Que. 1. What do you mean by term immunization?

Ans. 1. Immunization is a process of inducing or conferring immunity by artificial means.

Que. 2. Who did introduce the scientific immunization against smallpox?

Ans. 2. Edward Jenner in 1796.

Que. 3. Which were the vaccines introduced by Louis Pasteur?

Ans. 3. Anthrax in sheep in 1881, followed by Rabies Vaccine in man.

Que. 4. Who did introduce passive immunization? 

Ans. 4. Emil Von Behring who used antitoxin serum against Diphtheria & Tetanus.

Que. 5. What was the contribution of Behring & Wernicke (1891)?

Ans. 5. They introduced treatment of Diphtheria with antitoxin.

Que. 6. Which are the types of immunization?

Ans. 6. Immunization are of 3 types – 

1)     Active Immunization

2)     Passive Immunization

3)     Passive – Active Immunization

Que. 7. What do you mean by active immunization?

Ans. 7. It is a process conferring immunity by administration of live or dead immunizing agents, their products or derivatives.

Que. 8. What are the indications of active immunization?

Ans. 8. Indications of active immunization are as follows – 

1. a)     Routine Immunization of susceptible population
2. b)     Selective immunization of population at risk

Que. 9. What do you mean by term Passive Immunization?

Ans. 9. Passive Immunization is a process of inducing immunity by administration of readymade antibodies of human or animal origin. Immunity appears immediately after passive immunization and continue for small duration.

Que. 10. What are the indications of passive immunization?

Ans. 10. Indications of passive immunization are as follows – 

1. a)     Selective protection of high risk individuals.
2. b)     Treatment of few infectious diseases e.g. measles, diphtheria, mumps etc.

Que. 11. What do you mean by term passive-active immunization?

Ans. 11. It is a process in which immunity is conferred by simultaneous administration of agents for inducing active and passive immunity. Immunity as a result appears immediately and lost for longer period, e.g. post exposure management of tetanus and rabies.

Que. 12. How will you define term immunizing agents?

Ans. 12. Immunizing agents are used for inducing artificially active or passive immunity to the susceptible hosts.

Que. 13. What do you mean by term vaccine?

Ans. 13. Vaccine is an immune-biological substance designed to produce specific protection against a given disease. It stimulates the production of protective antibody and other immune mechanisms.

Que. 14. What are the properties of the ideal vaccine?

Ans. 14. Properties of the ideal vaccine are as follows – 

1)     Provide long lasting immunity

2)     Should induce both humoral and cellular immunity.

3)     Should not induce auto-immunity and cellular immunity

4)     Should not be expensive to produce

5)     Should be easy to store and administer

6)     Must be perceived to be safe

Que. 15. What do you mean by attenuated vaccine?

Ans. 15. Attenuated vaccines are also known as LIVE VACCINES and are prepared from live but attenuated organisms. These organisms after repeatedly passed in tissue culture or in the chick embryo in the laboratory, have lost their capacity to induce active disease but retain the immunogenicity.

Que. 16. Name few attenuated vaccines.

Ans. 16. BCG, Measles, Polio, Mumps, Influenza, plague, Typhoid etc.

Que. 17. What are the disadvantages of attenuated vaccines?

Ans. 17. The disadvantages of attenuated vaccines include – 

1)     Attenuated vaccines very rarely can cause clinical illnesses

2)     Proper storage of vaccine is must and critical

3)     Cannot be given safely to immunosuppressed individuals as may cause serious illness or death in them

Que. 18. What do you mean by the term inactivated vaccines?

Ans. 18. Inactivated vaccines are also known as Killed Vaccines and prepared from intact organisms killed by heat, U-V radiation, or by treatment with chemicals such as phenol, alcohol, formalin or beta-propiolactone.

Que. 19. Name few inactivated or killed vaccines.

Ans. 19. Typhoid, Cholera, Polio, Rabies, Hepatitis A etc.

Que. 20. What is the absolute contraindication of killed vaccines?

Ans. 20. A severe local or general reaction to a previous dose.

Que. 21. What are the advantages of an inactivated vaccine?

