Immunization and Vaccines (Cold Chain, NIS Schedule, Open Vial Policy) MCQs

Community Medicine (PSM) · 143 free questions with answers & explanations.

1. Under India's Universal Immunization Programme, Rotavirus vaccine is administered orally. As per the National Immunization Schedule (2023), at which ages is Rotavirus vaccine given?
2. A cold chain worker notices that the vaccine vial monitor (VVM) on an OPV vial shows the inner square darker than the outer circle. What should the health worker do?
3. Open Vial Policy (OVP) under UIP allows reuse of opened multi-dose vaccine vials at subsequent sessions. Which of the following vaccines is EXCLUDED from the Open Vial Policy?
4. A health worker administers measles-rubella (MR) vaccine to a child. Which of the following is the correct storage temperature for MR vaccine at the primary health centre level?
5. PCV (Pneumococcal Conjugate Vaccine) was introduced in India's UIP as a phased rollout. Which serogroup-specific antigen combination does PCV13 target compared to PCV10?
6. Per the revised National Immunization Schedule (NIS) under India's UIP, the Measles-Rubella (MR) second dose is administered at:
7. India's Open Vial Policy permits reuse of opened multi-dose vials at subsequent immunization sessions. This policy does NOT apply to which vaccine?
8. The Vaccine Vial Monitor (VVM) inner square has become DARKER than the outer circle. What action should be taken?
9. The Vaccine Vial Monitor (VVM) on a BCG vial is at Stage 2 (inner square lighter than outer circle). The cold chain box label shows a temperature excursion >25°C recorded. The appropriate action is:
10. Under the Open Vial Policy (OVP) in India's National Immunization Schedule, which vaccines can be used in subsequent sessions after opening, and for how long?
11. A 9-month-old child in India has received BCG at birth, OPV 0, OPV1/2/3, DPT 1/2/3, Hep-B 1/2/3, and IPV 1/2. According to the current National Immunization Schedule, which vaccines are due at 9 months of age?
12. Regarding cold chain equipment in India's Universal Immunization Programme, the correct temperature range for storing vaccines in an Ice-Lined Refrigerator (ILR) at the PHC level is:
13. Pentavalent vaccine used in the National Immunization Programme of India contains which combination of antigens?
14. Regarding Rotavirus vaccine (RVV) in India's NIS: how many doses are given, via which route, and at what ages?
15. The Open Vial Policy (OVP) under UIP allows multi-dose vials of vaccines to be used in subsequent sessions. Which of the following vaccines is EXCLUDED from the Open Vial Policy and must be discarded at end of session?
16. A cold chain technician finds that a vial of BCG vaccine has a Vaccine Vial Monitor (VVM) that has progressed to Stage 2 (inner square matches the outer circle). The correct action is:
17. Under the National Immunization Schedule, the Pneumococcal Conjugate Vaccine (PCV) was introduced in India's UIP. The schedule currently recommended for PCV is:
18. Regarding vaccine-associated paralytic polio (VAPP), which of the following is correct?
19. The Vaccine Vial Monitor (VVM) on a vaccine vial transitions from inner square lighter than outer circle to inner square darker than outer circle. This indicates:
20. Under the Universal Immunization Programme's revised Open Vial Policy, which of the following vaccines can be used in subsequent sessions after opening (i.e., has open vial policy)?
21. A cold chain technician finds that OPV vials have been accidentally stored at -25°C for 48 hours. The correct action is:
22. Under the NIS schedule, Pneumococcal Conjugate Vaccine (PCV) is given at which ages in India?
23. Under the Open Vial Policy of India's Universal Immunization Programme, which vaccine is NOT covered — meaning the vial MUST be discarded at the end of the session regardless of remaining doses?
24. A Vaccine Vial Monitor (VVM) is placed on a vial of OPV. The inner square has become darker than the outer circle. The correct interpretation is:
25. The pentavalent vaccine used in India's UIP contains which five antigens?
26. Under India's Universal Immunization Programme, the Rotavirus vaccine (RVV-116E) is given in how many doses, at which ages, and by which route?
