Immunization and Vaccine-Preventable Diseases Practice Questions

Q: A 2 year old child has presented for vaccination, who has never been vaccinated earlier. As per the Universal Immunization Program, which vaccines will be administered to the child on the first visit?

BCG, DPT-I and Measles vaccine. ***BCG, DPT-I and Measles vaccine*** - As per the **Universal Immunization Program (UIP)** for a previously unvaccinated child, **all age-appropriate vaccines** should be administered on the first visit. - At 2 years of age, the child is eligible for **BCG**, the first dose of **DPT (DPT-I)**, and **Measles vaccine** (if no prior measles vaccination, which is the case here). *BCG and Hepatitis B vaccine* - While **BCG** is appropriate, **Hepatitis B vaccine** is typically given at birth and then subsequent doses at 6, 10, and 14 weeks as part of the primary series. A 2-year-old would likely need further doses of DPT and Measles. - This option misses other crucial age-appropriate vaccines like **DPT-I** and the **Measles vaccine** for a 2-year-old child. *DPT-I vaccine only* - Administering only **DPT-I** would result in missed opportunities for protection against **tuberculosis (BCG)** and **measles**, both of which are critical for a 2-year-old. - This approach does not follow the principle of providing **all age-appropriate vaccines** on the first contact with an unvaccinated child. *DPT-I and Hepatitis B vaccine* - This option correctly includes **DPT-I** but misses the essential **BCG** and **Measles vaccine** for a 2-year-old, which are crucial for this age group. - While Hepatitis B is important, the primary series would have been missed, and focusing solely on DPT-I and Hepatitis B for a 2-year-old is an incomplete vaccination schedule.

Q: Which of the following are correct in respect of Diphtheria? 1. The incubation period is 14 to 28 days 2. Diphtheria antitoxin is used in treatment of cases 3. It is one of the diseases protected from, by the Pentavalent vaccine given in National Program

2 and 3 only. **Correct Answer: Option B (2 and 3 only)** **Analysis of Statements:** **Statement 1: INCORRECT** - The incubation period for diphtheria is **2 to 5 days** (range: 1-10 days), NOT 14 to 28 days - The stated period of 14-28 days is inaccurate **Statement 2: CORRECT** - **Diphtheria antitoxin (DAT)** is the mainstay of treatment - It neutralizes the exotoxin produced by *Corynebacterium diphtheriae* - Must be given early to prevent irreversible toxin-mediated tissue damage **Statement 3: CORRECT** - **Pentavalent vaccine** (DPT-HepB-Hib) is given under India's Universal Immunization Programme - Protects against 5 diseases: Diphtheria, Pertussis, Tetanus, Hepatitis B, and *Haemophilus influenzae* type b - Contains diphtheria toxoid for active immunization **Why Other Options are Incorrect:** *Option A (1, 2 and 3)* - Incorrect because Statement 1 has wrong incubation period *Option C (1 and 3 only)* - Incorrect because Statement 1 has wrong incubation period - Also omits the important fact about antitoxin treatment *Option D (1 and 2 only)* - Incorrect because Statement 1 has wrong incubation period - Also omits the important fact about Pentavalent vaccine protection

Q: Hepatitis B vaccine administered at birth is

A monovalent vaccine of Hepatitis B. ***A monovalent vaccine of Hepatitis B*** - The **initial dose** of the Hepatitis B vaccine given at birth is a **single-antigen (monovalent)** preparation. It is given as a **standalone vaccine** to ensure prompt protection against Hepatitis B virus. - This early administration is critical for preventing **perinatal transmission** of Hepatitis B from an infected mother to her newborn, and establishing immunity as soon as possible. *A pentavalent vaccine* - **Pentavalent vaccines** typically protect against five different diseases: **Diphtheria, Tetanus, Pertussis (DTP), *Haemophilus influenzae* type b (Hib), and Hepatitis B**. - While Hepatitis B is one component, the vaccine administered at birth is usually monovalent, and the pentavalent vaccine is given later in the infant's immunization schedule. *A fixed combination vaccine of Hepatitis B and Hib* - A fixed combination vaccine of Hepatitis B and **Hib (Haemophilus influenzae type b)** is available and used in some immunization schedules. - However, the **first dose** given at birth is specifically a monovalent Hepatitis B vaccine, not a combined Hib vaccine, to target immediate Hepatitis B protection. *A combined vaccine of inactivated Polio and Hepatitis B* - Combined vaccines that include **inactivated Polio vaccine (IPV)** and **Hepatitis B** do exist but are generally administered later, at 6 weeks and subsequent doses. - The **birth dose** of Hepatitis B vaccine is exclusively for Hepatitis B protection and does not typically include polio antigen.

