Which combination should be administered at the 23-month visit given the child’s immunization history (9 months and 13 months schedules described)?

Which combination should be administered at the 23-month visit given the child’s immunization history (9 months and 13 months schedules described)?

• A. DTaP, HIB, Hep B, IPV, PCV13
• B. Hep B, IPV, PCV7
• C. DTaP, HIB, HepB
• D. DTaP, HIB, Hep B, IPV, PCV7

Answer: (A)

At this age, the goal is to complete the remaining vaccines in the early-childhood primary series and use the current formulations. By around 23 months, the vaccines typically given or completed include DTaP (diphtheria, tetanus, pertussis), Hib (Haemophilus influenzae type b), HepB (hepatitis B) if not already finished, IPV (polio), and PCV13 (pneumococcal conjugate vaccine). PCV13 is the current vaccine used for pneumococcus; PCV7 is outdated. MMR and varicella are not due yet—first doses are given at 12–15 months with second doses later, usually around 4–6 years. So the most appropriate combination at the 23‑month visit is to administer DTaP, Hib, HepB (if not yet completed), IPV, and PCV13 to bring the child up to date. The other options omit a necessary vaccine dose or use an older pneumococcal vaccine, which is not aligned with current guidelines.

At this age, the goal is to complete the remaining vaccines in the early-childhood primary series and use the current formulations. By around 23 months, the vaccines typically given or completed include DTaP (diphtheria, tetanus, pertussis), Hib (Haemophilus influenzae type b), HepB (hepatitis B) if not already finished, IPV (polio), and PCV13 (pneumococcal conjugate vaccine). PCV13 is the current vaccine used for pneumococcus; PCV7 is outdated. MMR and varicella are not due yet—first doses are given at 12–15 months with second doses later, usually around 4–6 years. So the most appropriate combination at the 23‑month visit is to administer DTaP, Hib, HepB (if not yet completed), IPV, and PCV13 to bring the child up to date. The other options omit a necessary vaccine dose or use an older pneumococcal vaccine, which is not aligned with current guidelines.