Immunization and Vaccine-Preventable Diseases — MCQs

Immunization and Vaccine-Preventable Diseases Indian Medical PG Practice Questions and MCQs

Question 481: Which of the following vaccines is not included in the Mission Indradhanush program?

A. Diphtheria
B. Polio
C. Tetanus
D. Typhoid fever vaccine (Correct Answer)

Explanation: ***Typhoid fever vaccine*** - The **typhoid conjugate vaccine (TCV)** was introduced into India's Universal Immunization Programme in a phased manner starting from 2017-2018, but it is **not part of the core Mission Indradhanush vaccines** launched in 2014. - Mission Indradhanush primarily focuses on the original set of vaccines for common, preventable childhood diseases (BCG, DPT, OPV, Hepatitis B, Measles, etc.), and later additions like Rotavirus and PCV. - TCV rollout has been **state-specific and phased**, unlike the universal coverage of core Mission Indradhanush vaccines. *Diphtheria* - The **diphtheria vaccine** is a core component of the Mission Indradhanush program, aiming to protect children against this serious bacterial infection. - It is administered as part of the **DPT (Diphtheria, Pertussis, Tetanus)** or **Pentavalent vaccine** (DPT + Hib + Hepatitis B). *Polio* - The **polio vaccine** is a primary target of Mission Indradhanush, as India has maintained its polio-free status since 2014. - It is given as **OPV (Oral Polio Vaccine)** and/or **IPV (Inactivated Polio Vaccine)** to prevent poliomyelitis. *Tetanus* - The **tetanus vaccine** is included in the Mission Indradhanush program, administered with diphtheria and pertussis as the **DPT vaccine** or as part of the **Pentavalent vaccine**. - It protects against **tetanus**, a severe bacterial infection causing painful muscle spasms and lockjaw.

Question 482: Oral cholera vaccine is effective for:

A. 6 months
B. 12 months
C. 3 years (Correct Answer)
D. 2 years

Explanation: ***3 years*** - **Oral cholera vaccines** like Shanchol and Euvichol-Plus provide protection for at least **3 years** after complete 2-dose immunization. - Studies in endemic areas demonstrate sustained protection extending **up to 5 years** with Shanchol. - The **WHO recommends** OCVs as part of comprehensive cholera control strategies in endemic regions and outbreak settings. - This duration is based on field effectiveness studies and clinical trials in various populations. *2 years* - While **Dukoral** (another OCV) provides protection for approximately **2 years**, this is not the standard duration for the most widely used OCVs. - **2 years** represents the conservative lower estimate, not the established duration for Shanchol/Euvichol vaccines. - Current evidence supports longer protection than 2 years for most recipients. *12 months* - **12 months** significantly underestimates the protective duration of oral cholera vaccines. - All WHO-prequalified OCVs provide protection well beyond 1 year. - This duration might represent only the initial phase of immunity, not the full protective window. *6 months* - **6 months** is far too short and does not reflect the established efficacy of any current oral cholera vaccine. - While seroconversion occurs within weeks, the protective immunity lasts much longer. - No WHO-prequalified OCV has such a limited duration of protection.

Question 483: WHO immunization evaluation coverage survey is normally done in what age group?

A. 0-12 months
B. 6-12 months
C. 12-23 months (Correct Answer)
D. 9-12 months

Explanation: ***12-23 months*** - The **WHO immunization coverage survey** focuses on children aged **12-23 months** to ensure that they have completed their primary vaccination series, including doses that are typically given before 12 months of age but are evaluated after that period. - This age group allows for assessment of timely completion of vaccines like **measles (MCV1)** and the third dose of **DTP (DTP3)**, which are crucial indicators of a functioning immunization program. *0-12 months* - This age group is typically undergoing initial vaccinations, but evaluating coverage at this point might miss children who are still completing their scheduled doses. - Surveying this group wouldn't provide a complete picture of children who have received all recommended vaccines by their first birthday. *6-12 months* - Similar to 0-12 months, children in this age range are often in the process of receiving their primary vaccine series (e.g., DTP3 given around 6 months). - A survey at this stage would not fully capture the completion rates of all routine vaccinations due by the first birthday. *9-12 months* - While the first dose of measles vaccine (MCV1) is often given around 9 months, evaluating coverage only within this narrow window might not reflect the overall completion of the full primary immunization schedule. - It would miss children who might receive MCV1 at 12 months or later, and also wouldn't fully assess other vaccines given earlier.

