APhA Immunization Exam 338 Questions with Verified Answers,100% CORRECT

APhA Immunization Exam 338 Questions with Verified Answers The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report iden ...

APhA Immunization Exam 338 Questions with Verified Answers The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as: - CORRECT ANSWERS Integral to increasing vaccination rates Under the direction of the U.S. Department of Health and Human Services, the Healthy People initiative has identified the following as a goal for 2030: - CORRECT ANSWERS Increase the proportion of persons who are vaccinated annually against seasonal influenza Opportunities for Advocacy and Collaboration include: - CORRECT ANSWERS Membership in state Immunization coalition to serve as an expert on policy and practice issues affecting pharmacy Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued? - CORRECT ANSWERS Smallpox - eradicated in 1980 by WHO Which of the following is one of the five guidelines identified by the APhA Board of Trustees in 2019 to assist pharmacists in incorporating immunization activities into their practice? - CORRECT ANSWERS Prevention, Partnership, Quality, Documentation and Empowerment Active Immunity - CORRECT ANSWERS Long-term protection but takes 2 weeks to work Innate Immunity - CORRECT ANSWERS Barrier defense mechanism Adaptive Immunity - CORRECT ANSWERS Also known as acquired Passive Immunity - CORRECT ANSWERS Antibodies from an external source Antigens - CORRECT ANSWERS Evoke the immune response and bind to specific antibodies T/F: Vaccines contain antibodies which are recognized by the immune system. - CORRECT ANSWERS False What can a pharmacist do to reduce the risk of getting hepatitis B after exposure? - CORRECT ANSWERS 1. Post-exposure prophylaxis is needed right away 2. Give both Hep B immune globulin (HBIG) and Hepatitis B vaccine 3. HBIG contains antibodies that provide immediate protection via passive immunity 4. When a person is fully vaccinated, the hepatitis B vaccine provides long-term protection. Live Vaccines are: - CORRECT ANSWERS 1. Attenuated 2. Stimulates both humoral and cell-mediated immune response 3. May be interfered with by circulating antibodies 4. Not given to children less than 12 months of age due to presence of maternal antibodies Inactivated Vaccines are: - CORRECT ANSWERS 1. Killed virus or bacteria 2. Does not replicate 3. Stimulates humoral immunity (antibodies) 4. May be given to people who have received blood products or live vaccines, regardless of timing. 5. Predominantly given to infants (less than 12 months) because they may have circulating maternal antibodies which could reduce the effectiveness of a live vaccines. T/F: Inactivated vaccines do NOT have minimum intervals between administered vaccines - CORRECT ANSWERS True T/F: Inactivated vaccines are not affected by live vaccines and visa versa. - CORRECT ANSWERS True If two live vaccines are given simultaneously sly on the same day, then you must wait _____ minimum interval. - CORRECT ANSWERS 28-day minimum interval so that each vaccine can replicate properly. Live vaccines followed by blood products (contain antibodies) require ______minimum interval. - CORRECT ANSWERS 2 weeks. Which of the following is an example of passive immunity? a.) Contracting measles b.) Hep B Vaccine c.) Skin Barrier d.) Maternal antibodies - CORRECT ANSWERS d.) Maternal antibodies Why is spacing and timing of vaccines important? - CORRECT ANSWERS Circulating antibodies may interfere with immune response How long does it take for the immune system to provide protection by producing disease-specific antibodies and memory cells? - CORRECT ANSWERS 14 days When does Active Immunity occur? - CORRECT ANSWERS When a patient is exposed to an antigen that triggers the body's immune system to produce it's own disease-specific antibodies and memory cells. Children less than what age do not mount an adequate immune response to t-cell independent immunity? - CORRECT ANSWERS 2 years. Which of the following is found in vaccines to evoke an immune response? - CORRECT ANSWERS Antigens What does attenuated mean? - CORRECT ANSWERS weakened LAIV4 is the abbreviation for: - CORRECT ANSWERS Live Attenuated Influenza Vaccine RV1, RV5 is the abbreviation for: - CORRECT ANSWERS Rotavirus VAR is the abbreviation for: - CORRECT ANSWERS Varicella MMR is the abbreviation for: - CORRECT ANSWERS Measles, mumps, rubella MMRV is the abbreviation for: - CORRECT ANSWERS Measles, mumps, rubella, varicella Can inactivated vaccines replicate? - CORRECT ANSWERS No. It does not cause disease. What are two broad categories that vaccines are classified as? - CORRECT ANSWERS 1. Live attenuated vaccines 2. Inactivated vaccines Cellular Vaccines - CORRECT ANSWERS 1. Inactivated Vaccines 2. Whole viruses