A 9-month-old boy is due for his measles-rubella vaccine at the PHC. His mother says he developed hives on his face after eating scrambled egg two months ago, without breathing difficulty or swelling of the lips. He is otherwise well. What is the best course of action?

Give the MR vaccine as scheduled

Replace MR with measles vaccine only

During a measles outbreak in an urban slum in Delhi, a 7-month-old healthy girl is brought to the outbreak response clinic. She has received all vaccines due up to 14 weeks. What is the correct plan for measles vaccination?

MR now, then the usual 9-month and 16-24-month doses

MR now, counted as her first routine MR dose

Immunoglobulin now, MR at 12 months

No MR before 9 months, even in an outbreak

A baby girl born at 28 weeks to an HBsAg-negative mother is now 8 weeks old in a step-down nursery. She weighs 1.6 kg, is on full feeds and is clinically stable. She received no vaccines at birth. What is the most appropriate plan for her vaccination now?

All 6-week vaccines today at full doses

Wait until she reaches 6 weeks of corrected age

Give the 6-week vaccines at half doses

Immunisation schedules (UIP and IAP 2025)

26 NEET-PG practice questions on Immunisation schedules (UIP and IAP 2025), part of Paediatrics. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
A 9-month-old boy is due for his measles-rubella vaccine at the PHC. His mother says he developed hives on his face after eating scrambled egg two months ago, without breathing difficulty or swelling of the lips. He is otherwise well. What is the best course of action?
1. AReplace MR with measles vaccine only
2. BDefer MR until 2 years of age
3. CGive the MR vaccine as scheduled
4. DGive MR after an egg skin test
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Answer: C · Give the MR vaccine as scheduled
Egg allergy, even severe, is not a contraindication to measles-containing vaccines, which carry negligible egg protein, so the dose is given on time with the usual 30-minute observation. Delaying it leaves the child exposed at the age when measles is most dangerous. True contraindications are a severe allergic reaction to a previous dose or a vaccine component, severe immunodeficiency for live vaccines, and pregnancy. Skin testing with the vaccine or egg does not predict reactions and is not needed.
- A: The measles component is the same; egg allergy does not change the vaccine.
- B: Deferring leaves him unprotected; egg allergy is no reason to delay.
- D: Skin tests do not predict vaccine reactions and are not needed.
Question 2 · Hard
A 4-month-old boy received oral rotavirus vaccine (Rotavac, a three-dose vaccine) at 6 weeks at a PHC. His family has now moved to a city, and at 16 weeks a private clinic stocks only Rotarix, a two-dose vaccine. How many more rotavirus doses should he receive?
1. ARestart with two Rotarix doses
2. BNo more doses
3. CTwo more doses
4. DOne more dose
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Answer: C · Two more doses
When rotavirus vaccines of different products are mixed, or any dose was of a three-dose product (or is unknown), a total of three doses is given. He has had one Rotavac dose, so he needs two more doses of the available vaccine, at least 4 weeks apart. The series must be completed within the age limit for the vaccine, so the doses should not be delayed. Earlier doses are never repeated just because the product changed.
- A: Earlier doses count; the series is continued, not restarted.
- B: One dose of a three-dose vaccine is incomplete protection.
- D: One more dose would apply only if both doses were of a two-dose product.
Question 3 · Medium
During a measles outbreak in an urban slum in Delhi, a 7-month-old healthy girl is brought to the outbreak response clinic. She has received all vaccines due up to 14 weeks. What is the correct plan for measles vaccination?
1. AMR now, counted as her first routine MR dose
2. BImmunoglobulin now, MR at 12 months
3. CNo MR before 9 months, even in an outbreak
4. DMR now, then the usual 9-month and 16-24-month doses
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Answer: D · MR now, then the usual 9-month and 16-24-month doses
