A 3-year-old girl from Delhi is brought to the immunisation clinic by her mother for a routine check-up. The mother states that the child received all vaccines on schedule up to 18 months, but missed the DPT booster due to a family illness. On review of the immunisation card, the last documented vaccine was PCV booster at 12–15 months. The child is otherwise healthy and has no contraindications to vaccination. What is the most appropriate next step in the management of this child's immunisation status?

Explanation

## Catch-Up Immunisation in the UIP **Key Point:** Children who have missed doses or are behind schedule should receive catch-up vaccination as soon as possible. There is no upper age limit for completing the primary series or booster doses, provided the child is otherwise healthy and has no contraindications. ### UIP Booster Schedule | Vaccine | Booster Timing | Notes | | --- | --- | --- | | DPT | 16–24 months (1st booster) | Can be given up to school entry if missed | | Measles | 18–24 months (Measles-2) | Part of routine schedule | | OPV | 16–24 months (booster) | Optional if IPV given in primary series | | PCV | 12–15 months (booster) | Single booster dose | **High-Yield:** The concept of **"catch-up vaccination"** is critical in NEET PG PSM questions. A missed dose is never "too late" to give if the child is healthy. The interval between doses may be shortened, but doses should never be skipped. **Clinical Pearl:** In this case, the child is 3 years old and has missed the DPT booster (due at 16–24 months). She should receive it immediately. Additionally, Measles-2 (due at 18–24 months) should also be checked and administered if not given. **Mnemonic:** **"Catch-up, never skip"** — Always complete pending vaccines from the UIP schedule, regardless of age, as long as there are no contraindications. ### Why Deferral or Age-Based Exclusion is Wrong - There is **no age limit** for completing immunisation in a previously unvaccinated or partially vaccinated child. - Deferring vaccines increases the risk of vaccine-preventable disease. - Age alone (e.g., "older than 2 years") is never a contraindication to DPT or other UIP vaccines. ### Contraindications to DPT (Rare) - Anaphylaxis to a previous dose. - Encephalopathy within 7 days of a previous dose. - Progressive neurological disease (relative contraindication; specialist input needed). - **Fever or acute illness** (defer until recovery, not contraindicate). This child has no such contraindications.