Question 484: Vaccines at primary health care centers are stored in:

A. ILR (Correct Answer)
B. Ultra-low temperature freezer
C. Ice-lined box
D. None of the options

Explanation: ***ILR*** - An **ILR (Ice Lined Refrigerator)** is specifically designed to maintain vaccines within the **recommended temperature range (2°C to 8°C)**, even during power outages. - Its **ice lining** provides a cold reserve, ensuring temperature stability critical for vaccine efficacy, especially in primary health care settings that may have unreliable power supply. *Ultra-low temperature freezer* - **Ultra-low temperature freezers** (e.g., -70°C to -80°C) are used for storing highly sensitive vaccines like some mRNA COVID-19 vaccines, but they are not standard for routine primary health care vaccine storage due to their cost and specialized maintenance requirements. - Storing routine vaccines at such **extreme cold temperatures** can actually damage them or reduce their potency, as many are designed for storage in a refrigerator, not a freezer. *Ice-lined box* - An **ice-lined box** is primarily used for **transporting vaccines** for short periods, such as during outreach sessions or between health facilities. - While it helps maintain temperature, it is a **temporary solution** and not designed for long-term storage at a primary health care center. *None of the options* - This option is incorrect because the **ILR (Ice Lined Refrigerator)** is specifically designed and commonly used for vaccine storage at primary health care levels, making it the most appropriate answer.

Question 485: In a measles outbreak, measles vaccine can be given to infants at what age range:

A. 2-3 months
B. 3-5 months
C. 2-7 months
D. 6-9 months (Correct Answer)

Explanation: ***6-9 months*** - During a **measles outbreak**, infants as young as **6 months** can receive an early dose of the measles vaccine to provide protection. - This early vaccination is crucial in high-risk situations, even though the standard first dose is typically given at **12-15 months** of age. *2-3 months* - Administering the measles vaccine at **2-3 months** is generally avoided because of the presence of persistent **maternal antibodies**. - These antibodies can interfere with the infant's immune response to the vaccine, making it less effective. *3-5 months* - Similar to the 2-3 month range, **maternal antibodies** are still likely present and at sufficiently high levels in infants aged 3-5 months. - This interference reduces the vaccine's efficacy and the likelihood of developing a robust, lasting immune response. *2-7 months* - While this range includes the accepted 6-month age for early vaccination, infants under **6 months** still pose a challenge due to **maternal antibody interference**. - Combining these ages into a single range doesn't differentiate between the reduced efficacy in younger infants versus the permissible early vaccination at 6 months and older during an outbreak.

Question 486: Which of the following vaccines has the highest coverage among children aged 12-23 months according to NFHS-5 data?

A. BCG vaccine (Correct Answer)
B. DPT vaccine
C. Measles vaccine
D. None of the vaccines

Explanation: ***BCG vaccine (Correct Answer)*** - According to **NFHS-5 (2019-21)**, BCG vaccine has the **highest coverage at 93.3%** among children aged 12-23 months in India. - BCG is administered **at birth or as soon as possible thereafter**, making it the first vaccine in the immunization schedule. - Its high coverage is attributed to **institutional deliveries** and administration at birth in healthcare facilities. - BCG serves as a **key indicator** of access to immunization services. *Measles/MR vaccine* - NFHS-5 data shows **measles/MR first dose coverage at 88.7%**, which is lower than BCG. - Despite being part of routine immunization, measles coverage is **second highest** among commonly tracked vaccines. - Coverage gaps exist due to **dropout rates** and challenges in reaching children at 9-12 months of age. *DPT vaccine* - **DPT3 (third dose) coverage is 76.4%** according to NFHS-5, showing significant dropout from the first dose. - The **multi-dose requirement** (at 6, 10, and 14 weeks) leads to progressive decline in coverage. - DPT3 completion is used as an indicator of **immunization program performance** and demonstrates dropout challenges. *None of the vaccines* - This is incorrect as **all three vaccines have substantial coverage** in India's Universal Immunization Programme. - NFHS-5 data clearly documents **high coverage rates** for these essential childhood vaccines, with BCG leading at over 93%.

Question 487: Which of the following vaccines is not part of the National Immunization Programme?

