Immunisation & Communicable Disease
Use current local schedules and recognise infections with individual and public-health implications.
Quick revision ↓ Medical Dictionary
01Check the record
Review documented vaccines and use the current Pakistan EPI schedule and catch-up guidance rather than an assumed foreign schedule. Missing records need an appropriate catch-up plan. Explain benefits, expected reactions and when to seek advice, while addressing questions respectfully and documenting the agreed next steps.
02Contraindications and precautions
Distinguish true contraindications from situations that only require advice or deferral. Mild illness is not automatically a reason to postpone every vaccine. Significant immunosuppression changes the safety of some live vaccines, so check current guidance and relevant specialist advice before administration.
03Measles and exposure
Fever with cough, coryza, conjunctivitis and rash can suggest measles. Use appropriate infection precautions and notify the relevant service under local requirements. Suspected cases and exposed high-risk contacts need timely clinical and public-health advice; avoid placing a potentially infectious child in a crowded waiting area.
04Tuberculosis
Consider TB with relevant contact, persistent symptoms, poor growth or unexplained lymphadenopathy. Childhood disease may be difficult to confirm microbiologically, and negative tests do not automatically exclude it. Use the national or specialist pathway for diagnosis, contact assessment and treatment support, including adherence and adverse-effect monitoring.
05Dengue and prevention
Consider dengue in the appropriate epidemiological setting. Warning signs such as persistent vomiting, abdominal pain, bleeding or lethargy can develop as fever settles. Assess hydration and circulation carefully and follow the local dengue pathway; avoid assuming that defervescence alone means recovery. Prevention includes locally relevant vector control and exposure reduction.
High-Yield Revision
- Use the current local immunisation schedule.
- Measles suspicion needs infection precautions.
- Dengue can worsen as fever falls.
Common Pitfalls
- Treating every mild illness as a vaccine contraindication.
- Using a negative TB test as automatic exclusion.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.