Prompt

You are the paediatric registrar running a teaching immunisation clinic. The examiner will challenge definitions, validity rules, population protection and cross-country schedule reasoning.

Stem

The examiner moves from definitions to an infant multi-antigen visit, then to measles coverage and regional schedules. ^[4] ^[8] ^[30]

References40Show

[1]Fine P Herd immunity: a rough guide Clin Infect Dis, 2011.PMID 21427399
[2]Fine PE Herd immunity: history, theory, practice Epidemiol Rev, 1993.PMID 8174658
[3]Anderson RM Immunisation and herd immunity Lancet, 1990.PMID 1969023
[4]National Center for Immunization and Respiratory Diseases General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep, 2011.PMID 21293327
[5]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2024. MMWR. Morbidity and mortality weekly report, 2024.PMID 38206855
[6]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023. MMWR. Morbidity and mortality weekly report, 2023.PMID 36757872
[7]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2021. MMWR. Morbidity and mortality weekly report, 2021.PMID 33571172
[8]McLean HQ Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2013.PMID 23760231
[9]Tulchinsky TH Measles control in developing and developed countries: the case for a two-dose policy. Bulletin of the World Health Organization, 1993.PMID 8440043
[10]Colburn NE Measles - Resurgence of an Old Foe. The Medical clinics of North America, 2025.PMID 40185555
[11]Kiang MV Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US. JAMA, 2025.PMID 40272967
[12]Amirthalingam G Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet (London, England), 2014.PMID 25037990
[13]Gkentzi D Maternal vaccination against pertussis: a systematic review of the recent literature. Archives of disease in childhood. Fetal and neonatal edition, 2017.PMID 28468899
[14]Schillie S Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2018.PMID 29939980
[15]Cortese MM Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2009.PMID 19194371
[16]Petrosky E Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR. Morbidity and mortality weekly report, 2015.PMID 25811679
[17]Meites E Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR. Morbidity and mortality weekly report, 2019.PMID 31415491
[18]Kobayashi M Use of 15-Valent Pneumococcal Conjugate Vaccine Among U.S. Children: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR. Morbidity and mortality weekly report, 2022.PMID 36107786
[19]Parikh SR The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination. The Journal of infection, 2020.PMID 32504737
[20]Albers AN Invalid Vaccine Doses Among Children Aged 0 to 35 Months: 2011 to 2020. Pediatrics, 2025.PMID 39788151
[21]Stokley S Evaluation of invalid vaccine doses. American journal of preventive medicine, 2004.PMID 14700710
[22]GBD 2023 Vaccine Coverage Collaborators Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023. Lancet (London, England), 2025.PMID 40578370
[23]Hull B Immunisation Coverage Annual Report 2019. Communicable diseases intelligence (2018), 2021.PMID 33823758
[24]Hull B Annual immunisation coverage report 2020. Communicable diseases intelligence (2018), 2022.PMID 36154654
[25]Hull B Annual Immunisation Coverage Report 2022. Communicable diseases intelligence (2018), 2025.PMID 40925362
[26]Law C Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register. Australian and New Zealand journal of public health, 2019.PMID 30959563
[27]Giles ML How COVID-19 has impacted immunisation service delivery in Australia: a national study. Australian and New Zealand journal of public health, 2022.PMID 35616400
[28]Davies C School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination. Vaccine, 2021.PMID 34127299
[29]Wnukowski-Mtonga P Scientific evidence supporting recommendations on the use of the 9-valent HPV vaccine in a 2-dose vaccine schedule in Australia. Communicable diseases intelligence (2018), 2020.PMID 32299331
[30]Panovska-Griffiths J A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule. Vaccine, 2018.PMID 30055970
[31]Crowe S A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme. BMC infectious diseases, 2015.PMID 26714777
[32]Sherman SM UK healthcare professionals' attitudes towards the introduction of varicella vaccine into the routine childhood vaccination schedule and their preferences for administration. Vaccine, 2024.PMID 38480101
[33]Bell KN Risk factors for improper vaccine storage and handling in private provider offices. Pediatrics, 2001.PMID 11389298
[34]Kenigsberg TA Simultaneous administration of mRNA COVID-19 bivalent booster and influenza vaccines. Vaccine, 2023.PMID 37599140
[35]Lesinski GB Vaccines against polysaccharide antigens. Current drug targets. Infectious disorders, 2001.PMID 12455405
[36]Bröker M Polysaccharide conjugate vaccine protein carriers as a "neglected valency" - Potential and limitations. Vaccine, 2017.PMID 28487056
[37]Akkoyunlu M State of pneumococcal vaccine immunity. Human vaccines & immunotherapeutics, 2024.PMID 38567485
[38]Armstrong GL The economics of routine childhood hepatitis A immunization in the United States: the impact of herd immunity. Pediatrics, 2007.PMID 17200247
[39]Abbas K Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit-risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. The Lancet. Global health, 2020.PMID 32687792
[40]Fine PEM Population Immunity and Polio Eradication. Pathogens (Basel, Switzerland), 2024.PMID 38535527

