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Justification: In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. Process: The Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting on March 25, 2023, at Vaccicon, Kolkata, followed by online meetings to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. The contents were finalized on September 8, 2023, during the National Conference of Pediatric - Infectious Diseases (NCPID) at Aurangabad. An online meeting of all members was held on November 15, 2023 and the recommendations were finalized. Objectives: To review and revise the IAP immunization recommendations of 2020–21 and issue recommendations on existing and new vaccines. Recommendations: The major changes include recommendation of HPV vaccine for boys; a 2-dose schedule of 9vHPV for boys and girls aged 9–14 y; a dose of Td vaccine at 16–18 y; guidance for injectable polio vaccine (IPV) for those patients who are changing from National Immunization Program to IAP schedule. [ABSTRACT FROM AUTHOR]

Objective: To determine the utility of microscopic examination and culture of endotracheal aspirate (ETA) in the early diagnosis of ventilator-associated pneumonia (VAP) in preterm neonates. Methods: We enrolled 80 consecutive neonates (both inborn and out-born) with gestational age of < 37 weeks admitted in Special Newborn Care Unit (SNCU) and requiring mechanical ventilation (MV) for > 48 hours. The diagnosis of VAP was made using the criteria laid down by the Centers for Disease Control (CDC). Results: 47 preterm neonates (58.5%) developed VAP; the overall incidence was 74.7/1000 ventilator-days. The mean (SD) time (hours) to ETA culture was less as compared to diagnosis based on CDC criteria [108.9 (8.00 hrs) vs 132.4 (53.24); P = 0.004] with sensitivity and specificity of 80.8% and 72.7%, respectively. Outborn delivery was the single most important risk factor for VAP. Multidrug resistant (MDR) Klebsiella pneumoniae (63.9%) was the most prevalent organism. Conclusions: We noticed a very high incidence of VAP among preterm neonates in SNCU. ETA culture can aid in early diagnosis. [ABSTRACT FROM AUTHOR]

The extent, purpose, and model of performance assessment should be guided by our understanding of clinical competence. We have come a long way from believing that competence is generic, fixed, and transferable across contents; to viewing competence as dynamic, incremental, contextual, and non-transferable. However, our pattern of assessment largely remains what it was many years ago. Contemporary educationists view competency assessment as different from traditional format. They place more emphasis on the role of expert subjective judgment, especially for performance and domain-independent competencies. Such assessments have conclusively shown their validity, reliability, and utility. They; however, require trained assessors, trust between the teachers and the taught, and above all, a political and administrative will for implementation. [ABSTRACT FROM AUTHOR]

Justification: Data generated after the first wave has revealed that some children with Coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected COVID-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2–18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval. Objective: To provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use. Process: Formulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of COVID-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on COVID-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized. Recommendations: The IAP supports the Government of India's decision to extend the COVID-19 vaccination program to children between 2–18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out. [ABSTRACT FROM AUTHOR]

Framing an appropriate research question is the most critical and fundamental part of a study. This helps in developing a hypothesis, formulating aims and objectives and methodological execution of the study. Research questions are usually generated by literature backed thorough analysis of the gaps in previous studies and funnelling it to a specific focussed issue. The research question should be framed using the PICO (Population, Intervention/Exposure, Comparator and Outcome) format and should fulfil the FINER (feasible, interesting, novel, ethically sound, and relevant) criteria for practical aspects. Objectives should always be framed in alignment of the research question using SMART (specific, measurable, achievable, realistic and time defined) approach. Outcomes are classified as primary and secondary. It is advisable to have only one primary objective while secondary objectives can be multiple (usually not exceeding five). This paper describes a cascade approach starting from framing the research question and then deciding on the outcomes and study objectives. [ABSTRACT FROM AUTHOR]

During the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic, immunization practices of all age groups, especially routine childhood vaccines, have been interrupted. Immunization is considered an essential health activity, which needs to be resumed as early as possible. This pandemic has created several unique issues related to routine immunization of individual children at clinics, which needs to be addressed. In this communication, the Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics addresses the common questions and issues related to SARS-CoV-2 and routine immunization services. This also includes the recommendations for routine immunization of SARS-CoV-2 suspect and positive children, and for the logistics to be followed for immunization services. [ABSTRACT FROM AUTHOR]

Justification: In view of new developments in vaccinology and the availability of new vaccines, there is a need to revise/review the existing immunization recommendations. Process: Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics (IAP) had a physical meeting in March, 2020 followed by online meetings (September-October, 2020), to discuss the updates and new recommendations. Opinion of each member was sought on the various recommendations and updates, following which an evidence-based consensus was reached. Objectives: To review and revise the IAP recommendations for 2020–21 and issue recommendations on existing and new vaccines. Recommendations: The major changes include recommendation of a booster dose of injectable polio vaccine (IPV) at 4–6 years for children who have received the initial IPV doses as per the ACVIP/IAP schedule, re-emphasis on the importance of IPV in the primary immunization schedule, preferred timing of second dose of varicella vaccine at 3–6 months after the first dose, and uniform dosing recommendation of 0.5 mL (15 µg HA) for inactivated influenza vaccines. [ABSTRACT FROM AUTHOR]

During the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic, immunization practices of all age groups, especially routine childhood vaccines, have been interrupted. Immunization is considered an essential health activity, which needs to be resumed as early as possible. This pandemic has created several unique issues related to routine immunization of individual children at clinics, which needs to be addressed. In this communication, the Advisory Committee on Vaccines and Immunization Practices (ACVIP) of Indian Academy of Pediatrics addresses the common questions and issues related to SARS-CoV-2 and routine immunization services. This also includes the recommendations for routine immunization of SARS-CoV-2 suspect and positive children, and for the logistics to be followed for immunization services. [ABSTRACT FROM AUTHOR]

This document provides summaries of four articles related to medical education. The first article discusses the use of mobile technologies for workplace-based assessment in medical training. It describes different methods of assessment and the challenges faced in implementing mobile technology-based assessment. The second article focuses on the successful implementation of a rater training program for medical students to evaluate simulated pediatric emergencies. It highlights the importance of teamwork and communication in simulation-based training. The third article explores the improvement of communication between physicians through shared mental models. It describes a study that used a consultation model to assess the quality of information given by junior learners to senior learners. The fourth article discusses the use of cognitive science strategies for teaching clinical skills. It emphasizes the importance of integrating declarative and procedural knowledge and recommends techniques such as spacing, testing, feedback, and interleaving for skill retention. [Extracted from the article]

Justification: In India, till recently, breastfeeding women have been excluded from the coronavirus disease (COVID-19) vaccination program, rendering a significant population of the country, including frontline workers, ineligible to derive the benefits of the COVID-19 vaccine rollout. Objective: The objective of this recommendation is production of an evidence-based document to guide the pediatricians to give advice to breastfeeding mothers regarding the safety of COVID-19 vaccines in lactating women. Process: Formulation of key question was done under the chairmanship of president of the IAP. It was followed by review of literature regarding efficacy and safety of COVID-19 vaccines in breastfeeding women. The recommendations of other international and national professional bodies were also deliberated in detail. The available data was discussed in the ACVIP focused WhatsApp group. Opinion of all members was taken and the final document was prepared after achieving consensus. Recommendations: The IAP/ACVIP recommends the administration of COVID-19 vaccines to all breastfeeding women. The IAP/ACVIP endorses the recent recommendation of the Government of India, to consider all breastfeeding women as eligible for COVID-19 vaccination. [ABSTRACT FROM AUTHOR]