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Questions and Answers
What is the proper sequence for administering multiple vaccines?
What is the proper sequence for administering multiple vaccines?
What must be done to vaccines like BCG, AMV, and MMR after reconstitution?
What must be done to vaccines like BCG, AMV, and MMR after reconstitution?
Which type of cleaning material must be used on the injection site, and what is critical about its use?
Which type of cleaning material must be used on the injection site, and what is critical about its use?
How should BCG and Rotavirus be stored to maintain their effectiveness?
How should BCG and Rotavirus be stored to maintain their effectiveness?
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What information should caregivers be informed about regarding immunization?
What information should caregivers be informed about regarding immunization?
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Which condition does NOT need to be met for reusable vaccines to last a maximum of 4 weeks?
Which condition does NOT need to be met for reusable vaccines to last a maximum of 4 weeks?
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What is the significance of the vaccine vial monitor (VVM) in the preservation of reusable vaccines?
What is the significance of the vaccine vial monitor (VVM) in the preservation of reusable vaccines?
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Which of the following options does NOT directly impact the longevity of reusable vaccines?
Which of the following options does NOT directly impact the longevity of reusable vaccines?
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To ensure vaccine effectiveness, which of the following should be avoided?
To ensure vaccine effectiveness, which of the following should be avoided?
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Which of the following factors affects the reusability of vaccines while maintaining the cold chain?
Which of the following factors affects the reusability of vaccines while maintaining the cold chain?
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What is the route of administration for the Heptatitis B vaccine?
What is the route of administration for the Heptatitis B vaccine?
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Which vaccine can be administered at 6, 10, and 14 weeks of age?
Which vaccine can be administered at 6, 10, and 14 weeks of age?
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Which of the following vaccines is administered at birth?
Which of the following vaccines is administered at birth?
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What is the injection site for the Bacillus Calmette Guerin (BCG) vaccine?
What is the injection site for the Bacillus Calmette Guerin (BCG) vaccine?
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Which vaccine is available in a liquid form, clear for serum immunity?
Which vaccine is available in a liquid form, clear for serum immunity?
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At what age is the Measles Mumps Rubella (MMR) vaccine administered?
At what age is the Measles Mumps Rubella (MMR) vaccine administered?
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What is the injection site for the Inactivated Polio Vaccine (IPV)?
What is the injection site for the Inactivated Polio Vaccine (IPV)?
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Which vaccine is associated with pneumonia and meningitis prevention?
Which vaccine is associated with pneumonia and meningitis prevention?
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Which of the following vaccines uses a live-attenuated virus for its administration?
Which of the following vaccines uses a live-attenuated virus for its administration?
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What is the recommended dosage for the Bacillus Calmette Guerin (BCG) vaccine?
What is the recommended dosage for the Bacillus Calmette Guerin (BCG) vaccine?
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What is the primary symptom observed after administering the BCG vaccine?
What is the primary symptom observed after administering the BCG vaccine?
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What management is required if an indolent ulcer persists after 12 weeks from the BCG vaccination?
What management is required if an indolent ulcer persists after 12 weeks from the BCG vaccination?
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Which reaction is specifically associated with the OPV vaccine?
Which reaction is specifically associated with the OPV vaccine?
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How should local soreness at the injection site for the Hepatitis B vaccine be managed?
How should local soreness at the injection site for the Hepatitis B vaccine be managed?
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What is a notable side effect that can occur in children after the MMR vaccination?
What is a notable side effect that can occur in children after the MMR vaccination?
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Which vaccine is most likely associated with convulsions in children older than 3 months?
Which vaccine is most likely associated with convulsions in children older than 3 months?
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What symptom indicates the need for a cold compress after administering the IPV vaccine?
What symptom indicates the need for a cold compress after administering the IPV vaccine?
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What should be done if fever persists beyond 24 hours after receiving the Pentavalent vaccine?
What should be done if fever persists beyond 24 hours after receiving the Pentavalent vaccine?
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At what temperature should the Pentavalent Hepatitis B vaccine be stored for optimal stability?
At what temperature should the Pentavalent Hepatitis B vaccine be stored for optimal stability?
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Which action is recommended if the VVM result indicates that the square is darker than the circle?
Which action is recommended if the VVM result indicates that the square is darker than the circle?
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What is the maximum transport period for vaccines when using cold packs?
What is the maximum transport period for vaccines when using cold packs?
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For how long can vaccines be stored at a Rural Health Unit without compromising their efficacy?