27. A health worker at a sub-centre opens a vial of oral poliovirus vaccine (OPV) and uses it for 4 children during a session. The remaining doses are to be used at the next session 3 days later. The vial monitor (VVM) is still in Stage 1. Under the open vial policy, the correct course of action is:
28. A child born to an HBsAg-positive mother at 36 weeks gestation weighing 2.2 kg. The correct hepatitis B immunoprophylaxis approach within 24 hours of birth is:
29. The 'ice-lined refrigerator' (ILR) in the cold chain system for vaccines is designed to maintain temperature between:
30. The Vaccine Vial Monitor (VVM) on an OPV vial shows the inner square darker than the outer circle. The correct action by the health worker is:
31. Under the revised Open Vial Policy (OVP) in the National Immunization Schedule, which of the following vaccines does NOT follow the OVP (i.e., opened vials must be discarded after the session)?
32. In the National Immunization Schedule, the recommended storage temperature at ILR (Ice Lined Refrigerator) at PHC/CHC level for most vaccines (excluding polio and varicella) is:
33. Adverse Events Following Immunization (AEFI) causality assessment uses which classification system as per WHO (2012) guidelines adopted in India?
34. India introduced the Pneumococcal Conjugate Vaccine (PCV) into the Universal Immunisation Programme. What is the scheduled dosing regimen for PCV-13 under India's NIS (2024)?
35. During a vaccination session at a PHC, a health worker opens a vial of DPT vaccine. After the session ends with doses remaining, the nurse wants to know whether the vial can be used in the next session. According to India's Multi-Dose Open Vial Policy (MDOVP), which criterion MOST immediately determines whether this vial is usable?
36. Rotavirus vaccine (RVV) was included in India's UIP. Which of the following CORRECTLY describes the administration schedule for Rotarix (RV1) as given under India's programme?
37. A Vaccine Vial Monitor (VVM) on a vial of DPT shows that the inner square has become darker than the outer circle. The correct action is:
38. Under the Universal Immunization Programme, Rotavirus vaccine is now included. The current schedule for Rotavirus vaccine (Rotarix® type, 2-dose) is:
39. The Vaccine Vial Monitor (VVM) on a vial of OPV shows the inner square darker than the outer circle. This indicates:
40. A 6-week-old infant receives DPT-Hep B-Hib pentavalent vaccine. The infant develops inconsolable high-pitched crying for 3 hours that evening. This is classified as:
41. The Open Vial Policy (OVP) under UIP allows reuse of opened multi-dose vials at subsequent sessions. Which vaccine is EXCLUDED from OVP and must be discarded after each session?
42. Under India's Universal Immunization Programme, the Open Vial Policy (OVP) specifies that an opened vial of OPV can be reused for up to 4 weeks provided certain conditions are met. Which of the following vaccines is EXCLUDED from the Open Vial Policy?
43. A Vaccine Vial Monitor (VVM) on a pentavalent vial shows the inner square darker than the outer circle. The correct action for the health worker is:
44. Under India's Universal Immunisation Programme, the Vaccine Vial Monitor (VVM) helps healthcare workers make field decisions. A VVM where the inner square is DARKER than the outer circle should be interpreted as:
45. The Open Vial Policy applies to certain vaccines under UIP. A multi-dose vial of OPV that was opened during an immunisation session can be used in subsequent sessions within how many days if stored correctly at 2–8°C?
46. The Rotavirus vaccine currently included in India's UIP schedule is an oral vaccine administered at 6, 10, and 14 weeks. The vaccine used is:
47. Under India's Universal Immunization Programme, the Vaccine Vial Monitor (VVM) on an oral polio vaccine vial shows that the inner square has become slightly darker than the outer circle but the two are still distinguishable. According to WHO/UIP guidelines, this VVM reading indicates:
48. The 'Open Vial Policy' in the Universal Immunization Programme allows multi-dose vials of certain vaccines to be used in subsequent sessions. Which of the following vaccines is CORRECTLY excluded from the open vial policy and must be discarded at the end of each immunization session?
49. India's Mission Indradhanush 4.0 (Intensified Mission Indradhanush) targets immunization of which groups PRIMARILY?
50. In the Indian cold chain system, the Vaccine Van (State to District) is required to maintain which temperature range during transport?
51. The Open Vial Policy (OVP) under UIP allows multi-dose vials of which vaccine to be USED at subsequent sessions (not discarded) if certain conditions are met?
52. The Vaccine Vial Monitor (VVM) on an OPV vial shows the inner square darker than the outer circle. The correct action is:
53. The Open Vial Policy (OVP) as adopted in India's UIP allows multi-dose vials of which vaccine to be used for up to 28 days after opening, provided cold chain is maintained and VVM is not reached?
54. A child immunized against measles at 9 months develops measles at age 3 years. Which immunological mechanism BEST explains vaccine failure in this scenario?
