## Management of Missed Immunisation Doses ### Universal Immunisation Programme (UIP) Guidelines **Key Point:** There is NO need to restart the immunisation schedule when doses are missed. The child should receive the next due dose as soon as possible, regardless of the interval since the previous dose. **High-Yield:** According to the UIP schedule, if a dose is missed, the subsequent dose should be administered at the next opportunity without waiting for a specific interval. The schedule follows a **catch-up approach**, not a restart approach. ### Rationale for Correct Answer At 6 months of age, the child is due for: - DPT-1 (or DPT-2 if considering the missed 3-month dose) - OPV-1 (or OPV-2 if considering the missed 3-month dose) Since the child missed the 3-month dose, the **next due dose is administered immediately**. The primary series consists of 3 doses of DPT and OPV, and these should be given at intervals of **4 weeks minimum** between doses. **Clinical Pearl:** The UIP does not recognize "restarting" the schedule. Once a dose is given, the child progresses through the series regardless of delays. This is crucial for improving immunisation coverage in resource-limited settings. ### Standard UIP Schedule for DPT and OPV | Age | DPT | OPV | |-----|-----|-----| | Birth | — | OPV-0 | | 6 weeks | DPT-1 | OPV-1 | | 10 weeks | DPT-2 | OPV-2 | | 14 weeks | DPT-3 | OPV-3 | | 18 months | DPT Booster-1 | OPV Booster | **Note:** If a dose is missed, it is administered at the next visit, and the interval of 4 weeks is maintained between subsequent doses. ### Why Immediate Administration? 1. **Reduces disease risk:** Every day without protection increases vulnerability to vaccine-preventable diseases. 2. **Improves compliance:** Catching up immediately prevents further delays. 3. **Follows WHO guidelines:** Missed doses do not require restarting; they are simply given at the next opportunity. [cite:Park 26e Ch 8]
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