North American Registry of Midwives (NARM) Practice Exam

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What vaccination should not be given prior to 12 months of age?

Hepatitis B
MMR
DTaP
Polio

The correct answer is: MMR

The measles, mumps, and rubella (MMR) vaccine is specifically recommended to be administered after the age of 12 months. This timing is critical due to the infant's immature immune system and the presence of maternal antibodies, which can interfere with the effectiveness of the vaccine if given too early. Prior to 12 months, infants have a natural level of immunologic protection provided by maternal antibodies transferred during pregnancy or breastfeeding, which can diminish the immune response to the vaccine if administered too soon. The MMR vaccine is usually given as part of the routine immunization schedule at 12-15 months, with a second dose recommended between 4 to 6 years of age. In contrast, the other vaccines listed—Hepatitis B, DTaP (diphtheria, tetanus, and pertussis), and polio—can be administered during infancy, starting at birth or as early as 2 months of age. Therefore, the specific timing of vaccination for MMR is essential to ensure adequate immunogenic response and long-term protection against these diseases.