Immunization Certification

Which of the following tetanus booster vaccines would be most appropriate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies?

Tdap.

After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every:

10 years.

What is meant by the term "immunization neighborhood"?

Immunization stakeholders collaborate to meet community immunization needs.

Emily is a 16-year-old high-school student with no chronic medical conditions. Emily’s immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today?

Tdap, HPV, MCV, HepB, and influenza, if during influenza season.

Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient?

HZV 0.65 mL subcutaneously; IIV 0.5 mL intramuscularly

According to ACIP recommendations, what is the maximum number of doses of PPSV23 a patient should receive in his or her lifetime?

3 doses.

Which of these vaccines is an inactivated vaccine?

Tdap.

Kyle is a 5-year-old boy who is up to date with his vaccinations. He has never experienced any adverse effects from vaccinations. At his next well-child check-up, Kyle will be receiving the following vaccines: IPV, MMR, varicella vaccine, and a tetanus-containing vaccine. Which of the following tetanus-containing vaccines would be appropriate for him?

DTaP.

Which of the following patients should receive the MMR vaccine?

A pharmacist born in 1975 with documentation of 1 dose of MMR vaccine.

Ava has arrived at the clinic for her well-child visit. She is 4 months old. Ava’s immunization record reveals that she has received the following vaccines:
2 doses of HepB
1 dose of Hib
1 dose of rotavirus
1 dose of PCV13
1 dose of DTaP
1 dose of IPV
Which vaccines should Ava receive at today’s visit?

DTaP, Hib, PCV13, IPV, and rotavirus.

According to ACIP recommendations, HZV is indicated for the prevention of herpes zoster in adults aged:

60 years and older.

According to ACIP, which of the following is a contraindication to receiving HZV?

Current treatment for lymphoma.

Aiden is a 6-month-old healthy boy with no known allergies. He has received vaccinations in the past with no reported adverse reactions. Aiden’s father asks about having his son vaccinated against influenza. The most appropriate response would be to inform the father that Aiden:

Should receive 1 dose of IIV4 today followed by a second dose of IIV4 administered 4 weeks later

Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb?

Inject subcutaneously at a 45° angle in the outer aspect of the upper arm.

In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age?

HPV

In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to:

Comfort the child and engage in quiet activities.

Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations?

For the patient’s lifetime.

HZV should not be administered to a patient with a history of anaphylaxis to:

Gelatin

Which of the following key questions is important to ask a patient before administering IIV?

Are you sick today?

Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb?

Inject intramuscularly at a 90° angle in the deltoid muscle.

David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David’s immunization record reveals that he has received the following vaccines:
3 doses of HepB
4 doses of PCV13
2 doses of HepA
3 doses of IPV
2 doses of rotavirus
1 dose of MMRV
4 doses of DTaP
4 doses of Hib
Which vaccines should David receive at this visit?

DTaP, IPV, MMR, and varicella.

Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction?

Diphtheria

If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted?

The series should not be restarted; resume the series where it was interrupted.

Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate’s immunization record indicates that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines, and she received a dose of Tdap 2 years ago. For complete coverage, which of the following vaccines should she receive?

…

For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines?

Administer these 2 vaccines at the same visit.

In which publication does the CDC initially publish new or updated vaccine recommendations?

Morbidity and Mortality Weekly Report (MMWR)

A 69 year-old man received Td vaccination 4 years ago. He is preparing to travel to see his newborn granddaughter next month. Which of the following vaccines containing tetanus, diphtheria, and/or pertussis would be most appropriate for him?

Tdap

Which of the following is a requirement of the Occupational Safety and Health Administration’s (OSHA’s) Bloodborne Pathogens Standard?

Health care providers must use safety devices when administering injectable vaccines.

Which of the following is most likely to result in an influenza pandemic?

Antigenic shift in an influenza A virus.

Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine?

Tetanus and diphtheria toxoid-containing vaccines.

The incubation period for influenza can range from:

1 to 4 days

Which of the following is recognized by sociologists as a factor in a patient’s decision whether to be vaccinated?

Influence of a health care provider.

When Mary turned 64, she was diagnosed with type 2 diabetes. At that time, she received PPSV23. Which of the following represents appropriate pneumococcal coverage for Mary.

Administer PCV13 at age 65, then PPSV23 at age 69

Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B?

0, 1, and 6 months.

At what point during pregnancy is it recommended to administer the influenza vaccine?

Anytime is safe

According to the Advisory Committee on Immunization Practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary?

Diagnosis of chickenpox by a health care provider.

What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb?

1 inch.

Why should refrigerated vaccines be stored in the middle of the refrigerator?

There are fewer temperature fluctuations.

What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth?

Passive immunity

If pharmacists are called upon to assist with vaccination efforts following a natural disaster, which vaccine is likely to be needed by many of the victims?

Tetanus

Which of the following patients is a candidate for both MenACWY and MenB vaccines?

A 10 year-old who just had his spleen removed.

Which of the following statements is true regarding how vaccines evoke an immune response?

The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.

If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine?

Mark "do not use," place in the refrigerator, and call the manufacturer for further guidance.

Which of the following diseases are transmitted through mosquito bites?

Yellow fever and Japanese encephalitis.

Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities?

Local health departments

A health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient. In addition to hepatitis B vaccine, the health care provider also should receive hepatitis B Immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides:

Prompt immunity

There should be a flat hard surface in the area where vaccines will be administered to ensure:

There is room for the patient to lie down if fainting occurs or CPR is required.

Why are adjuvants added to vaccines?

To strengthen the immune response to the antigen.

Which of the following statements would be accurate when responding to a patient’s concerns about the safety of vaccines?