or bacteria 3. Known as Subunits (fractions) 4. DTP/DTaP Toxoid Vaccines - CORRECT ANSWERS 1. Inactivated Vaccine 2. Subunit (fractions) 3. Inactive or biological toxin 4. Tetanus toxoid Recombinant Vaccine - CORRECT ANSWERS 1. Produced by genetic engineering 2. May contain no actual virus or a modified strain of a virus 3. HepB, HPV, RZV, RIV4 What clinical factors need to be considered before administering a lie attenuated vaccine? - CORRECT ANSWERS 1. Patients who currently are immunocompromised 2. Live attenuated vaccines administered in the previous 28 days. T/F: MMR is a live attenuated vaccine. - CORRECT ANSWERS True Which of the following vaccines listed is a live attenuated vaccine? a.) Hep B b.) Hep A c.) RZV d.) VAR - CORRECT ANSWERS d.) VAR Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine? - CORRECT ANSWERS Inactivated Polysaccharide Vaccine Which of the following is true regarding the use of mRNA in vaccine technology? a.) mRNA is extremely stable in a host's body. b.) mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response. c.) mRNA vaccine technology requires replication similar to a live attenuated vaccine. d.) mRNA vaccine technology elicits its immune response and protects the host by altering the host's DNA. - CORRECT ANSWERS b.) mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, will elicit an immune response. Which vaccine technol is an ingredient added typically to inactivated vaccines to boost its immune response by targeting pathogen recognition receptors that are expressed on dendritic cells to trigger a pro-inflammatory response? Though this technology creates a more robust immune response, it can also increase local site reactions and systemic reactions, such as fevers, chills, and body aches. - CORRECT ANSWERS Adjuvants (manufactured to produce a more robust immune response to the vaccine) When administering measles, mumps, rubella (MMR) and pneumococcal conjugate vaccine (PCV13) to a patient at their 15-month appointment, what must be considered regarding vaccine spacing? - CORRECT ANSWERS MMR and PCV13 may be administered simultaneously or at any interval between doses. NVAC - CORRECT ANSWERS National Vaccine Advisory Committee established standards for adult immunization practice: ASSESS, RECOMMEND, ADMINISTER & DOCUMENT Which of the following are part of the four steps set by NVAC as the standards for Adult Immunization Practice? - CORRECT ANSWERS ASSESS, RECOMMEND, ADMINISTER & DOCUMENT PPCP - CORRECT ANSWERS Pharmacist Patient Care Process PPCP Step 1 - CORRECT ANSWERS COLLECT information to determine which vaccine and screen for any contraindications/precautions at every clinical encounter PPCP Step 2 - CORRECT ANSWERS ASSESS after collecting information and analyzing the need for vaccines following ACIP recommendations. PPCP Step 2 - Mass Screening - CORRECT ANSWERS Mass Screening can help identify candidates for vaccines based on a common factor, review child's vaccination status prior to school entry PPCP Step 2 - Diagnosis Based Screening - CORRECT ANSWERS Diagnosis Based Screening is when certain medical conditions may be indications for certain vaccines PPCP Step 2 - Procedure Based Screening - CORRECT ANSWERS Procedure Based screening is when certain procedures might indicate the need for specific vaccines PPCP Step 2 - Occurrence Based Screening - CORRECT ANSWERS Occurrence-Based Screening is when Patients who may have health conditions that warrant vaccination at a hospital visit PPCP Step 3 - CORRECT ANSWERS Plan - pharmacists creates an individualized patient-centered care plan with clear and strong evidence based recommendations PPCP Step 4 - CORRECT ANSWERS Implement - communicate and collaborate with other providers as part of the immunization neighborhood, VIS form to educate patients about the vaccine they might be getting and counseling patients on risks and benefits to all patients receiving vaccinations. PPCP Step 5 - CORRECT ANSWERS Follow-up with Patients, monitor and manage potential adverse events and schedule appt's for follow-up doses In the patient care process, how often should a pharmacist collect information on a patient? - CORRECT ANSWERS At every clinical encounter Screening Questions for All Patients - CORRECT ANSWERS 1. Current Health Status 2. Allergies and Past Reactions 3. Long-term Illness Screening Questions: Live Vaccines in immunocompromised - CORRECT ANSWERS Immunocompromised - Cancer, Leukemia, AIDS These individuals may be a contraindication for live vaccines such as MMR, VAR, LAIV4 Screening Questions: Live Vaccines, Family history - CORRECT ANSWERS Parent, brother/sister with immune system problem? Heredity immunodeficiency should be screened Screening Questions: Live Vaccines, Immunosuppressive Therapy - CORRECT ANSWERS In the past 3 months, have