In an outbreak, infants from 6 months of age can receive an early dose of measles-containing vaccine, because they are at high risk and maternal antibody has largely waned. A dose given before 9 months produces a weaker response, partly because of residual maternal antibody, so it is not counted. She still needs the two routine doses at 9-12 months and 16-24 months, with at least 4 weeks between doses. Vitamin A is also given to children with measles during an outbreak.
- A: A dose before 9 months is not counted, because the response is weaker.
- B: Immunoglobulin is for exposed infants, and it delays the vaccine response further.
- C: An early dose from 6 months is recommended during an outbreak.
Question 4 · Medium
A 2½-year-old girl from a migrant labour family is brought to a PHC with no vaccination record, and her mother says she has never been vaccinated. The medical officer plans catch-up vaccination under the UIP. Which vaccine is no longer given at her age?
1. AOPV
2. BDPT
3. CRotavirus vaccine
4. DMeasles-rubella vaccine
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Answer: C · Rotavirus vaccine
Rotavirus vaccine is given only in infancy: under the UIP it is not given after 1 year of age, and the IAP schedule also limits it to early infancy. This is because the vaccine has been linked with a small risk of intussusception, which rises naturally with age, and older children have usually met the virus already. She should receive DPT and OPV (three doses 4 weeks apart, then a booster), two doses of MR at least 4 weeks apart, vitamin A, and JE vaccine in endemic districts. The catch-up visit is also a chance to start a vaccination card or U-WIN record.
- A: OPV is given to unvaccinated children well beyond 2 years.
- B: DPT is given up to 7 years of age under the UIP.
- D: MR is given up to 5 years of age under the UIP.
Question 5 · Hard
A baby girl born at 28 weeks to an HBsAg-negative mother is now 8 weeks old in a step-down nursery. She weighs 1.6 kg, is on full feeds and is clinically stable. She received no vaccines at birth. What is the most appropriate plan for her vaccination now?
1. AWait until she weighs 2 kg
2. BAll 6-week vaccines today at full doses
3. CWait until she reaches 6 weeks of corrected age
4. DGive the 6-week vaccines at half doses
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Answer: B · All 6-week vaccines today at full doses
Medically stable preterm infants are vaccinated by chronological age, not corrected age, with full standard doses, because they respond adequately and are at greater risk of infection. So at 8 weeks she should receive the 6-week vaccines now, and BCG can be given as well. The weight threshold of 2 kg matters only for the hepatitis B birth dose in babies of HBsAg-negative mothers, which is not counted in the series if given below that weight. Splitting or reducing doses is never correct, because a reduced dose is not counted.
- A: Vaccination is not delayed for weight in a stable preterm infant.
- C: Corrected age is used for development, not for the vaccine schedule.
- D: Reduced doses give poor protection and are not counted.
Question 6 · Medium
A 4-year-old boy with perinatally acquired HIV infection is well on antiretroviral therapy, with a CD4 percentage of 22% for the last year. His mother asks which vaccines he can safely receive at your ART centre clinic. Consider four vaccines: 1. MMR. 2. Varicella vaccine. 3. BCG. 4. Inactivated influenza vaccine. Which of these can he receive?
1. A1 and 4 only
2. B2, 3 and 4 only
3. C1, 2, 3 and 4
4. D1, 2 and 4 only
Answer and explanation in LearnFree account
Question 7 · Hard
A baby girl was born to an HBsAg-positive mother and received hepatitis B vaccine with HBIG at 6 hours of age, followed by pentavalent vaccine at 6, 10 and 14 weeks. At 10 months, tests show HBsAg negative and anti-HBs 4 mIU/mL (protective level 10 mIU/mL or more). What is the next step?
1. AStart oral tenofovir
2. BNo action, as immune memory protects her
3. CRepeat hepatitis B vaccination and retest
4. DHBIG every 3 months until 5 years
Answer and explanation in LearnFree account
Question 8 · Hard
