Immunisation principles OSCE — well-child multi-antigen visit and schedule reasoning

recommendations of the Advisory Committee on Immunization Practices (ACIP)." source: "MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports" year: 2011 url: "https://pubmed.ncbi.nlm.nih.gov/21293327/"

• id: 5 pmid: 38206855 authors: "Wodi AP" title: "Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2024." source: "MMWR. Morbidity and mortality weekly report" year: 2024 doi: "10.15585/mmwr.mm7301a2" url: "https://pubmed.ncbi.nlm.nih.gov/38206855/"
• id: 6 pmid: 36757872 authors: "Wodi AP" title: "Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023." source: "MMWR. Morbidity and mortality weekly report" year: 2023 doi: "10.15585/mmwr.mm7206a1" url: "https://pubmed.ncbi.nlm.nih.gov/36757872/"
• id: 7 pmid: 33571172 authors: "Wodi AP" title: "Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2021." source: "MMWR. Morbidity and mortality weekly report" year: 2021 doi: "10.15585/mmwr.mm7006a1" url: "https://pubmed.ncbi.nlm.nih.gov/33571172/"
• id: 8 pmid: 23760231 authors: "McLean HQ" title: "Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP)." source: "MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports" year: 2013 url: "https://pubmed.ncbi.nlm.nih.gov/23760231/"
• id: 9 pmid: 8440043 authors: "Tulchinsky TH" title: "Measles control in developing and developed countries: the case for a two-dose policy." source: "Bulletin of the World Health Organization" year: 1993 url: "https://pubmed.ncbi.nlm.nih.gov/8440043/"
• id: 10 pmid: 40185555 authors: "Colburn NE" title: "Measles - Resurgence of an Old Foe." source: "The Medical clinics of North America" year: 2025 doi: "10.1016/j.mcna.2024.12.002" url: "https://pubmed.ncbi.nlm.nih.gov/40185555/"
• id: 11 pmid: 40272967 authors: "Kiang MV" title: "Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US." source: "JAMA" year: 2025 doi: "10.1001/jama.2025.6495" url: "https://pubmed.ncbi.nlm.nih.gov/40272967/"
• id: 12 pmid: 25037990 authors: "Amirthalingam G" title: "Effectiveness of maternal pertussis vaccination in England: an observational study." source: "Lancet (London, England)" year: 2014 doi: "10.1016/S0140-6736(14)60686-3" url: "https://pubmed.ncbi.nlm.nih.gov/25037990/"
• id: 13 pmid: 28468899 authors: "Gkentzi D" title: "Maternal vaccination against pertussis: a systematic review of the recent literature." source: "Archives of disease in childhood. Fetal and neonatal edition" year: 2017 doi: "10.1136/archdischild-2016-312341" url: "https://pubmed.ncbi.nlm.nih.gov/28468899/"
• id: 14 pmid: 29939980 authors: "Schillie S" title: "Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices." source: "MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports" year: 2018 doi: "10.15585/mmwr.rr6701a1" url: "https://pubmed.ncbi.nlm.nih.gov/29939980/"
• id: 15 pmid: 19194371 authors: "Cortese MM" title: "Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP)." source: "MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports" year: 2009 url: "https://pubmed.ncbi.nlm.nih.gov/19194371/"
• id: 16 pmid: 25811679 authors: "Petrosky E" title: "Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices." source: "MMWR. Morbidity and mortality weekly report" year: 2015 url: "https://pubmed.ncbi.nlm.nih.gov/25811679/"
• id: 17 pmid: 31415491 authors: "Meites E" title: "Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices." source: "MMWR. Morbidity and mortality weekly report" year: 2019 doi: "10.15585/mmwr.mm6832a3" url: "https://pubmed.ncbi.nlm.nih.gov/31415491/"
• id: 18 pmid: 36107786 authors: "Kobayashi M" title: "Use of 15-Valent Pneumococcal Conjugate Vaccine Among U.S. Children: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2022." source: "MMWR. Morbidity and mortality weekly report" year: 2022 doi: "10.15585/mmwr.mm7137a3" url: "https://pubmed.ncbi.nlm.nih.gov/36107786/"
• id: 19 pmid: 32504737 authors: "Parikh SR" title: "The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination." source: "The Journal of infection" year: 2020 doi: "10.1016/j.jinf.2020.05.079" url: "https://pubmed.ncbi.nlm.nih.gov/32504737/"
• id: 20 pmid: 39788151 authors: "Albers AN" title: "Invalid Vaccine Doses Among Children Aged 0 to 35 Months: 2011 to 2020." source: "Pediatrics" year: 2025 doi: "10.1542/peds.2024-068341" url: "https://pubmed.ncbi.nlm.nih.gov/39788151/"
• id: 21 pmid: 14700710 authors: "Stokley S" title: "Evaluation of invalid vaccine doses." source: "American journal of preventive medicine" year: 2004 doi: "10.1016/j.amepre.2003.09.002" url: "https://pubmed.ncbi.nlm.nih.gov/14700710/"
• id: 22 pmid: 40578370 authors: "GBD 2023 Vaccine Coverage Collaborators" title: "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." source: "Lancet (London, England)" year: 2025 doi: "10.1016/S0140-6736(25)01037-2" url: "https://pubmed.ncbi.nlm.nih.gov/40578370/"
