Immunisation: vaccine-associated paralytic polio: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Immunisation: vaccine-associated paralytic polio

Sample item

Which statement about vaccine-associated paralytic poliomyelitis from oral polio vaccine is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. The risk is highest after the first dose

VAPP is caused by reversion of the attenuated vaccine virus and occurs in vaccine recipients and their susceptible contacts. The risk is highest after the first dose, when the gut is naive, and falls with subsequent doses. This is why inactivated polio vaccine was added to the schedule.

Option by option

  • A. It is prevented by giving an extra booster of OPV

    More OPV does not prevent it; IPV avoids the risk because it contains killed virus.

  • B. It results from wild poliovirus excreted by contacts

    VAPP is caused by the vaccine virus, not by wild poliovirus.

  • C. The risk is highest after the fourth dose

    Risk falls with successive doses because immunity builds.

  • D. The risk is highest after the first dose (correct)

    Correct. The first OPV dose carries the greatest risk of reversion-related paralysis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, The risk is highest after the first dose. VAPP is caused by reversion of the attenuated vaccine virus and occurs in vaccine recipients and their susceptible contacts.

Why is "It is prevented by giving an extra booster of OPV" not the answer?

More OPV does not prevent it; IPV avoids the risk because it contains killed virus.

Why is "It results from wild poliovirus excreted by contacts" not the answer?

VAPP is caused by the vaccine virus, not by wild poliovirus.

Why is "The risk is highest after the fourth dose" not the answer?

Risk falls with successive doses because immunity builds.

What concept does this question test?

It tests Immunisation: vaccine-associated paralytic polio in Pediatrics. The risk is highest after the first dose, when the gut is naive, and falls with subsequent doses. This is why inactivated polio vaccine was added to the schedule.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunisation: vaccine-associated paralytic polio?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.