Ans. 21. The advantages of an inactivated vaccine are as follows – 

1)     Safe to use and can be given to immune-deficient and pregnant individuals.

2)     Cheaper than attenuated vaccine

3)     Storage is not so stringent as attenuated vaccines

Que. 22. What do you mean by derived vaccines?

Ans. 22. These vaccines are derived from bacterial toxins, bacterial capsules and viral envelopes. Derived vaccines generate only antibody mediated immune response.

Que. 23. Name few derived vaccines.

Ans. 23. Tetanus, Diphtheria, Meningococcal Meningitis, Pertussis, Influenza & Hepatitis B.

Que. 24. What do you mean by recombinant vaccines?

Ans. 24. These vaccines are developed by genetic engineering technology and contains pure disease agents.

Que. 25. What are the advantages of recombinant vaccines?

Ans. 25. Recombinant vaccines simulate natural infection, stimulate humoral as well as cell mediated immune response, contain no reactogenic material and satisfy economic as well as operational feasibility criteria.

Que. 26. What do you mean by Combined Vaccines?

Ans. 26. Combined vaccines contain more than one type of immunizing agents in a single vaccine. It is also known as Mixed Vaccine.

Que. 27. What is the aim of combined vaccine?

Ans. 27. The aim of combined vaccine is to simplify administration, reduce costs and minimize the number of contacts of the user with the health system.

Que. 28. Write few examples of combined vaccine.

Ans. 28. DPT, MMR, MR, Pentavalent vaccine, DT etc.

Que. 29. What do you mean by polyvalent vaccine?

Ans. 29. The term polyvalent vaccine means vaccine which are prepared from 2 or more strains of the same species of infectious agents e.g. polio & Influenza vaccine.

Que. 30. What do you mean by term Autogenous Vaccine?

Ans. 30. The term autogenous vaccine means that the organisms present in the vaccine is derived from the same individual.

Que. 31. Who did develop & introduce polio vaccine?

Ans. 31. Salk (IPV) & Sabin (OPV).

Que. 32. Name two diseases which were eradicated from India because of vaccination strategy.

Ans. 32. Smallpox & poliomyelitis.

Que. 33. After how many days of active immunization, immunity does appear in the body?

Ans. 33. 2-3 weeks after active immunization.

Que. 34. How will you classify immunizing agents?

Ans. 34. 3 types – Vaccines, Immunoglobulins & antisera.

Que. 35. How will you classify vaccines?

Ans. 35. 4 types – Attenuated, Inactivated, Derived & Refined.

Que. 36. Which type of vaccine does provide complete response, humoral as well as cell mediated?

Ans. 36. Attenuated vaccines.

Que. 37. In which type of vaccine, long term immunity is provided?

Ans. 37. Attenuated vaccines.

Que. 38. In which type of vaccine, multiple booster doses of the vaccine are required?

Ans. 38. Basically in inactivated vaccines.

Que. 39. Which is the preferred route of administration in inactivated vaccines?

Ans. 39. Intramuscular (IM) or Subcutaneous (SC).

Que. 40. Which type of immunity is induced by the inactivated vaccines?

Ans. 40. Only humoral immunity.

Que. 41. What is the mechanism of action of recombinant vaccine?

Ans. 41. When recombinant vaccine is administered, the attenuated carrier virus replicates in the tissues of the recipient host, releasing large quantities of pure antigens and generating massive immune response.

Que. 42. Give two examples of refined vaccines.

Ans. 42. Recombinant & synthetic vaccines.

Que. 43. What is the role of immunizing agents for passive immunization?

Ans. 43. These are used in the prophylaxis of viral and bacterial infections and in replacement of antibodies in immune deficient patients.

Que. 44. When are peak blood levels of immunoglobulin reached after intramuscular injection?

Ans. 44. Within 2 days.

Que. 45. What is the half-life of immunoglobulin preparations?

Ans. 45. 20-35 days.

Que. 46. Which are the immunizing agents available for passive immunization?

Ans. 46. Immunizing agents available for passive immunization are as follows – 

1)     Antisera or antitoxins

2)     Normal human immunoglobulins

3)     Specific (hyper immune) human immunoglobulins

Que. 47. What do you mean by human antisera?