For how long can vaccines be stored at a Rural Health Unit without compromising their efficacy?
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If the recommended storage location for vaccines is the Provincial/District Health Office, what is the duration for which they can be stored?
If the recommended storage location for vaccines is the Provincial/District Health Office, what is the duration for which they can be stored?
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Which of the following conditions is considered an indication rather than a contraindication?
Which of the following conditions is considered an indication rather than a contraindication?
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Which of these symptoms would NOT typically prevent vaccination?
Which of these symptoms would NOT typically prevent vaccination?
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What fever threshold is considered acceptable for proceeding with vaccination?
What fever threshold is considered acceptable for proceeding with vaccination?
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Which of the following is NOT typically a contraindication to vaccination?
Which of the following is NOT typically a contraindication to vaccination?
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Select the condition that is generally seen as a rationale for vaccination rather than a barrier.
Select the condition that is generally seen as a rationale for vaccination rather than a barrier.
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What is the primary purpose of examining all sick children for 'general danger signs' according to the IMCI guidelines?
What is the primary purpose of examining all sick children for 'general danger signs' according to the IMCI guidelines?
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Which symptom is NOT specifically mentioned for routine assessment in children aged 2 months to 5 years?
Which symptom is NOT specifically mentioned for routine assessment in children aged 2 months to 5 years?
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For children aged 1 week to 2 months, what two major symptoms must be assessed according to the IMCI guidelines?
For children aged 1 week to 2 months, what two major symptoms must be assessed according to the IMCI guidelines?
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What additional assessments should be conducted for older children (2 months to 5 years) as per IMCI guidelines?
What additional assessments should be conducted for older children (2 months to 5 years) as per IMCI guidelines?
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Which of the following best describes children who should be assessed for 'general danger signs'?
Which of the following best describes children who should be assessed for 'general danger signs'?
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Study Notes
Vaccine Administration Order
- When administering multiple vaccines, prioritize OPV, followed by Rotavirus, and then other vaccines.
Vaccine Storage and Handling
- Implement a "first expiry, first out" system for vaccine utilization.
- Clean injection sites with cotton. If using alcohol, ensure the area is completely dry before injecting the vaccine.
- BCG, AMV, and MMR vaccines require specific diluents and should be discarded 6 hours after reconstitution or after clinic hours.
- Protect BCG from sunlight and Rotavirus from exposure to light.
Post-Immunization Care
- Inform caregivers of children who receive immunizations about common side effects and appropriate management strategies.
Reusable Vaccines
- Reusable vaccines like OPV, Pentavalent, Hepatitis B, and Tetanus toxoid can last for a maximum of 4 weeks.
- To ensure the effectiveness of reusable vaccines, several critical conditions must be met:
- The vaccine must not have exceeded its expiry date.
- The recommended cold chain conditions need to be maintained throughout the storage period.
- Aseptic technique must be followed when drawing the vaccine from the vial.
- The vaccine vial monitor (VVM) should not have reached its discard portion, indicating potential temperature abuse.
- The vaccine septum should not be submerged in water, as doing so can compromise its sterility.
Bacillus Calmette Guerin (BCG) Vaccine
- Protects against Tuberculosis
- Contains live-attenuated bacteria
- Administered at birth
- Dosage: 0.05 mL
- Route: Intradermal (ID)
- Injection site: Right upper arm/deltoid
Hepatitis B Vaccine
- Protects against Hepatitis B
- Contains either plasma derivative or RNA recombinant
- Administered at birth
- Dosage: 0.5 mL
- Route: Intramuscular (IM)
- Injection site: Vastus lateralis
Pentavalent Vaccine
- Protects against Diphtheria, Pertussis, Tetanus, Hepatitis B, Pneumonia, Meningitis
- Contains weakened toxins (D and T), killed bacteria (P)
- Administered at 6, 10, and 14 weeks of age
- Dosage: 0.5 mL
- Route: IM
- Injection site: Vastus lateralis
Oral Polio Vaccine (OPV)
- Protects against Poliomyelitis
- Contains live-attenuated virus
- Administered at 6, 10, and 14 weeks of age
- Dosage: 0.5 mL
- Route: Oral (PO)
- Injection site: Mouth
Inactivated Polio Vaccine (IPV)
- Protects against Poliomyelitis
- Administered at 14 weeks of age
- Dosage: 0.5 mL
- Route: IM
- Injection site: Vastus lateralis
Pneumococcal Conjugate Vaccine (PCV)
- Protects against Pneumonia and Meningitis
- Administered at 6, 10, and 14 weeks of age, and one dose for children aged 2 to 5 years old
- Dosage: 0.5 mL
- Route: IM
- Injection site: Vastus lateralis
Measles Mumps Rubella (MMR) Vaccine
- Protects against Measles, Mumps, and Rubella (German Measles)
- Contains live-attenuated virus
- Administered at 9 months, and again between 12 to 15 months of age
- Dosage: 0.5 mL
- Route: Subcutaneous (SC)
- Injection site: Outer arm
Vaccines in the Philippine Immunization Program
- BCG (Bacillus Calmette Guerin) vaccinates against Tuberculosis with a live-attenuated bacteria. It is administered by intradermal (ID) injection at birth.
