A 14-month-old girl is brought to the primary health centre for her routine immunisation. The mother confirms that the child has received all vaccines according to the National Immunisation Schedule up to 12 months of age, including BCG at birth, DPT and IPV primary series, Hepatitis B series, PCV primary series, and OPV booster at 9–12 months. The child is clinically well with no contraindications. What is the appropriate immunisation at this 14-month visit?

Explanation

## National Immunisation Schedule — 14-Month Booster Phase **Key Point:** At 14 months (16–24 months window), the first booster doses of DPT and OPV are administered, along with IPV booster, to maintain immunity against diphtheria, pertussis, tetanus, and poliomyelitis. ### Vaccine Schedule at 14 Months (16–24 Month Window) | Vaccine | Dose | Age Window | Route | Notes | |---------|------|-----------|-------|-------| | DPT | Booster 1 | 16–24 months | IM | First booster of primary series | | OPV | Booster 2 | 16–24 months | Oral | Second booster (first at 9–12 months) | | IPV | Booster 1 | 16–24 months | IM | First booster of primary series | | Hepatitis B | Booster | 12–15 months | IM | Optional; not mandatory in all schedules | | PCV | Booster | 12–15 months | IM | Given at 12–15 months, not 14 months | | Varicella | — | Not in NIS | — | Not part of the routine NIS | | MMR | — | 9–12 months | IM | Given at 9–12 months, not 14 months | **High-Yield:** The core booster vaccines at 14 months are **DPT booster1, OPV booster2, and IPV booster1**. These are mandatory and protect against the major vaccine-preventable diseases of childhood. **Clinical Pearl:** The 14-month visit falls within the 16–24 month window recommended for booster doses. PCV booster is given earlier (at 12–15 months), and Hepatitis B booster is optional and not universally mandated in the NIS. ### Booster Schedule Summary 1. **DPT Booster 1** — at 16–24 months 2. **OPV Booster 2** — at 16–24 months (first booster at 9–12 months) 3. **IPV Booster 1** — at 16–24 months 4. **PCV Booster** — at 12–15 months (earlier than 14 months) 5. **Hepatitis B Booster** — at 12–15 months (optional, not mandatory) **Mnemonic:** **"DIP at 14M"** — DPT, IPV, and OPV booster at 14 months (16–24 month window). Remember: PCV booster is at 12–15 months (earlier), and Varicella is NOT in the NIS.