Ans. 47. Human antisera are antiviral and antibacterial, and are either obtained from volunteers who are subjected to repeated immunization to produce an adequate quantity of antibodies (Immune Sera) or from recovering cases from an attack of a particular communicable disease (convalescent sera).

Que. 48. What are the limitations of human antisera?

Ans. 48. The limitations of human antisera are as follows – 

1)     Higher cost

2)     Disappointing results

3)     Lack of human volunteers in case of immune sera

4)     Difficulty in obtaining adequate supply from recovering patients, usually being children, in case of convalescent sera.

Que. 49. What do you mean by normal human immunoglobulins?

Ans. 49. The normal human immunoglobulins are also called standard or polyvalent immunoglobulins and represent the normal pool of immunoglobulins possessed by healthy individuals.

Que. 50. What are the WHO standards for the preparation of normal human immunoglobulins?

Ans. 50. WHO standards are as follows – 

1)     Preparation should contain at least 90% intact IgG

2)     Should be free from IgG aggregates as much as possible

3)     All subclasses of IgG should present

4)     There should be low IgA concentration and

5)     The level of antibody against at least 2 bacterial species or 2 viruses should be ascertained

Que. 51. What do you mean by Specific Human Immunoglobulins?

Ans. 51. The specific or hyper immune human immunoglobulins should contain at least 5 times the antibody potential of the standard human immunoglobulins per unit volume.

Que. 52. How are specific human immunoglobulins prepared?

Ans. 52. These are prepared from the plasma of the patients who have recently recovered from an infection or are obtained from an individual who have been immunized against a specific infection.

Que. 53. Mention use of specific human immunoglobulins.

Ans. 53. Uses of specific human immunoglobulins are as follows – 

1)     Protection of chickenpox for highly susceptible individuals

2)     Post exposure prophylaxis of Hepatitis B & Rabies

3)     For tetanus prophylaxis in the wounded

Que. 54. Mention uses of normal human immunoglobulins.

Ans. 54. Uses of normal human immunoglobulins are as follows – 

1)     To prevent measles in highly susceptible individuals

2)     To provide 12 weeks temporary protection against Hepatitis A infection for travelers to endemic areas

3)     To control institutional & household outbreak of hepatitis A infection

Que. 55. What do you mean by Immunologic adjuvant?

Ans. 55. An immunologic adjuvant is defined as any substance that acts to accelerate, prolong or enhance antigen specific immune responses when used in combination with specific vaccine antigens.

Que. 56. What are the advantages of adjuvant?

Ans. 56. The advantages of adjuvants are as follows – 

1)     Immunological response resulting in greater output of antibodies

2)     Lesser quantity of vaccine and fewer number of doses of vaccines are required

3)     Both primary and secondary immune responses are achieved by a single injection of a vaccine

4)     Peak of antibodies generated is maintained over a long period

Que. 57. Give few examples of adjuvants.

Ans. 57. Mineral adjuvants – Aluminum Hydroxide and Aluminum phosphate

               Emulsified adjuvants – Water in oil

              Bacterial adjuvants – BCG, B. pertussis & Corynebacterium parvum.

Que. 58. Which are the absolute contraindications of immunization?

Ans. 58. Allergy & Immune deficiency

Que. 59. Which are the relative contraindications of immunization?

Ans. 59. The relative contraindications of immunization are as follows – 

1)     Acute febrile illness

2)     Pregnancy in case of live vaccines

3)     Chemotherapy

4)     Client on immunosuppressive drugs

5)     Immunotherapy

Que. 60. What is the dose of DPT vaccine and its route of administration?

Ans. 60. 0.5ml, intramuscularly.

Que. 61. What is the dose of Hepatitis B Vaccine and its route of administration?

Ans. 61. 0.5ml, intramuscularly.

Que. 62. What do you mean by Immunization Schedule?

Ans. 62. An immunization schedule is a time frame that regulates immunization by ensuring appropriate timing, appropriate dosage, appropriate combinations, intervals and frequencies for administration of vaccines.

Que. 63. What do you mean by cold chain?

Ans. 63. Cold Chain is a system of storing and transporting vaccines at recommended temperatures from the point of manufacturer to the point of use.