A 3-year-old boy from a tribal area of Gujarat has had three admissions with painful swelling of the hands and feet and one with pneumonia. Hb electrophoresis shows HbS 88%, HbF 10% and no HbA. He has received all UIP vaccines on time, including pneumococcal conjugate vaccine, and is on penicillin prophylaxis. Which additional vaccine is most needed?
1. ARepeat of the full infant PCV series
2. BPPSV23, 8 weeks after his last PCV dose
3. CPPSV23 in place of further PCV, starting at 5 years
4. DNone; penicillin prophylaxis is enough
Answer and explanation in LearnFree account
Question 9 · Easy
A 15-month-old girl received MMR at a private clinic 10 days ago. Her mother now asks for the varicella vaccine at your OPD so that she does not have to come back. If the two live injectable vaccines were not given on the same day, what is the minimum interval before varicella vaccine can be given?
1. A2 weeks
2. B4 weeks
3. C8 weeks
4. DNo interval is needed
Answer and explanation in LearnFree account
Question 10 · Medium
A 6-week-old girl is brought for her first vaccines. Her elder brother died at 5 months of severe diarrhoea and recurrent infections. Today her absolute lymphocyte count is 900/µL and newborn screening reports very low T-cell receptor excision circles (TRECs). Which of today's scheduled vaccines must be withheld?
1. AOral rotavirus vaccine
2. BPentavalent vaccine
3. CFractional IPV
4. DPneumococcal conjugate vaccine
Answer and explanation in LearnFree account
Question 11 · Medium
A 9-month-old boy received intravenous immunoglobulin 2 g/kg three weeks ago for Kawasaki disease and is now well. He is due for his first measles-rubella dose, and there is no measles outbreak in the area. What is the best plan?
1. ADefer MR until 11 months after IVIG
2. BGive MR today with vitamin A
3. CGive MR today and count the dose
4. DDefer MR for 4 weeks only
Answer and explanation in LearnFree account
Question 12 · Medium
A healthy 3-year-old girl in Chennai has never had chickenpox or varicella vaccine. Her 6-year-old brother developed a chickenpox rash yesterday, and they share a bedroom. What is the most appropriate step for the girl?
1. AVaccinate her after 4 weeks
2. BVaricella-zoster immunoglobulin today
3. CVaricella vaccine today
4. DOral acyclovir for 7 days from today
Answer and explanation in LearnFree account
Question 13 · Medium
A paediatrics postgraduate compares the national and IAP schedules with four statements: 1. The UIP gives fractional IPV intradermally, while the IAP schedule uses full-dose IPV intramuscularly. 2. The UIP gives pneumococcal conjugate vaccine as three primary doses at 6, 10 and 14 weeks. 3. The UIP measles vaccine at 9 months includes the mumps component. 4. The IAP schedule recommends hepatitis A and varicella vaccines, which the UIP does not include. Which statements are correct?
1. A1, 2, 3 and 4
2. B1 and 4 only
3. C1, 2 and 4 only
4. D2 and 3 only
Answer and explanation in LearnFree account
Question 14 · Medium
A 4-year-old boy with nephrotic syndrome has been taking prednisolone 2 mg/kg/day for the past 4 weeks. He is due for a varicella vaccine and his mother asks whether it can be given at today's OPD visit. What is the most appropriate advice?
1. AGive it 4 weeks after high-dose steroid stops
2. BGive it today with varicella immunoglobulin
3. CGive it today at a separate injection site
4. DGive it only 12 months after remission
Answer and explanation in LearnFree account
Question 15 · Medium
A term baby is born in a district hospital to a 26-year-old mother who is HBsAg positive and HBeAg positive. The baby weighs 3.1 kg and is well. What is the most appropriate management for the baby?
1. AHepatitis B vaccine alone within 24 hours
2. BHepatitis B vaccine and HBIG within 12 hours
3. CFormula feeding and vaccine at 6 weeks
4. DHBIG now and the vaccine at 6 weeks
Answer and explanation in LearnFree account
Question 16 · Easy
Before discharge from a NICU in Mumbai, the parents of an ex-preterm baby are told that a single long-acting injection of nirsevimab will protect him through his first RSV season. What is nirsevimab?
1. AA live attenuated intranasal RSV vaccine
2. BAn inactivated whole-virus RSV vaccine
3. CA recombinant RSV G-protein subunit vaccine
4. DA monoclonal antibody against the RSV F protein
Answer and explanation in LearnFree account
Question 17 · Hard