Q: The primary route of administration of measles vaccination is:

Subcutaneous. ***Subcutaneous*** - The **measles, mumps, and rubella (MMR) vaccine** is a live attenuated vaccine typically administered via the **subcutaneous route**. - Subcutaneous injection ensures the vaccine is delivered into the fatty tissue just below the skin, allowing for gradual absorption and an effective immune response. *Intravenous* - **Intravenous administration** delivers substances directly into the bloodstream, which is generally avoided for vaccines due to the risk of systemic reactions and rapid clearance. - This route is typically reserved for emergency medications or those requiring immediate systemic distribution. *Intranasal* - **Intranasal vaccines** are administered through the nasal passages and are designed to stimulate mucosal immunity, particularly against respiratory pathogens. - While some flu vaccines use this route, the standard measles vaccine does not. *Intradermal* - **Intradermal administration** involves injecting into the dermis layer of the skin, often used for sensitivity testing or certain vaccines like BCG. - This route requires a smaller volume and specific technique, which is not the primary method for routine measles vaccination.

Q: Consider the following statements: 1. Type 2 poliovirus was eliminated in India in 2005. 2. Main cause of vaccine derived polioviruses (VDPV) is Type 2 component of OPV. Which of the statements given above is/are correct?

2 only. ***2 only*** - Statement 2 is **correct**: The **Type 2 component of OPV** is the primary cause of vaccine-derived polioviruses (VDPV) due to its higher propensity to revert to neurovirulent forms compared to Types 1 and 3. - This significant risk led to the **global withdrawal of Type 2 from OPV** in April 2016, when the world switched from trivalent OPV (tOPV) to bivalent OPV (bOPV containing only Types 1 and 3). - Statement 1 is **incorrect**: The last **wild Type 2 poliovirus case in India was detected in 1999** (Aligarh, UP), not 2005. WHO declared wild poliovirus Type 2 **globally eradicated in September 2015**. *Both 1 and 2* - This is incorrect because statement 1 contains a factual error about the timing of Type 2 poliovirus elimination in India (1999, not 2005). - Only statement 2 is correct. *1 only* - This is incorrect because statement 1 is **factually wrong** - Type 2 poliovirus was eliminated from India in **1999, not 2005**. - The last wild Type 2 case globally was also in India (1999), making this statement doubly incorrect. *Neither 1 nor 2* - This is incorrect because statement 2 is **completely accurate** - Type 2 component of OPV is indeed the main cause of VDPV. - The high rate of genetic reversion and neurovirulence of OPV Type 2 necessitated its removal from routine immunization schedules worldwide.

Q: Influenza vaccine is recommended for: 1. Elderly 2. Persons with underlying chronic diseases 3. HIV infected 4. General population Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Influenza vaccine** is broadly recommended for individuals at higher risk of complications, which explicitly includes the **elderly**, persons with **underlying chronic diseases**, and the **HIV-infected**. - These groups often experience more severe illness, hospitalizations, and mortality from influenza infection. *2 and 3 only* - This option correctly identifies **persons with underlying chronic diseases** and the **HIV-infected** as recommendation groups. - However, it incorrectly excludes the **elderly**, who are a primary target group for influenza vaccination due to age-related immune senescence. *4* - While influenza vaccination is increasingly encouraged for the general population due to community benefits, the question asks for groups where it is specifically recommended for individual protection, focusing on those at higher risk. - This option is too broad and doesn't highlight the specific at-risk groups mentioned. *1 and 2 only* - This option correctly includes the **elderly** and **persons with underlying chronic diseases**. - However, it incorrectly omits the **HIV-infected**, who are also a priority group for influenza vaccination due to their immunocompromised status.

Q: Consider the following statements: The strategy to eradicate poliomyelitis in India comprised of: 1. Conducting National Immunization Days 2. Mopping up rounds with OPV 3. Acute Flaccid Paralysis surveillance 4. Public awareness through multimedia Which of these statements are correct?

1, 2, 3 and 4. ***1, 2, 3 and 4*** * All four strategies—**National Immunization Days (NIDs)**, **mopping-up rounds with OPV**, **Acute Flaccid Paralysis (AFP) surveillance**, and **public awareness campaigns**—were integral to India's successful polio eradication effort. * These components collectively ensured high vaccination coverage, targeted interventions in high-risk areas, effective case detection, and community engagement, leading to the country being declared polio-free. *1 and 3 only* * This option is incomplete as it omits **mopping-up rounds** and **public awareness**, both of which were crucial for achieving and maintaining high herd immunity and community participation. * While **NIDs** and **AFP surveillance** were foundational, they alone would not have been sufficient for complete eradication without the other critical components. *2 and 4 only* * This option overlooks **National Immunization Days (NIDs)**, which were large-scale, nationwide vaccination campaigns fundamental to delivering OPV to a vast population. * It also omits **Acute Flaccid Paralysis (AFP) surveillance**, which was essential for identifying and investigating all suspected polio cases, allowing for rapid response and containment. *1, 2 and 3 only* * This option does not include **public awareness through multimedia**, which was vital for informing parents about the importance of vaccination, addressing vaccine hesitancy, and mobilizing community support during campaigns. * While **NIDs**, **mopping-up rounds**, and **AFP surveillance** targeted the biological and operational aspects, public awareness was critical for the social and behavioral components of the eradication strategy.