Que. 64. What are the Key elements of cold chain?

Ans. 64. The key elements of cold chain are as follows –

1)     Personnel 

2)     Equipment 

3)     Procedures 

Que. 65. What do you mean by vaccine vial monitor (VVM)?

Ans. 65. It is a label containing a heat sensitive material which is placed on a vaccine vial to register cumulative heat exposure over a time.

Que. 66. If color of inner square of VVM matches that of outer circle or is darker than outer circle, whether not to use the vaccine?

Ans. 66. Yes.

Que. 67. Name few vaccines which lose their potency if frozen.

Ans. 67. Hepatitis B, IPV, PCV, Pentavalent, DPT, DT & TT vaccines.

Que. 68. Give the examples of few vaccines which are light sensitive.

Ans. 68. Measles, MR & BCG vaccines.

Que. 69. What does shake test determine?

Ans. 69. The shake test is designed to determine whether adsorbed vaccines (DPT, DT, TT & Hepatitis B) have been frozen at some point of time in the cold chain.

Que. 70. What precautions will you take in keeping all electrical cold chain equipment?

Ans. 70. The precautions are as follows – 

1)     At least 10 cm away from the walls.

2)     Protected from rain and flooding and away from direct sunlight

3)     Level and on wooden boxes

4)     Permanently fixed to the power switch, labelled do not unplug

5)     Permanently connected to one voltage stabilizer per equipment

6)     Locked and key accessible to designated personnel.  

Que. 71. What do you mean by LEAD TIME?

Ans. 71. The lead time refers to the time between ordering of new stock and its receipt.

Que. 72. What is the use of vaccine vial monitor (VVM)?

Ans. 72. Tells about heat damage to the vaccine. VVM does not measure exposure to freezing.

Que. 73. Where will you store diluents?

Ans. 73. Diluents must be stored between +2 to +8 degree Celsius in the ice-lined refrigerator (ILR).

Que. 74. What is the use of BCG vaccine?

Ans. 74. BCG vaccine is used for active immunization against tuberculosis. BCG is the only used live bacterial vaccine.

Que. 75. Why freeze-dried BCG vaccine is superior to liquid BCG vaccine?

Ans. 75. Because of superior keeping qualities. Therefore, now-a-days only freeze dried vaccines are used.

Que. 76. Why distilled water should not be used as diluent for reconstituting BCG vaccine?

Ans. 76. As it may cause irritation.

Que. 77. When will you call a BCG injection satisfactory?

Ans. 77. It should produce a wheal of 5 cm in diameter.

Que. 78. After BCG vaccination, when does a child become Monteux positive?

Ans. 78. After a period of 8-14 weeks.

Que. 79. How many live bacilli are contained in one dose of BCG vaccine?

Ans. 79. 0.1 – 0.4 million live viable bacilli per dose.

Que. 80. Why BCG is given on left upper arm to an infant?

Ans. 80. To maintain uniformity and for helping surveyors in verifying the receipt of the vaccine.

Que. 81. Which vaccines are given in newborn vaccination?

Ans. 81. BCG, OPV zero dose & Hepatitis B vaccine birth dose.

Que. 82. Whether BCG & measles or MR vaccine can be given together?

Ans. 83. Yes can be given at different sites of the body.

Que. 84. Up to what age BCG vaccine may be given?

Ans. 84. One year.

Que. 85. Name the scientists who developed the BCG vaccine.

Ans. 85. Calmette & Guerin.

Que. 86. Which bacillus strain has been recommended by WHO for the production of BCG Vaccine?

Ans. 86. Danish 1331 strain.

Que. 87. Which types of BCG vaccine are available?

Ans. 87. There are two types of BCG vaccine – the liquid (fresh) vaccine & the freeze dried vaccine.

Que. 88. Which diluent should be used for reconstituting the BCG vaccine?

Ans. 88. Normal Saline.

Que. 89. Up to what time, reconstituted BCG vaccine may be used?

Ans. 89. Within 3 hours and then remaining vaccine should be discarded.

Que. 90. What is the dose of BCG vaccine for vaccination in an infant?

Ans. 90. 0.1 mg in 0.1 ml volume.