55. The Open Vial Policy (OVP) under the Universal Immunisation Programme allows multi-dose vials of which vaccines to be reused at subsequent sessions within a 28-day period, provided specific conditions are met?
56. A Vaccine Vial Monitor (VVM) on a BCG vial shows that the inner square is darker than the outer circle. The correct action is:
57. Rotavirus vaccine is included in India's Universal Immunisation Programme with a 3-dose schedule. The UPPER age limit for the first dose of oral rotavirus vaccine (Rotavac/Rotasiil) under UIP is:
58. Under India's Universal Immunization Programme (UIP), the Vaccine Vial Monitor (VVM) changes colour from light to dark. A VVM in Stage 2 (inner square lighter than outer circle) indicates:
59. The Open Vial Policy (OVP) for multi-dose vaccine vials does NOT apply to which of the following vaccines under India's UIP?
60. India introduced HPV vaccine (Cervavac — quadrivalent, indigenous) into the Universal Immunization Programme in 2023. The recommended schedule is:
61. Which temperature zone of the cold chain system in India is maintained at -15°C to -25°C?
62. Under India's Universal Immunization Programme, the Open Vial Policy (OVP) was introduced for multi-dose vials. Which of the following vaccines is explicitly EXCLUDED from the Open Vial Policy and must be DISCARDED at end of the session regardless of remaining doses?
63. During a cold chain assessment in a PHC, a VVM (Vaccine Vial Monitor) on a pentavalent vial shows that the inner square is slightly darker than the outer ring but the two are still clearly distinguishable. The correct interpretation and action is:
64. Under India's Universal Immunisation Programme, the open vial policy applies to multi-dose vials of vaccines that meet all of the following criteria EXCEPT:
65. A health worker finds a vial of liquid pentavalent vaccine at the session site. The vial was opened 4 hours ago, the VVM shows Stage 1 (square still lighter than circle), ambient temperature is 24°C, and the vial contains 4 doses. According to the open vial policy, the correct action is:
66. In India's National Immunisation Schedule (2023), the MR (Measles-Rubella) vaccine given at 9–12 months is followed by which vaccine at 16–24 months under Mission Indradhanush?
67. The open vial policy for vaccines under India's UIP (Universal Immunization Programme) permits previously opened multi-dose vials to be used in subsequent sessions for which vaccines?
68. Vaccine vial monitors (VVMs) track cumulative heat exposure. A vial with VVM stage 3 (inner square darker than outer circle but same shade) is:
69. Under the National Immunization Schedule (NIS), rotavirus vaccine (RVV) is administered at which ages?
70. In cold chain management, the 'ice-lined refrigerator' (ILR) maintains vaccines at:
71. Herd immunity threshold (HIT) for a disease with basic reproduction number R0 = 5 is:
72. The meningococcal conjugate vaccine (MenACWY) currently recommended for pilgrims travelling to Saudi Arabia for Hajj is required because Neisseria meningitidis serogroup most commonly implicated in Hajj-associated outbreaks is:
73. The Mission Indradhanush (MI) programme aims to fully immunize children and pregnant women who are left out of routine immunization. The intensified phase (IMI 4.0, 2021) targets districts with which coverage threshold as primary eligibility?
74. Under the National Immunization Schedule 2023-24, the Pneumococcal Conjugate Vaccine (PCV) was introduced nationally for all children. The PCV schedule in NIS is:
75. The Vaccine Vial Monitor (VVM) on a multi-dose vial has the inner square darker than the outer circle. The correct action by the health worker is:
76. The Open Vial Policy (OVP) allows multi-dose vaccine vials to be re-used at subsequent sessions. Which vaccine is EXCLUDED from the Open Vial Policy in India?
77. Under the Universal Immunization Programme (UIP) of India, Rotavirus vaccine (RVV) is currently given orally at which schedule?
78. The 'Open Vial Policy' in UIP allows multi-dose vials to be reused in subsequent sessions. Which vaccine is the EXCEPTION and must be discarded after the session regardless of remaining doses?
79. Human Papillomavirus (HPV) vaccine has been introduced into India's UIP for adolescent girls. The current recommended schedule for girls aged 9–14 years under UIP is:
80. A Vaccine Vial Monitor (VVM) shows a colour change where the inner square is darker than the outer ring. The correct action by a vaccintor is:
81. Under the National Immunization Schedule of India, which vaccine is given as a fractional dose (1/5th of the full dose) intradermally at 6 weeks, 10 weeks, and 14 weeks?