Question 1

Consider the following statements :

Statement-1 : In the National Immunization Program, BCG vaccine is given only on the left upper arm

Statement-2 : This is done to maintain uniformity and for helping surveyors in verifying receipt of the vaccine

Which one of the following is correct in respect of the above Statements ?

Accepted Answer

Both Statement-1 and Statement-2 are correct and Statement-2 is the correct explanation for Statement-1

Answer

Statement-1 is true but Statement-2 is false

Answer

Both Statement-1 and Statement-2 are correct and Statement-2 is not the correct explanation for Statement-1

Answer

Statement-2 is true but Statement-1 is false

Question 2

A 2 year old child has presented for vaccination, who has never been vaccinated earlier. As per the Universal Immunization Program, which vaccines will be administered to the child on the first visit?

Accepted Answer

BCG, DPT-I and Measles vaccine

Answer

BCG and Hepatitis B vaccine

Answer

DPT-I vaccine only

Answer

DPT-I and Hepatitis B vaccine

Question 3

Which of the following are correct in respect of Diphtheria?

1. The incubation period is 14 to 28 days
2. Diphtheria antitoxin is used in treatment of cases
3. It is one of the diseases protected from, by the Pentavalent vaccine given in National Program

Accepted Answer

2 and 3 only

Answer

1, 2 and 3

Answer

1 and 3 only

Answer

1 and 2 only

Question 4

Hepatitis B vaccine administered at birth is

Accepted Answer

A monovalent vaccine of Hepatitis B

Answer

A pentavalent vaccine

Answer

A fixed combination vaccine of Hepatitis B and Hib

Answer

A combined vaccine of inactivated Polio and Hepatitis B

Question 5

The primary route of administration of measles vaccination is:

Accepted Answer

Subcutaneous

Answer

Intravenous

Answer

Intranasal

Answer

Intradermal

Question 6

The following are the indicators for assessing the sensitivity of surveillance of polio except:

Accepted Answer

A minimum of one case of AFP per 100,000 children under 5 years of age detected per year

Answer

At least 80% of the reporting sites should report each month even in the absence of cases

Answer

A minimum of one case of AFP per 100,000 children under 15 years of age detected per year

Answer

Percentage of AFP cases with 2 stools taken within 2 weeks after paralysis onset

Question 7

Consider the following statements:

1. Type 2 poliovirus was eliminated in India in 2005.
2. Main cause of vaccine derived polioviruses (VDPV) is Type 2 component of OPV. Which of the statements given above is/are correct?

Accepted Answer

2 only

Answer

Both 1 and 2

Answer

1 only

Answer

Neither 1 nor 2

Question 8

Influenza vaccine is recommended for:

1. Elderly
2. Persons with underlying chronic diseases
3. HIV infected
4. General population

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

2 and 3 only

Answer

4

Answer

1 and 2 only

Question 9

Districts are classified into different categories regarding neonatal tetanus risk. Which one of the following correctly describes 'Neonatal Tetanus Elimination' status?

Accepted Answer

Incidence rate less than 0.1/1000 births, two doses of TT vaccine coverage more than 90%, attended deliveries more than 75%

Answer

Incidence rate between 1 to 2/1000 births, three doses of TT vaccine coverage 70%, attended deliveries more than 75%

Answer

Incidence rate 0.5 to 1/1000 births, three doses of TT vaccine coverage between 70% and 80%, attended deliveries between 65% and 70%

Answer

Incidence rate more than 2/1000 births, two doses of TT vaccine coverage less than 70%, attended deliveries between 60% and 70%

Question 10

Consider the following statements: The strategy to eradicate poliomyelitis in India comprised of:

1. Conducting National Immunization Days
2. Mopping up rounds with OPV
3. Acute Flaccid Paralysis surveillance
4. Public awareness through multimedia

Which of these statements are correct?

Accepted Answer

1, 2, 3 and 4

Answer

1 and 3 only

Answer

2 and 4 only

Answer

1, 2 and 3 only

Immunization and Vaccine-Preventable Diseases — MCQs

Immunization and Vaccine-Preventable Diseases — MCQs

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