A. TT
B. OPV
C. Measles
D. Hepatitis A (Correct Answer)

Explanation: ***Hepatitis A*** - The **Hepatitis A vaccine** is **not included** in India's routine **Universal Immunization Programme (UIP)**. - While it protects against **hepatitis A infection**, it is only used in India for outbreak control in specific high-risk situations, not as a universal routine vaccine. - The UIP prioritizes vaccines for diseases with higher public health burden and those targeted for elimination/eradication. *TT (Tetanus Toxoid)* - **Tetanus Toxoid (TT)** is a crucial component of India's **Universal Immunization Programme**. - It is administered to pregnant women (to prevent neonatal tetanus) and as part of childhood immunization (DPT/Pentavalent vaccine). - Protects against **tetanus**, a potentially fatal bacterial infection. *OPV (Oral Polio Vaccine)* - **Oral Polio Vaccine (OPV)** has been a cornerstone of India's **Universal Immunization Programme** under the Pulse Polio Programme. - Administered to infants and children to provide protection against **poliomyelitis**. - India has been polio-free since 2014, with OPV being gradually replaced by IPV (Inactivated Polio Vaccine). *Measles* - The **Measles vaccine** (given as MR - Measles-Rubella vaccine) is a vital part of India's **Universal Immunization Programme**. - Administered at 9-12 months and 16-24 months of age. - Helps control **measles**, a highly contagious viral disease that can cause serious complications and death in children.

Question 488: Mission Indradhanush was started in

A. Jan-05
B. Jul-10
C. Dec-14 (Correct Answer)
D. Mar-16

Explanation: ***Dec-14*** - Mission Indradhanush, a flagship immunization program in India, was launched on **December 25, 2014**. - Its primary aim was to **immunize all children and pregnant women** against preventable diseases. *Jan-05* - This date does not correspond to the launch of Mission Indradhanush. Other health initiatives or policies may have been introduced around this time. - The focus on a comprehensive, nationwide immunization drive as seen in Mission Indradhanush came later. *Jul-10* - This date is incorrect for the inception of Mission Indradhanush. There were various health programs ongoing in India during 2010. - No major national immunization campaign of the scale of Mission Indradhanush began in July 2010. *Mar-16* - While significant developments and phases of Mission Indradhanush occurred after its launch, March 2016 was not the initiation date. - This period might have seen the implementation of subsequent phases or intensified efforts of the mission.

Question 489: What is the recommended regimen for human diploid cell vaccine for pre-exposure rabies vaccination?

A. 0, 7, 28 then booster dose 1 year (Correct Answer)
B. 0, 14, 28 then booster dose 90 days
C. 0, 7, 28 then booster dose 2 years
D. 0, 7, 21 then booster dose 12 months

Explanation: ***0, 7, 28 then booster dose 1 year*** - The recommended schedule for **pre-exposure prophylaxis** with human diploid cell vaccine (HDCV) in India is three doses on days **0, 7, and 28**. - A **booster dose at 1 year** is recommended for individuals with **continuous risk of exposure** (e.g., veterinarians, laboratory workers, animal handlers). - This schedule provides adequate antibody titers and long-term protection. Further boosters may be given every 3-5 years based on antibody titers or risk assessment. *0, 7, 21 then booster dose 12 months* - While the 0, 7, 21 (or 21-28) day schedule is used in some international protocols (WHO/CDC), the **standard schedule in India is 0, 7, 28 days**. - The booster timing at 12 months is appropriate, but the primary series schedule is not the preferred Indian guideline. *0, 7, 28 then booster dose 2 years* - The primary series schedule of 0, 7, 28 days is correct. - However, the **booster interval of 2 years is too long** for the first booster dose in pre-exposure prophylaxis. The first booster is recommended at **1 year**, with subsequent boosters at longer intervals (3-5 years) based on risk. *0, 14, 28 then booster dose 90 days* - A **day 14 dose is not part of the standard schedule** for pre-exposure rabies vaccination. - A **booster at 90 days is incorrect** – this is far too soon and not part of established pre-exposure prophylaxis guidelines. The first booster should be at 1 year, not 3 months.

Question 490: What are the possible mild reactions after receiving the influenza vaccine?

A. Itching
B. Local swelling
C. Fever
D. All of the options (Correct Answer)

Explanation: ***All of the options*** - All three reactions listed (local swelling, fever, and itching) are recognized **mild side effects** of the influenza vaccine. - **Local reactions** such as swelling, soreness, redness, and itching at the injection site are common and typically resolve within 1-2 days. - **Systemic reactions** like low-grade fever, headache, malaise, and muscle aches can occur as the immune system responds to the vaccine, usually lasting 1-2 days. - Since all the individual options represent possible mild reactions, the correct answer encompasses all of them. *Why individual options alone are incomplete* - Selecting only "Local swelling," "Fever," or "Itching" would be medically accurate but incomplete, as the question asks for "possible mild reactions" (plural). - Each individual option represents only one type of mild reaction, while multiple types can occur. - The most comprehensive and correct answer includes all possible mild reactions listed.

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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