The immune system is capable of stimulating an immune response to multiple vaccines administered at the same time.

Which viruses are associated with the development of cancer?

Human papillomavirus and hepatitis B virus.

Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis?

Rabies.

Which of the following statements about pharmacy-based vaccination programs is true?

Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians.

After reconstitution, within what time frame must HZV be administered?

30 minutes.

How often are the Healthy People targets for vaccination rates updated?

Every 10 years

For which age group is the adjuvanted inactivated influenza vaccine approved?

65 years and older

Which of the following statements about establishing clinics for administering vaccines is true?

Technicians can administer screening questionnaires and distribute VISs.

Which of these vaccines is a live attenuated vaccine?

Zoster.

Which of the following documents must be given to every patient or patient’s caregiver before administration of a vaccine covered under the National Childhood Vaccine Injury Act (NCVIA)?

VIS.

With the exception of rotavirus, the routinely recommended live vaccines are contraindicated in a patient who:

Is immunosuppressed.

Jackie is a 34-year-old woman who received an influenza vaccine from you today. She wants to know how long it will take for the vaccine to begin working to protect her from getting the flu. What would be the most appropriate response to this patient?

14 days

What is the standard dose of epinephrine for managing anaphylaxis?

0.01 mg per kg body weight, up to a maximum of 0.5 mg.

Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age?

Haemophilus influenzae type b.

Which of the following patients would be a candidate for PPSV23?

25-year-old man who smokes cigarettes.

Name the vaccine-preventable disease that may be contracted by unimmunized children from adults serving as reservoirs for the disease, which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death.

Pertussis.

Vaccines as well as exposure to natural disease are both examples of which type of immunity?

Active immunity

If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP’s recommendation for vaccinating this patient against influenza?

Administer any age-appropriate inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV)

What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines?

Within 6 weeks

Which of the following vaccines may be administered to boys and young men aged 9 through 26 years to reduce the likelihood of acquiring genital warts?

HPV9.

Which type of vaccine involves stimulation of B cells without the assistance of T helper cells?

Pure polysaccharide vaccines

When looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications, what does the orange bar represent?

Precautions for vaccination.

A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines?

IPV.

A history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines?

Varicella.

Which of the following best describes an opportunity for pharmacists to use diagnosis-based screening to identify people at risk for vaccine-preventable diseases?

Performing a medication review for a patient who has diabetes.

The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases?

Measles

If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine?

5 years.

Justin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease. He should receive:

2 doses of varicella vaccine separated by at least 4 weeks.

Tom is a 9-year old boy who has never had an influenza vaccine. Tom’s mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom?

…

Adolescents should be routinely vaccinated with MCV4 on the following schedule:

1 dose at age 11 to 12 years, followed by a booster dose at age 16 years.

All Medicare Part B enrollees are covered for which vaccines?

Influenza, PPSV23, and PCV13

According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient?

⅝ inch.

John is a 46-year-old man with diabetes. He requests a refill of his diabetes testing supplies on October 21st. His immunization record indicates that he has completed the primary series of MMR, DTaP, HepA, and HepB vaccines. John has a documented history of chickenpox, and his last Td booster dose was 19 years ago. Which of the following vaccines should he receive?

PPSV23, Tdap, and IIV.

RotaTeq (RV5) should be administered as a:

2-dose series to infants at 2 and 4 months of age.

Which of the following diseases has been successfully eradicated worldwide through vaccination efforts?

Smallpox

HealthMap Vaccine Finder is a free online tool that allows pharmacists to:

List their vaccination services so patients can find them when searching the website for nearby immunizers.

HPV vaccine is recommended for which of the following individuals?

12-year-old boy.

How is the live, cholera vaccine administered?

Orally.

Which of the following immunization strategies is preferred for adults under the age of 65 years with immunocompromising conditions who require both PCV13 and PPSV23?

PCV13 first, followed by PPSV23 at least 8 weeks later.

Upon giving a VIS to a patient who is to receive a vaccine cover under the National Childhood Vaccine Injury Act, what must be documented?

The date the VIS was given to the patient or caregiver and the title of the VIS.

Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated?

…

During which step of the Pharmacists’ Patient Care Process would a pharmacist analyze a patient’s need for certain vaccines?

Assess

The childhood/adolescent and adult immunization schedules are updated and published annually during which months?

January or February

Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9?

11 year-old girl with no medical conditions, series has not been started

Which entity determines the specific vaccines that a pharmacist may administer?

States through laws and regulations

Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP’s influenza vaccine recommendations?

Low effectiveness of this vaccine was seen during the 2013-2014 and 2015-2016 influenza seasons

Herd immunity refers to which of the following situations?

Vaccination of enough individuals in a community to protect those who cannot be vaccinated.

The monitoring system that health care providers should use to report serious adverse events after vaccination is:

VAERS.

Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan?

Tdap today; Td in 4 weeks; Td 6 months after the second dose

Which of the following vaccines is recommended for infants to receive within 24 hours of birth?

Hep B

Which of the following statements is true regarding varicella-containing vaccines?

The potency of HZV is greater than that of varicella vacicne

Kimberly is a 34 year-old woman who is 30 weeks pregnant. She received a Td booster dose 1 year ago when she cut her hand while working in the kitchen. She has no documentation of receiving a Tdap vaccine. The most appropriate recommendation would be to administer:

Tdap as soon as possible

Alex is a 32 year-old man who is scheduled to travel to a country where hep A us endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hep A vaccine today. Alex should be counseled to return for is second dose of hep A:

In 6 months

Which of the following statements about live attenuated vaccines is true?

They should generally be avoided in immunocompromised individuals