Stem

The examiner moves from definitions to an infant multi-antigen visit, then to measles coverage and regional schedules. ^[4] ^[8] ^[30]

References40Show

[1]Fine P Herd immunity: a rough guide Clin Infect Dis, 2011.PMID 21427399
[2]Fine PE Herd immunity: history, theory, practice Epidemiol Rev, 1993.PMID 8174658
[3]Anderson RM Immunisation and herd immunity Lancet, 1990.PMID 1969023
[4]National Center for Immunization and Respiratory Diseases General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep, 2011.PMID 21293327
[5]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2024. MMWR. Morbidity and mortality weekly report, 2024.PMID 38206855
[6]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023. MMWR. Morbidity and mortality weekly report, 2023.PMID 36757872
[7]Wodi AP Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2021. MMWR. Morbidity and mortality weekly report, 2021.PMID 33571172
[8]McLean HQ Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2013.PMID 23760231
[9]Tulchinsky TH Measles control in developing and developed countries: the case for a two-dose policy. Bulletin of the World Health Organization, 1993.PMID 8440043
[10]Colburn NE Measles - Resurgence of an Old Foe. The Medical clinics of North America, 2025.PMID 40185555
[11]Kiang MV Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US. JAMA, 2025.PMID 40272967
[12]Amirthalingam G Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet (London, England), 2014.PMID 25037990
[13]Gkentzi D Maternal vaccination against pertussis: a systematic review of the recent literature. Archives of disease in childhood. Fetal and neonatal edition, 2017.PMID 28468899
[14]Schillie S Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2018.PMID 29939980
[15]Cortese MM Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports, 2009.PMID 19194371
[16]Petrosky E Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR. Morbidity and mortality weekly report, 2015.PMID 25811679
[17]Meites E Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR. Morbidity and mortality weekly report, 2019.PMID 31415491
[18]Kobayashi M Use of 15-Valent Pneumococcal Conjugate Vaccine Among U.S. Children: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2022. MMWR. Morbidity and mortality weekly report, 2022.PMID 36107786
[19]Parikh SR The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination. The Journal of infection, 2020.PMID 32504737
[20]Albers AN Invalid Vaccine Doses Among Children Aged 0 to 35 Months: 2011 to 2020. Pediatrics, 2025.PMID 39788151
[21]Stokley S Evaluation of invalid vaccine doses. American journal of preventive medicine, 2004.PMID 14700710
[22]GBD 2023 Vaccine Coverage Collaborators Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023. Lancet (London, England), 2025.PMID 40578370
[23]Hull B Immunisation Coverage Annual Report 2019. Communicable diseases intelligence (2018), 2021.PMID 33823758
[24]Hull B Annual immunisation coverage report 2020. Communicable diseases intelligence (2018), 2022.PMID 36154654
[25]Hull B Annual Immunisation Coverage Report 2022. Communicable diseases intelligence (2018), 2025.PMID 40925362
[26]Law C Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register. Australian and New Zealand journal of public health, 2019.PMID 30959563
[27]Giles ML How COVID-19 has impacted immunisation service delivery in Australia: a national study. Australian and New Zealand journal of public health, 2022.PMID 35616400
[28]Davies C School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination. Vaccine, 2021.PMID 34127299
[29]Wnukowski-Mtonga P Scientific evidence supporting recommendations on the use of the 9-valent HPV vaccine in a 2-dose vaccine schedule in Australia. Communicable diseases intelligence (2018), 2020.PMID 32299331
[30]Panovska-Griffiths J A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule. Vaccine, 2018.PMID 30055970
[31]Crowe S A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme. BMC infectious diseases, 2015.PMID 26714777
[32]Sherman SM UK healthcare professionals' attitudes towards the introduction of varicella vaccine into the routine childhood vaccination schedule and their preferences for administration. Vaccine, 2024.PMID 38480101
[33]Bell KN Risk factors for improper vaccine storage and handling in private provider offices. Pediatrics, 2001.PMID 11389298
[34]Kenigsberg TA Simultaneous administration of mRNA COVID-19 bivalent booster and influenza vaccines. Vaccine, 2023.PMID 37599140
[35]Lesinski GB Vaccines against polysaccharide antigens. Current drug targets. Infectious disorders, 2001.PMID 12455405
[36]Bröker M Polysaccharide conjugate vaccine protein carriers as a "neglected valency" - Potential and limitations. Vaccine, 2017.PMID 28487056
[37]Akkoyunlu M State of pneumococcal vaccine immunity. Human vaccines & immunotherapeutics, 2024.PMID 38567485
[38]Armstrong GL The economics of routine childhood hepatitis A immunization in the United States: the impact of herd immunity. Pediatrics, 2007.PMID 17200247
[39]Abbas K Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit-risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. The Lancet. Global health, 2020.PMID 32687792
[40]Fine PEM Population Immunity and Polio Eradication. Pathogens (Basel, Switzerland), 2024.PMID 38535527

Immunisation principles and national schedule comparison — branching viva

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Immunisation principles and national schedule comparison — branching viva

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