• id: 23 pmid: 33823758 authors: "Hull B" title: "Immunisation Coverage Annual Report 2019." source: "Communicable diseases intelligence (2018)" year: 2021 doi: "10.33321/cdi.2020.45.18" url: "https://pubmed.ncbi.nlm.nih.gov/33823758/"
• id: 24 pmid: 36154654 authors: "Hull B" title: "Annual immunisation coverage report 2020." source: "Communicable diseases intelligence (2018)" year: 2022 doi: "10.33321/cdi.2022.46.60" url: "https://pubmed.ncbi.nlm.nih.gov/36154654/"
• id: 25 pmid: 40925362 authors: "Hull B" title: "Annual Immunisation Coverage Report 2022." source: "Communicable diseases intelligence (2018)" year: 2025 doi: "10.33321/cdi.2025.49.023" url: "https://pubmed.ncbi.nlm.nih.gov/40925362/"
• id: 26 pmid: 30959563 authors: "Law C" title: "Children overdue for immunisation: a question of coverage or reporting? An audit of the Australian Immunisation Register." source: "Australian and New Zealand journal of public health" year: 2019 doi: "10.1111/1753-6405.12891" url: "https://pubmed.ncbi.nlm.nih.gov/30959563/"
• id: 27 pmid: 35616400 authors: "Giles ML" title: "How COVID-19 has impacted immunisation service delivery in Australia: a national study." source: "Australian and New Zealand journal of public health" year: 2022 doi: "10.1111/1753-6405.13260" url: "https://pubmed.ncbi.nlm.nih.gov/35616400/"
• id: 28 pmid: 34127299 authors: "Davies C" title: "School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination." source: "Vaccine" year: 2021 doi: "10.1016/j.vaccine.2021.05.051" url: "https://pubmed.ncbi.nlm.nih.gov/34127299/"
• id: 29 pmid: 32299331 authors: "Wnukowski-Mtonga P" title: "Scientific evidence supporting recommendations on the use of the 9-valent HPV vaccine in a 2-dose vaccine schedule in Australia." source: "Communicable diseases intelligence (2018)" year: 2020 doi: "10.33321/cdi.2020.44.33" url: "https://pubmed.ncbi.nlm.nih.gov/32299331/"
• id: 30 pmid: 30055970 authors: "Panovska-Griffiths J" title: "A method for evaluating and comparing immunisation schedules that cover multiple diseases: Illustrative application to the UK routine childhood vaccine schedule." source: "Vaccine" year: 2018 doi: "10.1016/j.vaccine.2018.05.083" url: "https://pubmed.ncbi.nlm.nih.gov/30055970/"
• id: 31 pmid: 26714777 authors: "Crowe S" title: "A novel approach to evaluating the UK childhood immunisation schedule: estimating the effective coverage vector across the entire vaccine programme." source: "BMC infectious diseases" year: 2015 doi: "10.1186/s12879-015-1299-8" url: "https://pubmed.ncbi.nlm.nih.gov/26714777/"
• id: 32 pmid: 38480101 authors: "Sherman SM" title: "UK healthcare professionals' attitudes towards the introduction of varicella vaccine into the routine childhood vaccination schedule and their preferences for administration." source: "Vaccine" year: 2024 doi: "10.1016/j.vaccine.2024.03.002" url: "https://pubmed.ncbi.nlm.nih.gov/38480101/"
• id: 33 pmid: 11389298 authors: "Bell KN" title: "Risk factors for improper vaccine storage and handling in private provider offices." source: "Pediatrics" year: 2001 doi: "10.1542/peds.107.6.e100" url: "https://pubmed.ncbi.nlm.nih.gov/11389298/"
• id: 34 pmid: 37599140 authors: "Kenigsberg TA" title: "Simultaneous administration of mRNA COVID-19 bivalent booster and influenza vaccines." source: "Vaccine" year: 2023 doi: "10.1016/j.vaccine.2023.08.023" url: "https://pubmed.ncbi.nlm.nih.gov/37599140/"
• id: 35 pmid: 12455405 authors: "Lesinski GB" title: "Vaccines against polysaccharide antigens." source: "Current drug targets. Infectious disorders" year: 2001 doi: "10.2174/1568005014605964" url: "https://pubmed.ncbi.nlm.nih.gov/12455405/"
• id: 36 pmid: 28487056 authors: "Bröker M" title: "Polysaccharide conjugate vaccine protein carriers as a "neglected valency" - Potential and limitations." source: "Vaccine" year: 2017 doi: "10.1016/j.vaccine.2017.04.078" url: "https://pubmed.ncbi.nlm.nih.gov/28487056/"
• id: 37 pmid: 38567485 authors: "Akkoyunlu M" title: "State of pneumococcal vaccine immunity." source: "Human vaccines & immunotherapeutics" year: 2024 doi: "10.1080/21645515.2024.2336358" url: "https://pubmed.ncbi.nlm.nih.gov/38567485/"
• id: 38 pmid: 17200247 authors: "Armstrong GL" title: "The economics of routine childhood hepatitis A immunization in the United States: the impact of herd immunity." source: "Pediatrics" year: 2007 doi: "10.1542/peds.2006-1572" url: "https://pubmed.ncbi.nlm.nih.gov/17200247/"
• id: 39 pmid: 32687792 authors: "Abbas K" title: "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." source: "The Lancet. Global health" year: 2020 doi: "10.1016/S2214-109X(20)30308-9" url: "https://pubmed.ncbi.nlm.nih.gov/32687792/"
• id: 40 pmid: 38535527 authors: "Fine PEM" title: "Population Immunity and Polio Eradication." source: "Pathogens (Basel, Switzerland)" year: 2024 doi: "10.3390/pathogens13030183" url: "https://pubmed.ncbi.nlm.nih.gov/38535527/" --- [1]