82. The Vaccine Vial Monitor (VVM) on a vaccine vial shows the inner square has become the SAME colour as the outer circle. What action should a health worker take?
83. Under the Open Vial Policy (OVP) for immunization, which of the following vaccines can be used in subsequent immunization sessions provided the cold chain is maintained and vial is not contaminated?
84. The eVIN (Electronic Vaccine Intelligence Network) system in India is primarily designed to achieve which objective?
85. Under India's Universal Immunisation Programme, the Open Vial Policy (OVP) allows reuse of opened multi-dose vials in subsequent sessions, EXCEPT for which vaccine?
86. The cold chain equipment used at the district vaccine store for long-term storage of vaccines at -15°C to -25°C is:
87. Rotavirus vaccine is included in India's Universal Immunisation Programme. The CORRECT schedule for administration of Rotavirus vaccine (Rotavac/Rotasiil) in India is:
88. A Vaccine Vial Monitor (VVM) shows the inner square darker than the outer circle. This means the vaccine should be:
89. The Pneumococcal Conjugate Vaccine (PCV) was introduced in India's UIP in 2017. Its schedule (currently used in UIP) is:
90. Under the Universal Immunization Programme's Open Vial Policy, which of the following vaccines can be used in subsequent sessions after the first opening, provided they meet the criteria (VVM has not crossed the discard point, cold chain maintained, no contamination)?
91. The Vaccine Vial Monitor (VVM) changes color from light to dark when exposed to cumulative heat. A vial is discarded when:
92. Inactivated Polio Vaccine (IPV) was introduced into the Universal Immunization Programme as fractional IPV (fIPV) given intradermally. The dose of fIPV given intradermally is what fraction of the standard intramuscular dose?
93. Under the National Immunization Schedule (NIS) 2023, the Pneumococcal Conjugate Vaccine (PCV) is given in a 2+1 schedule. The primary two doses are given at which ages?
94. Hepatitis B vaccine given at birth must be administered within how many hours of birth for maximum protective efficacy against perinatal transmission?
95. The cold chain temperature requirement for BCG vaccine storage at the primary health centre level is:
96. Under the Open Vial Policy (OVP) of India, which vaccine is an EXCEPTION and must be discarded after opening at the end of every session?
97. A child is brought to a PHC for vaccination at 10 weeks of age. Which combination of vaccines is due at this visit as per the NIS?
98. Vaccine Vial Monitor (VVM) on a vaccine vial shows the inner square darker than the outer circle. The correct interpretation and action is:
99. The 'open vial policy' under the Universal Immunization Programme applies to which of the following vaccines at an outreach session?
100. Under NIS (National Immunization Schedule), the Pneumococcal Conjugate Vaccine (PCV) is currently given in India at:
101. In the cold chain for vaccine storage, the temperature at which vaccines should be stored at the Primary Health Centre level (PHC) is:
102. The Vaccine Vial Monitor (VVM) is a heat-sensitive label attached to vaccine vials. When should a vaccine vial be discarded based on VVM reading?
103. Fractional-dose IPV (fIPV) administered intradermally at 1/5th the full dose is used in India primarily for which reason?
104. The Vaccine Vial Monitor (VVM) on a vial of oral poliovirus vaccine shows that the inner square is DARKER than the outer circle. The vial has not expired. What action should be taken?
105. Under India's Universal Immunization Programme (UIP) Open Vial Policy, which of the following vaccines can be used in subsequent sessions after opening, if the cold chain is maintained and the cap is intact?
106. A 9-month-old child is brought to an immunization session and is found to have received all scheduled vaccines except Measles-Rubella (MR). On examination, the child has a low-grade fever of 38.2°C and mild URTI. What is the MOST appropriate action?
