Catch-up immunisation — branching viva

Stem

You are in clinic with a preschooler and caregiver who ask whether to restart every vaccine. ^[1]

Examiner: Parent says restart all needles. First response? ^[1]

Strong answer: Do not restart blindly. Check the national register and written records, count only valid doses, then build an antigen-by-antigen catch-up plan for age. ^{[1] [7]}

Examiner: How do you decide a dose is invalid? ^{[1] [3]}

Strong answer: Doses before minimum age or before minimum interval usually do not count. Wrong product age band can also invalidate a dose. Same-day inactivated vaccines are generally acceptable. ^{[1] [3]}

Examiner: Two live injectables due; only one stocked today. ^[1]

Strong answer: Give the available live vaccine today with other due inactivated vaccines if appropriate. Book the second live injectable at least 4 weeks later if not same-day. ^[1]

Examiner: Registry and records empty after a proper search. ^{[1] [4]}

Strong answer: After a safety screen, begin age-appropriate catch-up rather than assuming immunity. Give due vaccines today, write the next visit date, and report doses. Do not wait months for a default full serology panel. ^{[1] [4]}

Examiner: Measles contact in an under-immunised classmate. ^[2]

Strong answer: Urgent post-exposure care first, not a routine multi-visit booking. Follow public-health timing for vaccine or immunoglobulin, then complete longer-term catch-up. ^[2]

Examiner: One system action you will not skip? ^[7]