Station objectives

1. Reconcile immunisation card and register status. [1] /> [1] />
2. Apply valid minimum age/interval thinking. [4] [1] />
3. Prefer same-day due antigens when rules allow. [4]
4. Explain conjugate versus polysaccharide at infant level if challenged. [1] />
5. Document, report and set recall; keep cold-chain and anaphylaxis safety in view. [4] [1] />

Candidate brief

You are the paediatric doctor in a community immunisation clinic. You have 12 minutes for Station A and 8 minutes for Station B. Examiners score safety, validity reasoning and clear family language. [4]

Station A — Two-month multi-antigen visit

Setup: Well 8-week-old; parent asks for vaccines "one at a time each week"; handwritten notes conflict slightly with the register. [4] [1] />

Expected actions:

• Verify identity and reconcile card with register. [1] />
• List antigens due by local schedule principles without inventing brands. [1] />
• Explain same-day dosing reduces missed doses. [4]
• Screen only real deferral reasons; mild snuffles alone usually proceed. [4]
• Confirm bay safety (adrenaline available) and cold-chain-potent stock. [1] />
• Document batch/site/route, report to register, set next recall. [1] />

Station B — Coverage and validity counselling

Setup: Parent heard measles is "gone" so boosters do not matter; also asks why a dose given very early overseas might be repeated. [1] [1] />

Expected actions:

• Explain herd/population protection and measles coverage sensitivity in plain language. [1] [1] />
• Explain invalid early doses may not count and need correctly timed repeats. [1] />
• Avoid hesitancy deep-dive beyond brief, accurate risk framing (sibling topic if entrenched refusal).
• Offer written plan and recall. [4]

Marking anchors

Clear pass: reconciles records, applies validity and same-day principles, keeps safety equipment and documentation explicit, explains population protection without false numbers. [4] [1] [1] />
Borderline: correct labels but still splits visits without reason or counts early doses. [1] />
Fail: no register check; invents foreign calendars; no adrenaline awareness; dismisses measles coverage. [1] /> [1] />

Debrief pearls

• Card + register, not memory. [1] />
• Invalid if too early. [1] />
• Same day is usually safer for completion than serial deferral. [4]
• Shared science across countries; programme shells differ. [1] /> [1] />