107. Under India's Universal Immunization Programme (UIP), the Vaccine Vial Monitor (VVM) is used to:
108. The 'Open Vial Policy' under India's UIP applies to which of the following vaccines when stored at 2–8°C?
109. In India's National Immunization Schedule, the Pneumococcal Conjugate Vaccine (PCV) is given at which ages?
110. A PHC health worker notices that the freeze indicator (FreezeWatch) in the vaccine carrier has been activated. This indicates that the vaccines may have been damaged by exposure to:
111. The open vial policy under the National Immunization Schedule does NOT apply to which of the following vaccines?
112. The Vaccine Vial Monitor (VVM) changes from a lighter to a darker colour based on cumulative exposure to:
113. Pentavalent vaccine introduced in the Universal Immunization Programme (UIP) in India covers all of the following EXCEPT:
114. In the cold chain for vaccines in India, the temperature at which vaccines should be stored at the Primary Health Centre (PHC) level is:
115. Rotavirus vaccine in India's UIP is given as a liquid formulation at 6, 10, and 14 weeks. The vaccine strain used in the Government of India's UIP is:
116. The Human Papillomavirus (HPV) vaccine schedule under India's NIS for adolescent girls aged 9-14 years who start the series before 15 years of age is:
117. The 'Effective Vaccine Management (EVM)' assessment tool used by WHO/UNICEF evaluates cold chain performance. The main indicator in EVM is:
118. Under India's Universal Immunization Programme (UIP), which vaccine was MOST recently added to the National Immunization Schedule (NIS) as a routine vaccine?
119. The Vaccine Vial Monitor (VVM) on an oral polio vaccine vial shows that the inner square is darker than the outer circle. What should the health worker do?
120. Which vaccines under India's NIS are classified as 'freeze-sensitive' and must NEVER be frozen?
121. As per the Open Vial Policy (OVP) under UIP, which of the following vaccines can be RETURNED to the cold chain and used in subsequent sessions after opening?
122. In India's NIS, BCG vaccination is recommended at birth or as early as possible after birth. If BCG has not been given at birth, up to what age can it be given without a tuberculin test?
123. The Vaccine Vial Monitor (VVM) on a vaccine vial shows an inner square DARKER than the outer circle. The correct action is to:
124. Under the National Immunization Programme, Rotavirus vaccine (RVV) is given at which schedule (three doses)?
125. The Open Vial Policy under UIP states that which of the following vaccines can be used in subsequent immunization sessions after the vial has been opened?
126. Human Papillomavirus (HPV) vaccine (Cervarix or Gardasil 9) under the national programme in India targets which primary age group for routine immunization?
127. Under the Universal Immunisation Programme, the open vial policy allows multi-dose vials to be used in subsequent sessions ONLY for vaccines that:
128. A Vaccine Vial Monitor (VVM) is attached to vaccine vials to indicate heat exposure. The VVM reaches the discard point when:
129. The rotavirus vaccine included in the UIP in India is administered orally at 6, 10, and 14 weeks of age. The key reason for NOT administering it after 8 months of age is:
130. Which of the following vaccines in the National Immunisation Schedule is stored at -15°C to -25°C (freezer temperature)?
131. A health worker opens a vial of OPV and uses it to vaccinate children at a session. At the end of the session, 4 doses remain unused. According to the Open Vial Policy (OVP) under UIP India, what should be done with the remaining doses?
132. Which vaccine in the Indian NIS schedule requires the STRICTEST cold chain maintenance, as it cannot be used if it has been frozen even once?
133. A child aged 9 months is brought for immunization. The health worker notes the child is currently having mild fever (38.2°C) and mild URI. What is the CORRECT action per NIS guidelines?
134. The Vaccine Vial Monitor (VVM) on a vial of BCG shows the inner square slightly darker than the outer circle but has NOT reached the endpoint. What is the correct interpretation?
135. According to the National Immunization Schedule (2023–24), Pneumococcal Conjugate Vaccine (PCV) is administered at which ages?
136. The Open Vial Policy (OVP) allows multi-dose vaccine vials to be used across multiple sessions. Which vaccine is EXCLUDED from the Open Vial Policy?
137. A Vaccine Vial Monitor (VVM) on an OPV vial shows the inner square colour that is DARKER than the outer circle. The correct action is:
138. Under the National Immunization Schedule, Rotavirus vaccine (Rotavac or Rotasiil) is given at which time points?
139. The Vaccines Vial Monitor (VVM) on a vaccine vial shows the inner square DARKER than the outer circle. What action should the healthcare worker take?
140. Under India's National Immunization Schedule (NIS) as updated in 2023–24, Pneumococcal Conjugate Vaccine (PCV) is given at:
141. The Open Vial Policy (OVP) does NOT apply to which of the following vaccines?
142. Which component of the cold chain is responsible for transporting vaccines from district vaccine store to the Primary Health Centre (PHC)?
143. Rotavirus vaccine (Rotavac) under India's UIP is administered at 6, 10, and 14 weeks. A child presents at 18 weeks having received only the first dose at 6 weeks. What is the recommended action?