# A 6-month-old infant is brought to the well-child clinic for routine vaccinations. The parent asks the nurse which vaccines are scheduled at this visit per the CDC immunization schedule. Which response by the nurse is correct?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=363351&lang=en  
> language: en  
> subject: Health Promotion/Disease Prevention  
> category: HPM

## Question

A 6-month-old infant is brought to the well-child clinic for routine vaccinations. The parent asks the nurse which vaccines are scheduled at this visit per the CDC immunization schedule. Which response by the nurse is correct?

## Option

1. DTaP, Hib, IPV, PCV15, hepatitis B, and rotavirus per CDC schedule **✔ Correct answer**
2. Influenza vaccine because the infant is too young for other immunizations
3. MMR, varicella, and influenza vaccines per the recommended schedule
4. HPV vaccine, Tdap, and meningococcal vaccines per the CDC schedule

**Correct answer: 1**

## Explanation

Per the CDC 2026 immunization schedule, a 6-month-old typically receives DTaP (third dose), Hib (third dose if PRP-T), IPV (third dose), PCV15 (third dose), hepatitis B (final dose if 0-1-6 schedule), and rotavirus (third dose if RotaTeq). Annual influenza becomes due starting at 6 months. MMR and varicella are first given at 12-15 months. HPV starts at age 9-11. Tdap is for adolescents and adults. Limiting to influenza alone misses required catch-up doses.

## In-depth explanation

Clinical Judgment
The 6-month visit is a high-yield well-child checkpoint. Routine vaccines at 6 months: DTaP, Hib, IPV, PCV15, hepatitis B, rotavirus, plus first influenza dose if season-appropriate. Each is given separately or as combination products (Pediarix, Pentacel, Vaxelis).

Memory Tip
6-month vaccines: DR. HIPP — DTaP, Rotavirus, Hib, IPV, PCV15, Polio (IPV), HepB

KR vs US
The Korean National Immunization Program (NIP) schedule closely matches CDC for infants. Korea adds JE vaccine starting at 12 months and BCG at birth (vs. risk-based BCG in the US). NCLEX expects CDC schedule unless the question specifies otherwise.

## Clinical scenario

Clinical Practice Guide
CDC 2026 child schedule (key milestones):
- Birth: hepatitis B (#1)
- 2 months: DTaP, Hib, IPV, PCV15, hepatitis B (#2), rotavirus
- 4 months: DTaP, Hib, IPV, PCV15, rotavirus
- 6 months: DTaP, Hib, IPV, PCV15, hepatitis B (#3 if 0-1-6), rotavirus, influenza (annual, first dose)
- 12-15 months: MMR, varicella, hepatitis A, MenB-FHbp (if high risk), DTaP (#4)

Caution
Live vaccines (MMR, varicella, rotavirus) are contraindicated in immunocompromised clients. Defer for fever >38.5°C but mild illness is not a contraindication. Document each lot number and site for VAERS reporting.

## Key concepts

- **CDC immunization schedule** — Annually updated childhood vaccination guideline by the CDC Advisory Committee on Immunization Practices (ACIP). Defines doses and timing from birth through age 18. Aligns with the Korean NIP and most international schedules.
- **Live attenuated vaccine** — Vaccine made from weakened live pathogen. Examples: MMR, varicella, rotavirus, intranasal influenza, BCG, yellow fever. Contraindicated in pregnancy, immunocompromise, and recent immunoglobulin therapy.
- **VAERS** — Vaccine Adverse Event Reporting System maintained by CDC and FDA. Healthcare providers must report serious adverse events after immunization. Helps detect rare or emerging vaccine safety signals.

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