- Hepatitis B Vaccine (Monovalent) is administered at birth via intramuscular (IM) injection in the vastus lateralis. It can be a plasma derivative or RNA recombinant.
- Pentavalent Vaccine (DPT-HepB-Haemophilus influenza) is administered at 6, 10, and 14 weeks of age. It offers protection against diphtheria, pertussis, tetanus, hepatitis B, pneumonia, and meningitis.
- Oral Polio Vaccine (OPV) is administered at 6, 10, and 14 weeks of age via the oral (PO) route. It uses a live-attenuated virus to build GI mucosal immunity.
- Inactivated Polio Vaccine (IPV) is administered at 14 weeks via intramuscular (IM) injection in the vastus lateralis. It provides serum immunity against poliomyelitis.
- Pneumococcal Conjugate Vaccine (PCV) is administered at 6, 10, and 14 weeks of age. It protects against pneumonia and meningitis. A single dose is given between the ages of 2-5 years.
- Measles Mumps Rubella (MMR) is administered at 9 months and 12-15 months via subcutaneous (SC) injection. It is a live-attenuated virus that offers protection against mumps, measles, and German measles.
BCG Vaccine
-
Common side effects:
- Wheal lasting 30 minutes followed by ulceration within 2 weeks
- Scar formation within 12 weeks or 3 months
- Koch's phenomenon: acute inflammatory reaction within 2-4 days indicating previous tuberculosis exposure
- Deep abscess due to subcutaneous injection
- Indolent ulcer persisting after 12 weeks
- Glandular enlargement of lymph glands draining the injection site
-
Management:
- Normal reaction requires no management
- Deep abscess needs incision and drainage by a physician
Hepatitis B Vaccine
- Common side effect: Local soreness at the injection site
- Management:
- Treat with Isoniazid (INH) powder
- If suppuration occurs, manage as a deep abscess
Pentavalent Vaccine
-
Common side effects:
- Fever lasting for 1 day
- Local soreness at the injection site
-
Management:
- No treatment needed for 24-hour fever
- May apply cold compress
- Advise parents to give antipyretics
Oral Polio Vaccine (OPV)
-
Common side effects:
- Abscess after a week due to insufficient injection depth or non-sterile needle
- Convulsions, rare in children over 3 months, caused by pertussis component
-
Management:
- Reassure parents that soreness will subside after 3-4 days
- Provide paracetamol for pain
- Incision and drainage may be necessary for abscess
- For convulsions:
- Nothing per orem for 30 minutes to prevent vomiting and enhance absorption
- If vomiting occurs, give another dose
- If simple diarrhea, administer OPV but it doesn't count towards the dose, return for next due dose
Inactivated Polio Vaccine (IPV)
- Common side effect: Local tenderness
- Management: Cold compress
Measles, Mumps, Rubella (MMR) Vaccine
- Common side effects: Local soreness, fever, irritability, and malaise
- Management:
- Reassure parents
- Instruct parents to give antipyretics
- Administer 200,000 IU of Vitamin A for epithelialization and immunity boost
Vaccine Storage Temperatures
- Oral poliovirus vaccine (OPV) should be stored between -15 and -25 degrees Celsius.
- OPV can be stored at room temperature for up to 8 hours.
- Pentavalent Hepatitis B vaccine should be stored between 2 and 8 degrees Celsius.
- Pentavalent Hepatitis B vaccine can be stored at room temperature for 4 to 6 hours.
- Diphtheria Tetanus Toxoid vaccine should be stored in the body of the refrigerator.
- Diphtheria Tetanus Toxoid vaccine can be stored at room temperature for up to 8 hours.
Vaccine Storage Duration
- Vaccines stored at the Regional Health Office can remain viable for six months.
- Vaccines stored at the Provincial/District Health Office can remain viable for three months.
