Q: Is it OK to give MMR, DPT booster, Typhoid, Chicken pox and HiB vaccine simultaneously? Which of these can be given together? What should be the gap between the vaccines? I need to plan my trip to India and would like to give these vaccines to my 19-month-old son.

A:Let us first see what vaccines should your child receive now: 1. He needs a DPT & OPV booster if he had completed his primary immunisation with 3 doses of the same during the first year and has not yet recieved the booster due at 18 months 2. He needs MMR vaccine, single dose if it has not been given so far: MMR is usually given at 15 months of age 3. He needs a single dose of HiB if he has not recieved 2 doses during infancy. If he has already recieved 3 doses during infancy, he doesn't need another dose now. If he has not, he may be given a single dose now. 4. He can be given chickenpox vaccine, though it is not mandatory 5. He is not due for typhoid vaccine which is not recommended for children under 2 years of age. Therefore, if my presumptions are correct, your child requires injectable DPT, MMR, chicken pox vaccine & HiB vaccine and oral OPV. All of these can be given together but may cause discomfort to the child when 4 injections are given together. However a commercial preparation containing both DPT & HiB is available which may be used. So administer at least DPT preferably with a HiB combination & OPV on the first go. The remaining vaccines can be given after 1 month. A gap of 1 month is recommended between two vaccines that are not administered simultaneously.