you taken medications that affect your immune system like Prednisone or other steroids, anticancer drugs or treatment of rheumatoid arthritis, Crohn's disease or psoriasis, or radiation treatments? Immunosuppression may reduce vaccine efficacy or pose a risk for disseminated infection Screening Questions: Live Vaccines, Blood Products - CORRECT ANSWERS Past year, have you received transfusion of blood/blood products or given Immune (gamma) globulin Blood or blood products may contain antibodies that reduce vaccine efficacy. Screening Questions: Live Vaccines, Vaccine Timing - CORRECT ANSWERS Received vaccinations in the last 4 weeks? Vaccines should be given BEFORE initiation of immunosuppressive therapies Screening Questions: Pregnant Women - CORRECT ANSWERS Pregnant women should receive IIV4 and Tdap vaccinations Some live vaccines may be contraindicated in pregnancy Screening Questions: Patients considering tetanus-containing vaccines - CORRECT ANSWERS Seizure, brain or other nervous system problem Guillain-Barre syndrome (GBS) may be a precaution What is the name of the document published by the CDC that describes the risks and benefits of a vaccine in lay terms? - CORRECT ANSWERS VIS - Vaccine Information Statement An electronic prescription for glipizide 10mg is received by a pharmacist for a new patient. The prescription indicates a diagnosis of E11, Type 2 diabetes mellitus. In addition to filling the prescription, the pharmacist could assess the patient for potential immunizations to recommend. What form of assessment is the pharmacist utilizing? - CORRECT ANSWERS Diagnosis-based screening The community pharmacist, while filling discharge orders from the hospital, recognizes a patient's need for receiving the pneumococcal vaccine during a transition of care to a personal care home. This is an example of what part of the patient care process? - CORRECT ANSWERS Assess A male patient presents to the pharmacy for a shingles vaccine appointment. The patient is a new patient to the pharmacy. Which of the following information would be most appropriate to collect as part of the patient care process? - CORRECT ANSWERS Patient's age, current health, vaccine history, and allergies Which of the following statements best meets the definition of precaution? - CORRECT ANSWERS A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine. Star Pharmacy has been providing influenza vaccines for years and is now implementing a Hepatitis B vaccine program in their pharmacy next month. A crucial step in the Pharmacists' Patient Care Process for this vaccine is: - CORRECT ANSWERS Create a reminder and recall system. EUA - CORRECT ANSWERS Emergency Use Authorizations - allow for medical countermeasures, such as medications or vaccines to be made available during a public health emergency ex: COVID-19 EUA Process - CORRECT ANSWERS Phase 1/2 have to be completed Phase 3 - long term so monitor safety and FDA may allow it to move forward. ACIP - CORRECT ANSWERS Advisory Committee on Immunization Practices: -housed within the CDC -15 voting/30 nonvoting medical health experts -7 domains of framework that examines the vaccine At what age can the 2-dose schedule of the human papillomavirus (HPV) Vaccine be given? - CORRECT ANSWERS A 2 dose schedule is recommended for girls and boys who initiate the vaccination series at ages 9 through 14 years. CDC Immunization Schedules - CORRECT ANSWERS age, # of doses, time between doses, indications, precautions - UPDATED ANNUALLY How often are the CDC immunization schedules published? - CORRECT ANSWERS Annually Precautions vs. Contraindications - CORRECT ANSWERS Precautions - conditions that may diminish response to vaccine and increases risk of serious reaction Contraindications - when a conditions exists that will result in a severe, life-threatnening event if patient receives this vaccine. ex: severe allergy/reaction to previous dose or vaccine component. Schedule for Children up to 18 years - CORRECT ANSWERS Table 1 - Age Table 2 - Catch-up schedule for pts. behind on vaccines Table 3 - Medical indication If a child is behind on the rotavirus vaccine, what is the interval of time between dose 1 & 2 to start getting the child caught up? - CORRECT ANSWERS At least 4 weeks LAIV is contraindicated if child has asthma or wheezing for what age? - CORRECT ANSWERS Children ages 2-4 with heart disease or chronic disease should still be vaccinated against influenza using INACTIVATED The herpes zoster vaccine is first recommended what age for immunocompetent adults - CORRECT ANSWERS 50 If patient is pregnant then which vaccines should be avoided? - CORRECT ANSWERS MMR, VAR, HPV but can be given immediately after she gives birth. Influenza should be inactivated. Steps when using Immunization schedules - CORRECT ANSWERS 1. start with patients age, which vaccines should they have and are they behind? 