Que. 91. What is the dose of BCG vaccine for vaccination in newborns less than 4 weeks age?

Ans. 91. 0.05ml.

Que. 92. What is the mode of vaccination of BCG vaccine?

Ans. 92. As per WHO, vaccine is administered intradermally using a 1 cm steel 26 gauze intradermal needle (tuberculin syringe).

Que. 93. What is the advantages of BCG administration at birth?

Ans. 93. Provides a high level of protection, particularly against the severe forms of childhood tuberculosis & tuberculous meningitis.

Que. 94. What are the complications associated with BCG vaccination?

Ans. 94. The complications associated with BCG vaccination are as follows – 

1)     Severe ulceration at injection site

2)     Suppurative Lymphadenitis

3)     Osteomyelitis

4)     Disseminated BCG infection

5)     Death

Que. 95. What is the duration of protection following BCG vaccinations?

Ans. 95. 15-20 years.

Que. 96. What are the contraindications of BCG administration?

Ans. 96. The contraindications of BCG administration are as follows – 

1)     Generalized eczema

2)     Infective dermatitis

3)     Hypogammaglobulinemia

4)     Impaired Immunity status

5)     Patient undergoing immunosuppressive treatment

6)     Pregnancy

Que. 97. What is the preferred site of BCG administration?

Ans. 97. The convex aspect of left shoulder, at level of deltoid insertion is preferred site of BCG vaccination.

Que. 98. Whether we can give BCG vaccine to a HIV positive infant?

Ans. 98. HIV positive infants can be given BCG only if they are asymptomatic and living in high endemic area for tuberculosis.

Que. 99. Name the diseases which are protected by giving pentavalent vaccine.

Ans. 99. Diphtheria, Pertussis, Tetanus, Hepatitis B & Haemophilus influenzae type B.

Que. 100. What are the advantages of pentavalent vaccine over giving single vaccines?

Ans. 100. Pentavalent vaccine not only reduces the number of pricks to a child but also provides protection against all five diseases.

Que. 101. What are the indicators of Hepatitis B & DPT vaccines with use of pentavalent vaccine?

Ans. 101.  Hepatitis B birth dose will continue as before, in institutional birth within 24 hours of birth. DPT will be given in booster doses at 16-24 months and at 5 years of age.

Que. 102. What is the schedule of pentavalent vaccination?

Ans. 102. 6 weeks, 10 weeks & 14 weeks.

Que. 103. What is the dose, route and site of pentavalent vaccination?

Ans. 103. Dose – 0.5ml using AD syringes

                  Route – Intramuscularly

                  Site – Anterolateral aspect of mid-thigh

Que. 104. When will you discard pentavalent vaccine?

Ans. 104. Pentavalent vaccine is discarded if vaccine is frozen or VVM reaches discard point.

Que. 105. What vaccine will you give if a completely unimmunized child of 10 months age comes to the facility? 

Ans. 105. He/she should receive BCG, measles & rubella (MR) vaccine 1st dose & 1st dose of pentavalent vaccine with OPV drops, 1st dose of rotavirus vaccine, 1st dose of fractional IPV, 1st dose of PCV & 1st dose of JE vaccine & vitamin A syrup.

Que. 106. When will you say a child of one year to be fully immunized?

Ans. 106. Child should receive 3 doses of OPV, Rota & Penta, single dose of BCG, 3 doses of fractional IPV, 3 doses of PCV (where applicable), 1st dose of MR vaccine & 1st dose of JE vaccine (Where applicable).

Que. 107. What are the side effects of pentavalent vaccine?

Ans. 107. Mild fever & redness, pain and swelling at injection site.

Que. 108. What are the contraindications of pentavalent vaccine?

Ans. 108. The contraindications of the pentavalent vaccine are as follows – 

1)     A child who has had a severe reaction to pentavalent vaccine earlier should not receive another dose.

2)     Children with moderate or severe acute illness

Que. 109. What is the protective efficacy of pentavalent vaccine?

Ans. 109. 85% – 95% protection.

Que. 110. Which vaccine has replaced the current Hepatitis B & DPT vaccination schedule in the primary immunization?