- Vaccines stored at the Rural Health Unit can remain viable for one month.
- Vaccines can be transported with cold packs for up to five days.
Vaccine Vial Monitor (VVM)
- If the square on the VVM is lighter than the circle, the vaccine can be used if the expiry date has not passed.
- If the square on the VVM matches the circle, the vaccine can be used if the expiry date has not passed.
- If the square on the VVM is darker than the circle, the vaccine should not be used and the supervisor should be informed.
Vaccine Administration Sequence
- Different vaccines have specific administration sequences depending on the type of vaccine and the age of the recipient.
Vaccine Reconstitution
- Vaccines like BCG, AMV, and MMR require reconstitution before administration.
- After reconstitution, these vaccines must be used within a specific time frame, as indicated by the manufacturer's instructions.
Injection Site Cleaning
- The injection site should be cleaned with a 70% alcohol wipe or solution.
- The area should be wiped once and allowed to air dry, avoiding re-contamination.
Vaccine Storage
- BCG and Rotavirus vaccines need to be stored at a specific temperature to maintain efficacy.
- The recommended storage temperature for these vaccines is 2–8°C, and they should be kept in a refrigerator away from direct sunlight.
Caregiver Information
- Caregivers should be informed about the potential side effects of vaccines and how to manage them.
- They should also be educated on the importance of completing the entire vaccination schedule.
Reusable Vaccines
- Reusable vaccines can last for a maximum of 4 weeks, but this does not depend on whether the vaccine has been opened.
- Other factors, like proper storage conditions, influence the longevity of opened reusable vaccines.
Vaccine Vial Monitor (VVM)
- The VVM is crucial for preserving the effectiveness of reusable vaccines.
- It indicates the vaccine's exposure to heat, which can affect its potency.
Reusable Vaccine Longevity
- Factors like the duration of storage, exposure to extreme temperatures, and the handling of the vials impact the longevity of reusable vaccines.
- The type or brand of the vaccine does not directly affect its reusability within the context of proper cold chain management.
Maintaining Vaccine Effectiveness
- To ensure vaccine effectiveness, it's crucial to avoid exposing the vaccine to extreme temperatures, especially freezing or heat.
- Freezing can permanently damage the vaccine, while excessive heat can degrade its effectiveness.
Reusable Vaccine Factors
- Maintaining the cold chain plays a significant role in the reusability of vaccines.
- Factors like the number of times a vaccine vial has been opened and the duration of storage within the prescribed cold chain impact its reusability.
Hepatitis B Vaccine Route
- The Hepatitis B vaccine is administered intramuscularly, typically in the deltoid muscle of the upper arm.
Pentavalent Vaccine Schedule
- The Pentavalent vaccine can be administered at 6, 10, and 14 weeks of age.
- This schedule helps to ensure that the child receives the necessary protection against various diseases.
Birth Vaccine
- The Hepatitis B vaccine can be administered at birth, providing immediate protection against this potentially life-threatening infection.
BCG Injection Site
- The BCG vaccine is typically injected into the left upper arm, slightly below the shoulder.
- This specific location helps to minimize potential complications.
Liquid Vaccine
- The Measles, Mumps, and Rubella (MMR) vaccine is available in liquid form, and its clarity is a crucial indicator of its viability.
- A clear liquid ensures that the vaccine is suitable for administration.
MMR Administration Age
- The MMR vaccine is administered in two doses, typically at 1 year of age and at 18 months.
- This two-dose schedule ensures optimal protection against measles, mumps, and rubella.
IPV Injection Site
- The Inactivated Polio Vaccine (IPV) is typically administered intramuscularly into the anterolateral thigh muscle of infants and children younger than 7 years.
- This site allows for efficient absorption of the vaccine.
Pneumonia and Meningitis Prevention
- The Haemophilus influenzae type b (Hib) vaccine is essential for preventing pneumonia and meningitis caused by Haemophilus influenzae type b bacteria.
- It provides crucial protection during the first two years of life when infants are most vulnerable to these infections.
Live-Attenuated Virus Vaccine
- The Measles, Mumps, and Rubella (MMR) vaccine utilizes a live-attenuated virus for its administration.
- This means that the virus in the vaccine has been weakened, so it cannot cause the diseases it prevents while still generating the necessary immune response.
BCG Dosage
- The recommended dose of the BCG vaccine is a single dose of 0.05 ml, administered intradermally.
- This dose is sufficient to induce an effective immune response.