A 5-month-old boy is admitted with clusters of flexor spasms that started at 4 months; EEG shows hypsarrhythmia, and he has been started on high-dose oral steroids. He received his 6- and 10-week pentavalent, OPV and rotavirus doses but missed the 14-week dose. The spasms are still uncontrolled. What is the best plan for his missed vaccines?
1. AStop all vaccines until 2 years of age
2. BDefer pertussis; give other inactivated antigens
3. CGive the pentavalent dose as due today
4. DSwitch to DTaP and give it today
Answer and explanation in LearnFree account
Question 18 · Medium
A 4-month-old girl developed prolonged seizures and remained unresponsive for 24 hours, starting 2 days after her second pentavalent dose. CSF, imaging and metabolic tests found no other cause, and she has since recovered. How should her remaining doses be given?
1. AContinue without any pertussis component
2. BContinue pentavalent with paracetamol
3. CSwitch to an acellular pertussis vaccine
4. DStop all further vaccination
Answer and explanation in LearnFree account
Question 19 · Easy
In a private paediatric clinic in Kochi, the parents of a 9-month-old girl ask why their paediatrician offers MMR, while their neighbour's baby received MR at the government PHC. Which disease does the 9-month vaccine on the IAP schedule cover that the UIP vaccine does not?
1. AMumps
2. BRubella
3. CHepatitis A
4. DVaricella
Answer and explanation in LearnFree account
Question 20 · Easy
A healthy 3-year-old boy is brought to a private clinic in Pune for influenza vaccine before the monsoon. He has never received influenza vaccine before. How many doses should he receive this season?
1. ATwo doses 4 weeks apart
2. BThree doses at 0, 1 and 6 months
3. CA single dose
4. DTwo doses 6 months apart
Answer and explanation in LearnFree account
Question 21 · Easy
An 8-year-old boy who has never been vaccinated is brought to a PHC after his family moves from a remote village. Under the UIP, which vaccine should be used to start his protection against diphtheria and tetanus?
1. ATd
2. BDT (paediatric)
3. CDTwP
4. DPentavalent
Answer and explanation in LearnFree account
Question 22 · Hard
A 5-year-old boy with steroid-dependent nephrotic syndrome has been taking prednisolone 2 mg/kg/day for 3 weeks. His cousin, who played with him the whole day 2 days ago, now has chickenpox. He has never had chickenpox or varicella vaccine. What is the most appropriate prophylaxis?
1. ANormal immunoglobulin for measles
2. BVaricella-zoster immunoglobulin
3. CVaricella vaccine within 72 hours
4. DStopping prednisolone at once
Answer and explanation in LearnFree account
Question 23 · Easy
A 14-week-old boy is brought to the PHC for his third dose of pentavalent, OPV and rotavirus vaccine. He has had a runny nose for two days, his axillary temperature is 37.8 °C, he is feeding well and he is taking amoxicillin for an ear infection. What should the medical officer do?
1. AGive only the oral vaccines today
2. BDefer all vaccines for two weeks
3. CGive all the due vaccines today
4. DWait until the amoxicillin course ends
Answer and explanation in LearnFree account
Question 24 · Medium
At an immunisation clinic, the paediatric resident reviews four events reported after DTwP-containing vaccine in different infants: 1. Anaphylaxis within minutes of the previous dose. 2. Encephalopathy 3 days after a dose, with no other cause found. 3. Persistent inconsolable crying for 3 hours within 48 hours of a dose. 4. A febrile seizure within 48 hours of a dose. Which of these are absolute contraindications to further doses of pertussis vaccine?
1. A1 and 2 only
2. B1, 2, 3 and 4
3. C1, 2 and 3 only
4. D2 and 4 only
Answer and explanation in LearnFree account
Question 25 · Medium
A 7-month-old boy received BCG, OPV-0, the hepatitis B birth dose and his first pentavalent, OPV and rotavirus doses at 6 weeks. He then missed all visits because the family moved for work, and he is now back at the PHC. How should his pentavalent vaccination continue?
1. AGive dose 2 now and dose 3 after 4 weeks
2. BRestart the three-dose series from dose 1
3. CGive a single dose now and stop
4. DGive doses 2 and 3 today in each thigh
Answer and explanation in LearnFree account