Ans. 110. Pentavalent vaccine.

Que. 111. What is the period in that a child should receive pentavalent vaccine?

Ans. 111. 6 weeks to 1 year.

Que. 112. What is the duration of protection offered by pentavalent vaccine?

Ans. 112. 15 years.

Que. 113. Why pertussis component in DPT vaccine is important?

Ans. 113. Pertussis component in DPT vaccine enhances the potency of diphtheria toxoid.

Que. 114. Which procedure does increase the effectiveness of the DPT vaccine?

Ans. 114. Adsorption.

Que. 115. Which constituent of the DPT vaccine is responsible for neurological complications?

Ans. 115. Pertussis component of the DPT vaccine.

Que. 116. What is the use of plain DPT vaccine?

Ans. 116. Can be used as a booster.

Que. 117. Which are the types of DPT vaccine?

Ans. 117. Two types of DPT vaccines – 

1. a)     Plain DPT vaccine
2. b)     Adsorbed DPT vaccine

Que. 118. Which are the diseases protected by DPT vaccine?

Ans. 118. Diphtheria, Pertussis & Tetanus.

Que. 119. What is the efficiency of DPT vaccine?

Ans. 119. 70%.

Que. 120. What is the dose and mode of DPT vaccination?

Ans. 120. 0.5ml, deep Intra muscularly.

Que. 121. What is the preferred site of DPT vaccination?

Ans. 121. In children especially under one year of age, DPT vaccine should be administered in anterolateral aspect of mid-thigh.

Que. 122. What are the adverse effects of DPT vaccination?

Que. 122. The adverse effects of DPT vaccination are as follows – 

1)     Fever

2)     Swelling, induration & pain at injection site

3)     Neurological complications 

Que. 123. What are the contraindications of DPT vaccination?

Ans. 123. Seriously ill children & severe reaction to a previous dose.

Que. 124. What is the use of pneumococcal vaccine?

Ans. 124. It is used for active immunization against streptococcus pneumoniae which is most common cause of bacterial pneumonia.

Que. 125. Which are the types of pneumococcal vaccines available for vaccination?

Ans. 125. Two types of pneumococcal vaccine are available – 

1)     Pneumococcal polysaccharide vaccine

2)     Pneumococcal conjugate vaccine

Que. 126. How many doses are required for pneumococcal conjugate vaccination in infants?

Ans. 126. 3 doses of vaccine, one dose each at 6 weeks & 14 weeks with booster on 9 completed month.

Que. 127. How long does pneumococcal conjugate vaccine protect children?

Ans. 127. At least 3 years. The vaccine protects the children when they are at great risk as most serious pneumococcal infections happen during the first 2 years of age.

Que. 128. Which type of pneumococcal vaccine is required for immunizing the older children and adults?

Ans. 128. Pneumococcal Polysaccharide Vaccine.

Que. 129. Which are the indications of pneumococcal conjugate vaccine in some children between 2 to 5 years of age?

Ans. 129. The indications are as follows – 

1)     Have Sickle cell disease

2)     Have a damaged spleen or no spleen

3)     Have HIV/AIDS

4)     Have other diseases which affect immune system e.g. diabetes or cancer

5)     Have chemotherapy or steroid treatment

Que. 130. What will you do with PCV administration, if a child has fever or serious illness?

Ans. 130. PCV administration may be withheld or delayed.

Que. 131. Whether there is evidence linking the PCV with the development of autism?

Ans. 131. No evidence is there.

Que. 132. What is the use of tetanus vaccine?

Ans. 132. Vaccine is used for active immunization against tetanus.

Que. 133. What is the immunization schedule of TT vaccine in an adult?

Ans. 133. Immunization schedule includes two doses of vaccine, 0.5 ml each, given by I/M route at an interval of 4-6 weeks. The first booster is given after one year of 2nd dose while 2nd booster is given 5 years after the first booster.

Que. 134. What is the immunization schedule of Td vaccine in pregnant women?

Ans. 134. In pregnant women, two doses of TT vaccine is given between 16-36 weeks of pregnancy, with an interval of 4-6 weeks in between 2 doses. In subsequent pregnancies, one booster dose is sufficient.

