PE18.{3,6,14} | Vaccine Classification and Schedules — Summary & Reflection

KEY TAKEAWAYS

Vaccines are classified by antigen type: live-attenuated (BCG, OPV, MR, rotavirus, JE-live), inactivated (IPV, hepatitis A), toxoids (DT, TT, Td), subunit/conjugate (HepB, Hib, PCV, HPV), and polysaccharide (plain, for ≥2 years only). Live vaccines are contraindicated in significant immunodeficiency and pregnancy; inactivated/subunit vaccines are safe in these populations. The NIS India provides free vaccines at birth (BCG, OPV-0, HepB), at 6/10/14 weeks (pentavalent, OPV, rotavirus, fIPV), at 9–12 months (MR, JE in endemic areas, Vitamin A), at 16–24 months (DPT+OPV booster, MR-2), at 5–6 years (DPT+OPV), and TT/Td at 10 and 16 years. Newer vaccines — pentavalent, PCV, rotavirus, JE, TCV, fIPV, HPV, influenza, COVID — have expanded protection. Prescribing the schedule requires assessing fitness, applying catch-up principles, and avoiding false contraindications (mild fever, prematurity, family history of reactions). AEFI management requires adrenaline availability at all immunization sites; serious AEFI must be reported.

REFLECT

Recall the 14-month-old in the opening scenario whose family had never vaccinated him. What vaccines would he have missed? Using the NIS and catch-up principles, sketch the schedule you would prescribe for this child today. What would you say to the mother to address her likely anxieties about giving 'many injections at once'? How does your response to her change if she mentions that an older sibling had a 'bad reaction' to a vaccine — what questions would you ask to determine whether that was a true contraindication or a false one? Reflect on a community immunization outreach setting you have observed: what barriers to vaccination did you notice, and how did the health worker address them?