# Situation: The nurse holds a weekly well-baby clinic at a Barangay Health Station (BHS) for infants who come for immunization, growth monitoring, and feeding counseling. A mother who moved from another region brings her infant's card and asks about the remaining visits. Which vaccine schedule matches the routine National Immunization Program (NIP) calendar?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629434  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: The nurse holds a weekly well-baby clinic at a Barangay Health Station (BHS) for infants who come for immunization, growth monitoring, and feeding counseling.

A mother who moved from another region brings her infant's card and asks about the remaining visits. Which vaccine schedule matches the routine National Immunization Program (NIP) calendar?

## 보기

1. Pneumococcal conjugate vaccine at 6, 10, and 14 weeks and 12 months
2. Hepatitis B vaccine at birth, 1 month, and 6 months
3. Measles-mumps-rubella vaccine at 9 and 12 months **✔ 정답**
4. Pentavalent vaccine at 6, 10, and 14 weeks and 18 months

**정답: 3**

## 해설

The routine NIP calendar gives measles-mumps-rubella (MMR) vaccine at 9 and 12 months, earlier than many other schedules. Hepatitis B is given as a birth dose and then within the pentavalent vaccine at 6, 10, and 14 weeks, and the NIP pneumococcal and pentavalent series have 3 infant doses with no booster in the second year. The distractors are real schedules used in other countries or in private practice.

## 심화 해설

The NIP schedule that matches
The routine Philippine National Immunization Program (NIP) gives the measles-mumps-rubella (MMR) vaccine at 9 and 12 months. This is earlier than in many high-income country schedules, which often start MMR at 12 months or later. The earlier start reflects the higher risk of measles exposure in infancy. Of the four schedules, only MMR at 9 and 12 months matches the routine NIP calendar.

How the NIP handles hepatitis B
In the NIP, hepatitis B vaccine is given as a birth dose within 24 hours, and the later hepatitis B doses are delivered within the pentavalent vaccine at 6, 10, and 14 weeks. A separate series at birth, 1 month, and 6 months is a real schedule used in other settings, but it is not the NIP pattern.

Pneumococcal and pentavalent series
The NIP gives the pneumococcal conjugate vaccine (PCV) at 6, 10, and 14 weeks and the pentavalent vaccine at 6, 10, and 14 weeks, each as three infant doses with no booster in the second year. Schedules that add a 12-month PCV booster or an 18-month pentavalent booster appear in some private or foreign schedules. Watch out! The distractors in this item are not invented; each is a genuine schedule used somewhere. The task is to recognize the one that belongs to the routine NIP calendar.

| Vaccine | Routine NIP timing |
| --- | --- |
| BCG | At birth |
| Hepatitis B | Birth dose within 24 hours; later doses within pentavalent |
| Pentavalent | 6, 10, and 14 weeks |
| Bivalent oral polio | 6, 10, and 14 weeks |
| Inactivated polio | First dose at 14 weeks |
| Pneumococcal conjugate | 6, 10, and 14 weeks |
| Measles-mumps-rubella | 9 and 12 months |

Applying it at the clinic
When a mother moves from another region, the nurse reviews the card against the national calendar, credits every valid dose already given, and schedules the remaining doses. A child who received doses on a different schedule is not restarted; the nurse continues from where the child left off.

Exam takeaway
Remember the NIP anchors: three infant doses of pentavalent, oral polio, and PCV at 6, 10, and 14 weeks, and MMR at 9 and 12 months. Key point! When choices look like familiar foreign schedules, return to the Philippine calendar.

## 임상 시나리오

Routine NIP Calendar CheckReviewing a transferred infant's card
The NIP gives MMR at 9 and 12 months. Pentavalent, bivalent oral polio, and pneumococcal conjugate vaccines are given at 6, 10, and 14 weeks.

Hepatitis B is a birth dose within 24 hours; later hepatitis B doses come within the pentavalent vaccine.

Credit all valid doses on the card, continue the series, and schedule the remaining visits.

CautionThe NIP pentavalent and PCV series have no second-year booster. Boosters at 12 or 18 months belong to other schedules.

## 핵심 개념

- **National Immunization Program (NIP)** — The DOH program that provides free routine vaccines to Filipino infants, children, and other target groups.
- **MMR vaccine** — A live vaccine against measles, mumps, and rubella, given in the NIP at 9 and 12 months.
- **Pneumococcal conjugate vaccine** — A vaccine against Streptococcus pneumoniae disease, given in the NIP at 6, 10, and 14 weeks.
- **Hepatitis B birth dose** — The first hepatitis B vaccine, given within 24 hours of birth to prevent mother-to-child transmission.

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