2. If patient has medical condition, check for precautions and contraindications 3. Refer to vaccine notes for types, frequencies, intervals and special considerations Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended? - CORRECT ANSWERS 50 years Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2? - CORRECT ANSWERS MMR A 10 year-old child received one dose of the hepatitis A vaccine at 1 year of age, but never returned for a second dose. Which of the following is true regarding the need for a second dose of the hepatitis A vaccine for this child? - CORRECT ANSWERS Give 1 dose now as catch up Which of the following is TRUE of the emergency use authorization process? - CORRECT ANSWERS Manufacturers must include a plan for safety monitoring Which of the following vaccines is not recommended during pregnancy? - CORRECT ANSWERS Human papillomavirus vaccine (HPV) If an 11 year old child never got the hepatitis B vaccine series, what is the minimum amount of time that must occur between dose 1 and dose 3 when getting this child caught up? - CORRECT ANSWERS 16 weeks A 9 year-old was just diagnosed with asplenia. This child is up to date on all routinely recommended vaccines. Which additional vaccine does this child need? - CORRECT ANSWERS MenACWY - Meningococcal ACWY Under the direction of the U.S. Department of Health and Human Services, the Healthy People initiative has identified the following as a goal for 2030: - CORRECT ANSWERS Increase the proportion of persons who are vaccinated annually against seasonal influenza The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as: - CORRECT ANSWERS Integral to increasing vaccination rates Opportunities for Advocacy and Collaboration include: - CORRECT ANSWERS Membership in state immunization coalition to serve as an expert on policy and practice issues affecting pharmacy Which of the following is one of the five guidelines identified by the APhA Board of Trustees in 2019 to assist pharmacists in incorporating immunization activities into their practice? - CORRECT ANSWERS Prevention Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued? - CORRECT ANSWERS Smallpox Which of the following statements is false regarding polysaccharide and conjugated vaccines? - CORRECT ANSWERS The conjugate protein used, such as diphtheria, can also provide adequate protection against itself in addition to the polysaccharide Which of the following vaccines listed is a live attenuated vaccine? - CORRECT ANSWERS Varicella (VAR) When administering measles, mumps, rubella (MMR) and pneumococcal conjugate vaccine (PCV13) to a patient at their 15-month appointment, what must be considered regarding vaccine spacing? - CORRECT ANSWERS MMR and PCV14 may be administered simultaneously or at any interval between doses Which vaccine technology listed below is an ingredient added typically to inactivated vaccines to boost its immune response by targeting pathogen recognition receptors that are expressed on dendritic cells to trigger a pro-inflammatory response? Though this technology creates a more robust immune response, it can also increase local site reactions and systemic reactions, such as fevers, chills, and body aches. - CORRECT ANSWERS Adjuvants Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine? - CORRECT ANSWERS Inactivated polysaccharide vaccine Star Pharmacy has been providing influenza vaccines for years and is now implementing a Hepatitis B vaccine program in their pharmacy next month. A crucial step in the Pharmacists' Patient Care Process for this vaccine is: - CORRECT ANSWERS Create a reminder and recall system A male patient presents to the pharmacy for a shingles vaccine appointment. The patient is a new patient to the pharmacy. Which of the following information would be most appropriate to collect as part of the patient care process? - CORRECT ANSWERS Patient's age, current health, vaccine history, and allergies An electronic prescription for glipizide 10mg is received by a pharmacist for a new patient. The prescription indicates a diagnosis of E11, Type 2 diabetes mellitus. In addition to filling the prescription, the pharmacist could assess the patient for potential immunizations to recommend. What form of assessment is the pharmacist utilizing? - CORRECT ANSWERS Diagnosis-based screening The community pharmacist, while filling discharge orders from the hospital, recognizes a patient's need for receiving the pneumococcal vaccine during a transition of care to a personal care home. This is an example of what part of the patient care process? - CORRECT ANSWERS Assess Which of the following statements best meets the definition of precaution? - CORRECT ANSWERS A condition that may alter or diminish the patient's response or may increase the patient's risk of a serious reaction to a vaccine. Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended? - CORRECT ANSWERS 50 years If an 11 year old child never got the hepatitis B vaccine series, what is the minimum amount of time that must occur between dose 1 and dose 3 when getting this child caught up? - CORRECT ANSWERS 16 weeks Which of the following vaccines is not recommended during pregnancy? - CORRECT ANSWERS Human papillomavirus vaccine (HPV) Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2? - CORRECT ANSWERS Measles, mumps, rubella (MMR) A 10 year-old child received one dose of the hepatitis A vaccine at 1 year of age, but never returned for a second dose. Which of the following is true regarding the need for a second dose of the hepatitis A vaccine for this child? - CORRECT ANSWERS Give 1 dose now as catch up A 9 year-old was just diagnosed with asplenia. This child is up to date on all routinely recommended vaccines. Which additional vaccine does this child need? - CORRECT ANSWERS MenACWY Which of the following is TRUE of the emergency use authorization process? - CORRECT ANSWERS Manufacturers must include a plan for safety monitoring Which of the following patient scenarios regarding influenza vaccination is correct? - CORRECT ANSWERS A 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone Which of the following are true regarding the influenza virus? - CORRECT ANSWERS It is transmitted through respiratory droplets that contain the virus. Which of the following symptoms are usually associated with influenza? - CORRECT ANSWERS chills Counseling on vaccine safety should include: - CORRECT ANSWERS Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days. Options to increase influenza vaccine effectiveness include: - CORRECT ANSWERS Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season Which of the following is true for the 23-valent pneumococcal polysaccharide vaccine (PPSV23)? - CORRECT ANSWERS PPSV23 should not be given to children less than 2 years of age How is streptococcus pneumoniae primarily transmitted? - CORRECT ANSWERS Respiratory droplets or secretions A 3-yearmold child recently underwent a splenectomy. Previous to the surgery, the child was up to date on all pediatric vaccinations. According to the CDC, which of the following vaccines should be recommended? - CORRECT ANSWERS PPSV23 Using shared clinical decision-making, which of the following recommendation is most appropriate for a 65-year old living in a skilled nursing facility with multiple co-morbid conditions? This patient has no record of receiving either pneumococcal vaccine and is immune competent. - CORRECT ANSWERS Give PCV13 now, then give PPSV23 one year later For which of the following conditions are both PCV13 and PPSV23 recommended? - CORRECT ANSWERS Asplenia A healthy 70-year old female who received PPSV23 at 65-years of age is inquiring about pneumococcal vaccination. Which of the following should you recommend? - CORRECT ANSWERS No pneumococcal vaccination is recommended Which of the following scenarios is an appropriate shared clinical decision making for meningococcal vaccine? - CORRECT ANSWERS Healthy 16 year old who received meningococcal B vaccine An adolescent received his first meningococcal conjugate quadrivalent (MenACWY) vaccine at age 13 years, when should he receive his booster dose? - CORRECT ANSWERS 16 years What type of vaccine is meningococcal quadrivalent vaccine? - CORRECT ANSWERS Conjugate The advisory committee on immunization practices (ACIP) recommends routine vaccination with the meningococcal conjugated quadrivalent vaccine (MenACWY) which of the following age groups? - CORRECT ANSWERS 11-12 years of age Which of the following is a potential long term complication from meningococcal disease? - CORRECT ANSWERS Amputations What percentage of HPV infections are cleared by the body and do not develop to CIN2 or CIN3? - CORRECT ANSWERS 70% Which of the following factors does not need to be considered when utilizing shared decision making to evaluate the need to vaccinate an adult (27-45 years of age) with 9vHPV vaccine? - CORRECT ANSWERS HPV antibody test results A 16-year old patient presents to the pharmacy for her first dose of 9vHPV. The patient is instructed to wait in the pharmacy for 15 minutes after receiving the dose. Three minutes after receiving the dose, the patient experiences syncope. What is the recommended response to treat the patient's syncope? - CORRECT ANSWERS Lay the patient flat on the ground and elevate her legs. Monitor the patient's vitals and initiate emergency services if the patient does not regain consciousness Which of the below statements regarding Human papillomavirus (HPV) serotypes is true? - CORRECT ANSWERS High risk serotypes are estimated to cause 99% of cervical