According to the National Immunisation Schedule, all of the following vaccines are administered at 16-24 months, EXCEPT:

Appeared in: DSSSB 12 August 2024

Explanation

'Pentavalent second dose' because it is not administered at 16-24 months.
The Pentavalent vaccine is part of the primary immunization series, which provides initial protection against Diphtheria, Pertussis, Tetanus, Hepatitis B, and Haemophilus influenzae type b.
According to the NIS, the three primary doses of the Pentavalent vaccine are given at 6, 10, and 14 weeks of age.
Therefore, the second dose of the Pentavalent vaccine is administered at 10 weeks, which falls outside the 16-24 month window mentioned in the question.

Option A: The second dose of the Measles vaccine (now given as Measles-Rubella or MR vaccine) is administered between 16 and 24 months of age, as per the NIS.
Option B: The first booster dose of DPT (Diphtheria, Pertussis, and Tetanus) is correctly scheduled to be given between 16 and 24 months of age.
Option D: A booster dose of the Oral Polio Vaccine (OPV) is administered between 16 and 24 months, along with the DPT booster and the second dose of the MR vaccine.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Knowledge of the vaccine schedule as per the National Immunisation Schedule (NIS) of India as background academic context rather than a clinical decision trigger.
A nurse's precise knowledge of the NIS is critical for ensuring children receive timely protection against vaccine-preventable diseases, contributing to both individual and community (herd) immunity.
Nurses play a key role in educating parents about the importance of completing the entire immunization schedule, including both primary and booster doses, and clarifying any misconceptions.
What if a child misses their 10-week appointment? The nurse should advise the parent to reschedule as soon as possible. The immunization schedule does not need to be restarted; the missed Pentavalent-2 dose is given, and the schedule resumes from that point.

How to Approach the Question

First, identify the core of the question: It asks for an exception ('EXCEPT') from a specific time frame (16-24 months) in the National Immunisation Schedule.
This means three of the options are given at 16-24 months, and one is not.
Systematically review each option by recalling the NIS.
Recall that the primary series of vaccinations (like Pentavalent) occurs in early infancy (6, 10, 14 weeks).
Recall that the 16-24 month period is primarily for the first set of booster doses and the second measles dose.
Identify 'Pentavalent second dose' as part of the primary series (given at 10 weeks), which makes it the correct exception.

Concept Tested & Keywords

Concept Tested: Knowledge of the vaccine schedule as per the National Immunisation Schedule (NIS) of India.
Stem keywords: National Immunisation Schedule, vaccines, 16-24 months
Lead-in keywords: EXCEPT
Negative lead-in flag: Question is negatively framed with 'EXCEPT'

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E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 292-294

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 189-191

Practise the full DSSSB 12 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.