Que. 135. Which are the contraindications of TT vaccine?

Ans. 135. The contraindications of TT vaccine are as follows – 

1)     Outbreak of polio

2)     Acute illnesses 

3)     Adverse reaction to a previous dose

4)     High grade fever

Que. 136. Why purified tetanus toxoid (adsorbed) has replaced plain toxoid?

Ans. 136. Because it provides long lasting immunity.

Que. 137. Which are the types of hepatitis B vaccines available for vaccination?

Ans. 137. Two types of Hepatitis B vaccines are available – 

1)     Plasma derived vaccines

2)     Recombinant DNA yeast derived vaccines

Que. 138. What is the dose, site and mode of administration of Hepatitis B (rDNA) vaccine in adults?

Ans. 138. 1 ml, given intramuscularly into the deltoid muscle on 0, 1 & 6 months.

Que. 139. What is the dose, site and mode of administration of Hepatitis B (rDNA) vaccine in unvaccinated children less than 10 years of age?

Ans. 139. 0.5 ml, given intramuscularly into anterolateral aspect of thigh on 0, 1 and 6 months.

Que. 140. What are the long-term advantages of Hepatitis B vaccination?

Ans. 140. Long term advantages of Hepatitis B vaccination include the followings – 

1)     Reduces incidence of the disease

2)     Reduces disease’s chronic complications e.g. chronic active hepatitis, cirrhosis of liver and hepatocellular carcinoma.

Que. 141. Which are the contraindications of hepatitis B vaccine?

Ans. 141. Hypersensitivity to any vaccine component and severe febrile illnesses. Special precautions should be taken in Pregnancy.

Que. 142. Which are the adverse reactions following hepatitis B vaccination?

Ans. 142. Mild reaction at injection site and low-grade fever, malaise, fatigue, headache, nausea rarely.

Que. 143. What is the indication of specific hepatitis B immunoglobulins?

Ans. 143. Should be given for post exposure prophylaxis e.g. after accidental exposure. It should be given within 48 hours of exposure along with hepatitis B vaccine.

Que. 144. Whether you will give Hepatitis B vaccine to those who are Hepatitis B surface antigen (HBsAg) positive?

Ans. 144. Never.

Que. 145. Why hepatitis B vaccine should not be administered in the gluteal region or intradermally?

Ans. 145. Because of lower immune response.

Que. 145. Within which period reconstituted live attenuated and inactivated JE vaccine should be used?

Ans. 145. Live attenuated JE vaccine ——- within one hour of reconstitution.

Inactivated JE vaccine ——– Within 6 hours of reconstitution.

Que. 146. What is the schedule of JE vaccination in children in Immunization program in India?

Ans. 146. 1st dose – 9-12 months; 2nd dose – 16-24 months.

Que. 147. What are the side effects of live attenuated JE vaccine?

Ans. 147. Side effects include transient fever, local irritation, rash & irritability.

Que. 148. What are the contraindications of live JE vaccines?

Ans. 148. contraindications are as follows – 

1)     Known hypersensitivity

2)     Children under 12 months of age

3)     Pregnancy

Que. 149. What are the indications of JE vaccination?

Ans. 149. Indications of JE vaccination are as follows –

1)     Persons living in endemic areas

2)     Travelers to endemic areas

3)     Laboratory workers at risk of exposure to JE vaccine.

Que. 149. Which polio vaccine does neither prevent spread of polio infection in the community nor effective in controlling the epidemic of polio?

Ans. 149. IPV.

Que. 150. Which polio vaccine is safe in pregnancy & immune deficiency conditions?

Ans. 150. IPV.

Que. 151. In which conditions, you will take special precautions during OPV vaccination?

Ans. 151. Diarrhoea & pregnancy.

Que. 152. What types of polio vaccine are available?

Ans. 152. Two types of polio vaccine are available – 

1)     Inactivated or Salk polio vaccine

2)     Oral or Sabin polio vaccine

Que. 153. What is the immunization schedule for fractional IPV vaccination?

Ans. 153. At 6 weeks, 14 weeks & 9 months, 0.1 ml of vaccine given intradermal in Right upper arm.

Que. 154. What is the storage temperature of IPV?