precancers A 25-year old female comes to the pharmacy inquiring about the 9vHPV series. What would be the recommended vaccination series? - CORRECT ANSWERS 3 doses administered intramuscularly at 0, 1-2, 6 months Which of the following is the most common type of tetanus? - CORRECT ANSWERS Generalized Which of the following vaccines is used as a booster every 10 years? - CORRECT ANSWERS Td What is the recommended timing for Tdap during pregnancy ? - CORRECT ANSWERS 27-36 weeks The whooping cough associated with pertussis occurs in this stage of disease: - CORRECT ANSWERS Paroxysmal DTaP is recommended to be administered using which of the following schedules? - CORRECT ANSWERS 2, 4, 6, 12-15 months, 4-6 years Which of the following is true regarding the recombinant herpes zoster vaccination? - CORRECT ANSWERS It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age Which of the following is true regarding varicella zoster transmission? - CORRECT ANSWERS Period of contagiousness: 1-2 days before rash to 4-7 days later Which of the following are true regarding vaccine efficacy and safety for the live varicella vaccine and the recombinant zoster vaccine? - CORRECT ANSWERS Both vaccines have over 90% effectiveness in prevention of disease after two doses Which of the following complications are correctly matched to the associated condition? - CORRECT ANSWERS Postherpetic neuralgia-herpes zoster Which of the following correctly describes current ACIP recommendations? - CORRECT ANSWERS The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age The ACIP recommends the hepatitis A vaccine be administered to all children starting at which age? - CORRECT ANSWERS 12 months Which of the following vaccines contains a synthetic adjuvant? - CORRECT ANSWERS Heplisav Which of the following is the reason for the most recent hepatitis A outbreaks? - CORRECT ANSWERS Person-to-person transmission Post-vaccination testing for hepatitis B immunity is recommended for which of the following? - CORRECT ANSWERS Health-care workers Which of the following is a clinical feature of hepatitis B but not hepatitis A? - CORRECT ANSWERS Chronic infection What is youngest age that hepatitis B vaccine is recommended in infants and children? - CORRECT ANSWERS At birth A child received the MMR vaccine when he was 9 months of age before moving out of the country with his parents. He is now 4 years old and about to enter Kindergarten. How many, if any, doses of MMR should the child receive now? - CORRECT ANSWERS 2 A young adult presenting with swelling of the parotid glands most likely has which of the following diseases: - CORRECT ANSWERS Mumps Which of the following individuals are contraindicated from receiving the MMR vaccine? - CORRECT ANSWERS 23-year-old in her 3rd trimester Which of the following is the primary reason we have measles outbreaks in the U.S.? - CORRECT ANSWERS Unvaccinated people with measles coming to the U.S. During a public health declared mumps outbreak, a 21-year old college student with a history of 2 MMR vaccine doses as a child wants to know if she needs a dose of MMR now. Which of the following is the best response? - CORRECT ANSWERS Yes, since there is a declared mumps outbreak When counseling the parent of a 1-year-old receiving the MMR vaccine, they should be told that their child may get a measles-like rash after how long from vaccination? - CORRECT ANSWERS 1 week Which vaccination is NOT part of a combined antigen vaccine? - CORRECT ANSWERS Rotavirus A patient presents to the pediatric clinic for their 5-year-old well check before entering kindergarten. They received rotavirus at 2 and 4 months and Pentacel (DTaP/IPV/Hib) at 2 and 4 and 6 and 15 months. What vaccine should they need to receive today? - CORRECT ANSWERS IPV Although the primary series for Hib varies between 2-3 doses, all vaccines are recommended to have a booster dose at age: - CORRECT ANSWERS 12-15 months Which disease state(s) can potentially lead to meningitis? - CORRECT ANSWERS Polio and Haemophilus influenzae Which of the following patients is eligible to receive their first dose of the rotavirus vaccine? - CORRECT ANSWERS A 10-week old presenting to the pediatrician for their 2 month well check Which of the following is true regarding 3rd dose and booster doses for COVID-19? - CORRECT ANSWERS The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines Which COVID-19 vaccination has 2 doses administered 28 days apart? - CORRECT ANSWERS Moderna Documentation requirements for COVID-19 vaccinations include: - CORRECT ANSWERS Report administration data to your jurisdiction's system (e.g. IIS) within 72 hours after administration Which of the following is true regarding risk for COVID-19? - CORRECT ANSWERS Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications Which of the