An 18-month-old child in India is due for the second dose of OPV booster under the National Immunization Schedule. The child had received birth dose OPV, and three doses of IPV at 6, 10, and 14 weeks. Which statement best reflects the current IAP recommended schedule for combining OPV and IPV?

• A IPV alone at 6 and 14 weeks; OPV given only for Pulse Polio days
• B Complete switch to IPV-only schedule; all OPV doses discontinued since bOPV introduction
• C Sequential IPV (2 doses) then switch to bOPV (2 doses) without any additional boosters needed
• D IPV at 6 and 14 weeks plus fractional IPV intradermally at 6, 10, 14 weeks; OPV boosters at 15–18 months and 4–6 years ✓

Explanation

India's UIP adopted a sequential IPV + OPV strategy: fractional dose IPV (fIPV, 0.1 mL intradermal) at 6 and 14 weeks alongside OPV at 6, 10, 14 weeks to achieve both humoral (IPV) and intestinal (OPV) mucosal immunity. Bivalent OPV (bOPV, types 1 and 3) replaced trivalent OPV after type 2 tOPV withdrawal in April 2016. OPV boosters continue at 15–18 months and 4–6 years per UIP. A complete IPV-only switch has not been implemented in India's routine UIP due to cost and cold chain considerations.

Reference: Ghai Essential Pediatrics, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.