of tuberculosis (TB)**, particularly **tuberculous meningitis** and **disseminated (miliary) TB** in young children. - Early administration is crucial as infants are at highest risk of developing severe TB if exposed. *Incorrect: 1 year* - While other vaccinations might be given at 1 year (such as MMR), the BCG vaccine is specifically recommended at or soon after birth. - Delaying BCG vaccination until 1 year increases the risk of early exposure to TB before immunity can be established, defeating its protective purpose. *Incorrect: 2 years* - The recommended schedule for BCG vaccination in India does not include administration at 2 years of age. - By 2 years, potential exposure to TB may have already occurred, and the vaccine's efficacy in preventing severe forms of the disease would be compromised. *Incorrect: 6 weeks* - At 6 weeks, other vaccines like OPV, DPT, Hepatitis B, Hib, and Rotavirus are administered as part of the UIP schedule. - BCG is specifically given at birth, not at 6 weeks, to provide early protection against severe childhood tuberculosis.
Practice by Chapter
Principles of Immunization
Practice Questions
Types of Vaccines
Practice Questions
Universal Immunization Program
Practice Questions
Cold Chain System
Practice Questions
Vaccine Storage and Handling
Practice Questions
Adverse Events Following Immunization
Practice Questions
National Immunization Schedule
Practice Questions
Polio Eradication
Practice Questions
Measles Elimination
Practice Questions
Tetanus Control
Practice Questions
New and Underutilized Vaccines
Practice Questions
Vaccination Coverage Assessment
Practice Questions
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