AMC Pediatrics

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6-month-old male infant is brought to a rural health camp for his third dose of the DTPa vaccine. He previously received the first two doses at 6 weeks and 4 months of age. Today, the infant has a runny nose, sneezing, and a temperature of 38.2°C. On examination, findings are consistent with a mild upper respiratory tract infection (URTI). The mother mentions that after the previous DTPa injection, he developed significant swelling at the injection site, which resolved without intervention.

What is the most appropriate next step regarding DTPa vaccination?

A) Defer the DTPa vaccine until the URTI resolves completely
B) Administer paracetamol and reschedule vaccination after 1 week
C) Proceed with administration of the third dose of DTPa vaccine
D) Withhold DTPa vaccine permanently due to prior local reaction
E) Refer to a tertiary center before proceeding with vaccination

Ans c

C) Proceed with administration of the third dose of DTPa vaccine

Explanation: Mild illness (including low-grade fever and URTI symptoms) and previous local reactions are not contraindications to routine vaccination.