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CM10.5 | CM10.5 | Immunization and Childhood Illness Programmes — SDL Guide (Part 3)
Applying Immunization Knowledge in Field Practice
Practical management of an immunization session at the PHC or sub-centre level requires systematic preparation and execution. Pre-session preparation (one day before): calculate vaccine demand (count children due for each antigen from the MCTS defaulter list + expected walk-ins); requisition cold supply (ice packs, vaccine carrier); verify cold chain equipment function (ILR temperature log, alarm status); prepare the immunization register and beneficiary cards. Session execution: at the session site, arrange vaccines in order of use; verify VVM on each vial before use; reconstitute BCG and MR within the session window (BCG: use within 3 hours of reconstitution; MR: use within 4 hours); administer vaccines simultaneously when multiple are due (multiple injections at different sites — alternate thighs for two IM injections, deltoid vs thigh for oral + IM); record each dose in the immunization register, mark the MCP card, and update the MCTS mobile application if available. Post-session: discard used vials (puncture and bury syringes, incinerate vials at PHC); update the cold chain temperature log; identify defaulters (children who were expected but did not attend) for ASHA home-visit follow-up. For catch-up immunization of older children with incomplete schedules: all needed vaccines appropriate for the child's current age can be given simultaneously on the same day; subsequent doses are administered at the minimum interval (≥4 weeks between live vaccines administered subcutaneously; ≥28 days for OPV doses; ≥4 weeks between Pentavalent doses). There is no need to restart a series; continue from where it was left off. Documenting every dose in the MCP card and MCTS ensures continuity regardless of which ANM or sub-centre the child visits next.
SELF-CHECK
A 15-month-old child presents at the PHC with no prior immunizations recorded. Which vaccines can be given TODAY under the UIP catch-up schedule?
A. Only BCG and OPV-0 (birth doses must be given first before moving to older doses)
B. BCG, OPV, Pentavalent (3rd dose), MR, and Vitamin A 1st dose — all simultaneously on the same visit
C. BCG, OPV, and MR only today; all other vaccines require a new schedule starting over
D. No vaccines today — the child is too old for the UIP, which ends at 14 weeks
Reveal Answer
Answer: B. BCG, OPV, Pentavalent (3rd dose), MR, and Vitamin A 1st dose — all simultaneously on the same visit
For a 15-month-old with zero prior doses, the catch-up schedule allows giving all vaccines appropriate for the current age simultaneously: BCG (no upper age limit in UIP catch-up for unvaccinated children, given up to 1 year formally but administered for catch-up); OPV (2 drops); since Pentavalent series was never started, begin at first dose today; MR (appropriate at 15 months — the second dose); and Vitamin A first dose. There is no requirement to restart from birth doses — the catch-up schedule begins with whatever is currently due. The UIP targets children up to 5 years (not 14 weeks). Multiple simultaneous vaccines are recommended (different sites) to minimise missed opportunities.