Childhood Immunisation — SAQ

Stem

A 6-week-old infant is brought to the primary health centre for vaccination. The baby was born at 34 weeks gestation (6 weeks premature) and had neonatal jaundice that resolved at 2 weeks. Today, the baby has a mild runny nose and low-grade fever (37.9 degrees C). The mother is breastfeeding.

Questions

a) What vaccines are due at 6 weeks of age according to the National Immunisation Schedule? (3 marks)

1. Pentavalent-1 (DPT + HepB + Hib) — intramuscular
2. OPV-1 (oral polio) — oral
3. Rotavirus-1 — oral
4. PCV-1 (pneumococcal conjugate) — intramuscular
5. IPV-1 (if in schedule) — intramuscular

b) Are there any contraindications to vaccination for this baby today? Justify your answer. (3 marks)

NO contraindications. All of the following are NOT contraindications:

• Prematurity: vaccinate by CHRONOLOGICAL age (this baby is 6 weeks old chronologically — correct timing).
• Mild runny nose and low-grade fever (37.9 degrees C): mild illness is NOT a contraindication.
• History of neonatal jaundice (resolved): NOT a contraindication.
• Breastfeeding: NOT a contraindication.

The baby SHOULD be vaccinated as scheduled.

c) What is the cold chain and how is it maintained? (2 marks)

Cold chain: the system for maintaining vaccines at 2 to 8 degrees Celsius from manufacture to administration. Maintained by: refrigerators at health facilities, vaccine carriers with ice packs for transport, VVM (Vaccine Vial Monitor) on each vial to check heat exposure (discard if inner square darker than outer circle). Regular temperature monitoring twice daily.

d) Explain why BCG is given at birth and what it prevents. (2 marks)

BCG is given at birth (or first contact) because:

• Maximum benefit when given early (before TB exposure)
• Protects against TB meningitis and miliary (disseminated) TB in children
• Does NOT reliably prevent pulmonary TB
• Given intradermally in the left upper arm
• BCG scar indicates successful vaccination (but absence does NOT mean failure)