Which of the following vaccine firstly should be given soon after birth?

Appeared in: NORCET 3 - 2022 (Shift-2)

Explanation

The Hepatitis B vaccine birth dose is critically important and should be given as soon as possible after birth, preferably within 24 hours.
This immediate vaccination is a key strategy to prevent perinatal transmission of the Hepatitis B virus from mother to child.
Unlike other birth dose vaccines like BCG and OPV-0, which have a slightly wider window for administration, the Hep-B vaccine's effectiveness in preventing vertical transmission is highest when given immediately.
In cases where the mother is HBsAg-positive, the infant requires both the vaccine and Hepatitis B Immunoglobulin (HBIG) within 12 hours for maximum protection.

Option A: While BCG is a birth dose vaccine, it is not the most time-critical. It can be given anytime from birth up to one year of age.
Option C: The zero dose of Oral Polio Vaccine (OPV-0) is given at birth, but the administration window extends up to the first 15 days of life, making it less immediately critical than the Hepatitis B vaccine.
Option D: The Diphtheria vaccine is not given at birth. It is administered as part of a combination vaccine (like Pentavalent or DTaP) starting at 6 weeks of age.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain National Immunization Schedule for newborns as background academic context rather than a clinical decision trigger.
A nurse's primary responsibility is to check the maternal HBsAg status and administer the Hepatitis B vaccine within the correct timeframe (within 24 hours, or 12 hours if the mother is HBsAg positive).
Accurate documentation of the vaccine administration, including time, date, site, and batch number, is crucial for patient records and follow-up.
Patient education is vital. Nurses must inform parents about the importance of the birth dose and the schedule for subsequent vaccine doses.

How to Approach the Question

Identify the core of the question: It asks which vaccine must be given 'firstly' or most urgently after birth.
Recall the standard immunization schedule for newborns in India.
List the vaccines given at birth: Hepatitis B, BCG, and OPV (zero dose).
Compare the recommended timeframes for each vaccine. Note that Hep-B is recommended within 24 hours, OPV within 15 days, and BCG up to 1 year.
Recognize that the prevention of mother-to-child transmission makes the Hepatitis B vaccine the most time-sensitive.
Conclude that Hep-B should be given first due to the narrow and critical window for administration.

Concept Tested & Keywords

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E6 Comprehensive Textbook of Community Health NursingShyamala D part 1 (pp 26-389 of 389) p. 37-39

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) p. 67-69

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