A 15-month-old girl from urban Delhi is brought to the immunisation clinic by her father. Her immunisation card shows she has received all primary doses (DPT-1, 2, 3 at 6 weeks, 10 weeks, and 14 weeks respectively) and OPV-0, 1, 2, 3 as per schedule. She also received Hepatitis B-1, 2, 3 and Measles at 12 months. The father is concerned about the next set of vaccinations and asks when the booster doses will be given. According to the Universal Immunisation Programme, what is the appropriate next immunisation action?

Question

Accepted Answer

B. Wait until 18 months and give DPT-B1, OPV-B1, and Hepatitis A-1. ## UIP Booster Schedule and Timing

**Key Point:** The first booster doses (DPT-B1 and OPV-B1) are administered at 18 months of age, not at 15 months. Hepatitis A-1 is also given at 18 months as part of the booster schedule in the updated UIP.

### UIP Booster and Later Immunisation Timeline

| Age | Vaccines |
| --- | --- |
| 12 months | Measles/MR, DPT-3, Hepatitis B-3, PCV-3 |
| **18 months** | **DPT-B1, OPV-B1, Hepatitis A-1, IPV-B1** |
| 4–6 years (school entry) | DPT-B2, OPV-B2 |
| 10 years | TT-1 |
| 16 years | TT-2 |

**High-Yield:** The 18-month visit is the critical booster checkpoint. This is when the first booster of DPT and OPV is administered to maintain immunity. Hepatitis A-1 is part of the current UIP booster schedule (added in recent years).

**Mnemonic:** **"18M = DIP-B1, HepA-1"** — At 18 months, give the first booster of DPT (D), OPV (O), and the first dose of Hepatitis A (HepA).

**Clinical Pearl:** The 15-month age is not a standard immunisation checkpoint in the UIP. The next scheduled visit after 12 months is at 18 months. Premature administration of boosters at 15 months is not recommended and may not provide optimal immune response timing.

### Rationale for 18-Month Booster

Boosters are given to maintain and enhance immunity after the primary series. The 18-month booster ensures sustained protection against diphtheria, pertussis, tetanus, and poliomyelitis. The interval of 6 months between the primary series completion (12 months) and the first booster (18 months) is evidence-based for optimal immune response.

Answer

A. Administer DPT-B1 and OPV-B1 now, as the child is 15 months old

Answer

C. Give DPT-B2 and IPV-B1 at 15 months as per accelerated schedule

Answer

D. Defer all boosters until 4–6 years of age as per school entry requirements

Explanation

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