BCG Symptom
- A common symptom observed after administering the BCG vaccine is the formation of a small, red nodule at the injection site.
- This reaction indicates that the vaccine is working and stimulating the immune system.
BCG Ulcer Management
- If an indolent ulcer persists beyond 12 weeks after the BCG vaccination, it signifies that the immune system is not responding as expected.
- It's important to refer the child to a healthcare professional for evaluation and potentially further management.
OPV Vaccine Reaction
- A specific reaction associated with the Oral Polio Vaccine (OPV) is vaccine-associated paralytic poliomyelitis (VAPP).
- This rare complication involves paralysis related to the vaccine, but it is significantly less common than the natural form of polio.
Hepatitis B Pain Management
- Local soreness at the injection site after the Hepatitis B vaccine can be managed with simple measures like a cold compress or a warm compress.
- Over-the-counter pain relievers can also provide relief from discomfort.
MMR Side Effect
- A notable side effect that can occur in some children after the MMR vaccination is fever, which typically occurs 7 to 12 days after vaccination.
- Other potential side effects include rash, joint pain, and transient swelling in the glands around the ears.
Convulsions Association
- The DTaP vaccine is most strongly associated with the risk of convulsions in children over 3 months.
- However, it's important to emphasize that the risk of seizures associated with the DTaP vaccine is quite low.
IPV Cold Compress
- If a child develops a hard, painful lump at the injection site after receiving the Inactivated Polio Vaccine (IPV), applying a cold compress can help to alleviate discomfort.
- This measure can reduce inflammation and pain.
Pentavalent Fever Management
- If a child develops fever beyond 24 hours after receiving the Pentavalent vaccine, it's crucial to seek medical attention.
- The fever might be related to the vaccine or another underlying cause, requiring further investigation.
Pentavalent Storage Temperature
- The Pentavalent Hepatitis B vaccine should be stored at 2–8°C (36–46°F), which ensures its stability and effectiveness.
- Deviations from this temperature range can compromise the vaccine's potency.
VVM Result
- If the VVM result indicates that the square is darker than the circle, it means the vaccine has been exposed to temperatures above the recommended range and may have lost its potency.
- In this situation, the vaccine should not be used.
Vaccine Transport Duration
- The maximum transport period for vaccines using cold packs is 12 hours.
- Exceeding this duration can compromise the vaccine's effectiveness.
Rural Health Unit Storage
- Vaccines can be stored at a Rural Health Unit for a maximum of 3 months, provided they adhere to proper storage conditions.
- This duration allows for a sufficient supply while maintaining the integrity of the vaccines.
Provincial/District Health Office Storage
- If the recommended storage location for vaccines is the Provincial/District Health Office, they can be stored for a maximum of 6 months.
- This extended duration allows for larger-scale storage and distribution to healthcare facilities.
Indication vs. Contraindication
- Pregnant women are considered an indication rather than a contraindication for vaccination.
- This is because vaccinating pregnant women helps to protect both the mother and the developing fetus.
Vaccination Prevention
- Severe allergic reaction to a previous dose of the same vaccine would typically prevent vaccination.
- This is because the risk of a severe allergic reaction occurring again is significantly higher.
Vaccination Fever Threshold
- A temperature of 38.5°C or below is considered an acceptable threshold for proceeding with vaccination.
- A higher fever might indicate an underlying illness that could interfere with the vaccine's effectiveness.
Vaccination Contraindication
- A recent exposure to a contagious disease is not typically a contraindication to vaccination.
- In such situations, vaccination can still be administered after a period of observation to ensure that the individual does not develop the disease.
Vaccination Rationale
- A family history of allergy to eggs is generally seen as a rationale for vaccination rather than a barrier.
- This is because egg allergy is not a contraindication to most vaccines, and the risk of severe allergic reaction is low.
Integrated Management of Childhood Illness (IMCI) Principles
- IMCI guidelines emphasize immediate assessment of "general danger signs" in all sick children. These danger signs signal the need for urgent referral or hospitalization.
- Children aged 2 months to 5 years should be routinely assessed for major symptoms including cough, difficulty breathing, diarrhea, fever, and ear problems.
- Children aged 1 week to 2 months, in addition to major symptoms, should be assessed for bacterial infection and diarrhea.
- Routinely assessing nutritional and immunization status is crucial for all sick children.
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Description
This quiz covers key principles of vaccine administration, storage, and post-immunization care. It emphasizes prioritization of vaccine types, proper handling and usage protocols, and informing caregivers about side effects. Test your knowledge on effective immunization practices.