Ans. 154. 2 to 8 degrees Celsius.

Que. 155. What is the dose of OPV?

Ans. 155. 2 drops given orally.

Que. 156. What are the contraindications of OPV vaccination?

Ans. 156. Immune deficiency conditions.

Que. 157. What types of rabies vaccines are available?

Ans. 157. Types of rabies vaccines are as follows – 

1)     Nervous tissue vaccine (NTV)

–        Sheep brain vaccine

–        Suckling mouse brain vaccine

2)     Duck embryo vaccine (DEV)/ Chick embryo vaccine (CEV)

3)     Cell culture vaccines – 

–        Human diploid cell vaccine (HDCV)

–        2nd generation tissue culture vaccines

Que. 158. What is the schedule of pre-exposure prophylaxis for anti-rabies vaccine?

Ans. 158. Given intramuscularly (1 ml) or intradermally (0.5 ml) on days 0, 7 & 28.

Que. 159. When the use of nervous tissue anti-rabies vaccine was stopped in India?

Ans. 159. In 2004.

Que. 160. What is the schedule of MR vaccination?

Ans. 160. MR vaccine will be given in two doses, first dose – 9-12 months; Second dose – 16-24 months of age.

Que. 161. What is the storage temperature of MR vaccine?

Ans. 161. +2 to +8-degree C.

Que. 162. Whether open vial policy is applicable to MR vaccines?

Ans. 162. Not Applicable.

Que. 163. What is the dose, site & route of administration of MR vaccine?

Ans. 163. 0.5 ml, given subcutaneously in right upper arm.

Que. 164. What are the adverse reactions following MR vaccination?

Ans. 164. The adverse reactions are – 

1)     Mild pain & tenderness at the injection site

2)     Fever

3)     Transient rash

4)     Arthralgia or joint pain

5)     Febrile convulsions (Rare)

6)     Thrombocytopenic purpura (Very Rare)

7)     Anaphylaxis (Very Rare)

Que. 165. What are the contraindications of MR vaccination?

Ans. 165. The contraindications of MR vaccination are as follows – 

1)     High Fever or serious disease

2)     Pregnancy

3)     History of Anaphylactic reaction

4)     Severely immunocompromised individuals

Que. 166. What is the efficacy of MR vaccination?

Ans. 166. It is 85% when given at 9 months and 95% when given at >1 year of age.

Que. 167. Which type of immune response is generated by MR vaccination?

Ans. 167. Both cellular & humoral immune response.

Que. 168. What does coloured glass vials of MR vaccine indicate?

Ans. 168. Its sensitivity to light.

Que. 169. What is the dose & route of administration of rotavirus vaccine?

Ans. 169. 5 drops, orally.

Que. 170. When did WHO recommend to include Rota virus vaccination in all national immunization programs?

Ans. 170. June 2009.

Que. 171. At what interval, WHO does recommend revaccination with yellow fever for an international travel?

Ans. 171. Every 10 years.

Que. 172. If given together, whether cholera & yellow fever vaccines interfere each other?

Ans. 172. Yes, therefore should be given at different sites of the body.

Que. 173. When will you give yellow fever vaccine before international travel?

Ans. 173. Minimum 10 days before international travel.

Que. 174. Why one should not donate blood for 14 days following the vaccination with yellow fever?

Ans. 174. Because there is a risk of transmitting the vaccine virus through blood products during that period.

Que. 175. Whether cholera vaccination is essential for international travel?

Ans. 175. No, Cholera vaccination certificate is not essential for international travel since May 1973.

Que. 176. For which age group, cholera vaccination is not recommended?

Ans. 176. For children under 2 years of age.

Suggested further readings – 

1)     Immunization Handbook for medical officers by Ministry of Health and Family Welfare, Government of India, 2017

2)     Park Textbook of Preventive and Social Medicine, by K Park, 23rd edition, 2015

3)     Textbook of Public Health and Community Medicine by AFMC & WHO, 1st edition, 2009

4)     Mahajan & Gupta Textbook of Preventive and Social Medicine, 4th edition, 2013

5)     IAP Guidebook on Immunization, by IAP Committee on immunization, 2009-2011