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Immunisation schedules (UIP and IAP 2025)

A 9-month-old boy is due for his measles-rubella vaccine at the PHC. His mother says he developed hives on his face after eating scrambled egg two months ago, without breathing difficulty or swelling of the lips. He is otherwise well. What is the best course of action?

A 4-month-old boy received oral rotavirus vaccine (Rotavac, a three-dose vaccine) at 6 weeks at a PHC. His family has now moved to a city, and at 16 weeks a private clinic stocks only Rotarix, a two-dose vaccine. How many more rotavirus doses should he receive?

During a measles outbreak in an urban slum in Delhi, a 7-month-old healthy girl is brought to the outbreak response clinic. She has received all vaccines due up to 14 weeks. What is the correct plan for measles vaccination?

A 2½-year-old girl from a migrant labour family is brought to a PHC with no vaccination record, and her mother says she has never been vaccinated. The medical officer plans catch-up vaccination under the UIP. Which vaccine is no longer given at her age?

A baby girl born at 28 weeks to an HBsAg-negative mother is now 8 weeks old in a step-down nursery. She weighs 1.6 kg, is on full feeds and is clinically stable. She received no vaccines at birth. What is the most appropriate plan for her vaccination now?

A baby girl was born to an HBsAg-positive mother and received hepatitis B vaccine with HBIG at 6 hours of age, followed by pentavalent vaccine at 6, 10 and 14 weeks. At 10 months, tests show HBsAg negative and anti-HBs 4 mIU/mL (protective level 10 mIU/mL or more). What is the next step?

A 15-month-old girl received MMR at a private clinic 10 days ago. Her mother now asks for the varicella vaccine at your OPD so that she does not have to come back. If the two live injectable vaccines were not given on the same day, what is the minimum interval before varicella vaccine can be given?

A 9-month-old boy received intravenous immunoglobulin 2 g/kg three weeks ago for Kawasaki disease and is now well. He is due for his first measles-rubella dose, and there is no measles outbreak in the area. What is the best plan?

A healthy 3-year-old girl in Chennai has never had chickenpox or varicella vaccine. Her 6-year-old brother developed a chickenpox rash yesterday, and they share a bedroom. What is the most appropriate step for the girl?

A 4-year-old boy with nephrotic syndrome has been taking prednisolone 2 mg/kg/day for the past 4 weeks. He is due for a varicella vaccine and his mother asks whether it can be given at today's OPD visit. What is the most appropriate advice?

A term baby is born in a district hospital to a 26-year-old mother who is HBsAg positive and HBeAg positive. The baby weighs 3.1 kg and is well. What is the most appropriate management for the baby?

Before discharge from a NICU in Mumbai, the parents of an ex-preterm baby are told that a single long-acting injection of nirsevimab will protect him through his first RSV season. What is nirsevimab?

A 4-month-old girl developed prolonged seizures and remained unresponsive for 24 hours, starting 2 days after her second pentavalent dose. CSF, imaging and metabolic tests found no other cause, and she has since recovered. How should her remaining doses be given?

In a private paediatric clinic in Kochi, the parents of a 9-month-old girl ask why their paediatrician offers MMR, while their neighbour's baby received MR at the government PHC. Which disease does the 9-month vaccine on the IAP schedule cover that the UIP vaccine does not?

A healthy 3-year-old boy is brought to a private clinic in Pune for influenza vaccine before the monsoon. He has never received influenza vaccine before. How many doses should he receive this season?

An 8-year-old boy who has never been vaccinated is brought to a PHC after his family moves from a remote village. Under the UIP, which vaccine should be used to start his protection against diphtheria and tetanus?

A 5-year-old boy with steroid-dependent nephrotic syndrome has been taking prednisolone 2 mg/kg/day for 3 weeks. His cousin, who played with him the whole day 2 days ago, now has chickenpox. He has never had chickenpox or varicella vaccine. What is the most appropriate prophylaxis?

A 14-week-old boy is brought to the PHC for his third dose of pentavalent, OPV and rotavirus vaccine. He has had a runny nose for two days, his axillary temperature is 37.8 °C, he is feeding well and he is taking amoxicillin for an ear infection. What should the medical officer do?

A 7-month-old boy received BCG, OPV-0, the hepatitis B birth dose and his first pentavalent, OPV and rotavirus doses at 6 weeks. He then missed all visits because the family moved for work, and he is now back at the PHC. How should his pentavalent vaccination continue?