following is true regarding transmission of SARS-CoV-2? - CORRECT ANSWERS Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus. A contraindication to receiving a COVID-19 vaccination includes: - CORRECT ANSWERS A known (diagnosed) allergy to a component of a COVID-19 vaccine Post-vaccination counseling for patients should include: - CORRECT ANSWERS Information about adverse reactions that require contact with the health care system If patients believe that influenza vaccines can cause influenza because they were ill after receiving the vaccine last year, pharmacists should educate them that: - CORRECT ANSWERS Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms A simple way to communicate information about risks and benefits of vaccines to all patients is to: - CORRECT ANSWERS Give them the Vaccine Information Statements The first step in AHRQ's "SHARE" approach to vaccines is to: - CORRECT ANSWERS Seek your patient's participation in a discussion Vaccine hesitancy is defined as: - CORRECT ANSWERS The delay in acceptance or refusal of a vaccination despite the availability of vaccination services The cold chain for vaccines - CORRECT ANSWERS Must be maintained from manufacture until the vaccine is administered to the patient Refrigerated vaccines should be maintained at temperatures between: - CORRECT ANSWERS 35ºF and +46ºF Which of the following vaccines must be frozen? - CORRECT ANSWERS Zostavax Why is it important to preserve the cold chain for vaccines? - CORRECT ANSWERS Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency When storing vaccines in the refrigerator, pharmacists should: - CORRECT ANSWERS Use water bottles to help stabilize temperatures When administering an intramuscular injection, pharmacists should: - CORRECT ANSWERS Use a 22- to 25- gauge needle When preparing vaccines for administration, pharmacists should: - CORRECT ANSWERS Always use aseptic technique When reconstituting a vaccine for injection, pharmacists should: - CORRECT ANSWERS Always refer to the vaccine package insert for specific information When administering a subcutaneous injection, pharmacists should - CORRECT ANSWERS Pinch a fold of skin over the triceps muscle To prevent errors of vaccine administration, pharmacists should: - CORRECT ANSWERS select the appropriate needle length In a patient experiencing anaphylaxis, pharmacists should administer epinephrine: - CORRECT ANSWERS As a first-line treatment Generalized urticaria following a vaccine is considered: - CORRECT ANSWERS An allergic reaction An adverse event that is considered a systemic reaction to a vaccine is: - CORRECT ANSWERS Fever Which of the following is considered a systemic symptom of anaphylaxis? - CORRECT ANSWERS Diarrhea and vomiting Which of the following over-the-counter medications may be recommended to treat systemic reactions after vaccination? - CORRECT ANSWERS NSAIDs and acetaminophen An important benefit of standing orders and protocols is that they: - CORRECT ANSWERS Improve patient access to vaccines and efficiency of services Which of the following best describes a standing order? - CORRECT ANSWERS A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine/ Which of the following organizations provides standing order templates? - CORRECT ANSWERS Immunization Action Coalition A standing order or protocol should include information about: - CORRECT ANSWERS Managing medical emergencies that may occur after administration of a vaccine Which of the following statements about standing orders and protocols is true? - CORRECT ANSWERS Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations. Which statement is true regarding gloves and handwashing? - CORRECT ANSWERS Employers must make available to employees appropriately sized gloves and a hand washing facility or antiseptic hand cleansers for employees to use while providing immunizations Westend Pharmacy is launching an immunization program next month. The pharmacy manager, John, has a list of items that still need to be completed. Which item below is not required by OSHA to be completed before implementing the program? - CORRECT ANSWERS Create a network with local physicians to refer patients to the new immunization program. Which of the following is not a benefit of a reminder and recall system? - CORRECT ANSWERS Incentivizes patients to make a primary care appointment. The OSHA exposure control plan is used by employers to achieve what goal? - CORRECT ANSWERS Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace Which vaccine is required by OSHA to be offered to all employees with potential exposure to bloodborne pathogens? - CORRECT ANSWERS Hepatitis B vaccine According to the Affordable Care Act, which of the following must be covered without cost-share to the patient? - CORRECT ANSWERS An ACIP routinely recommended vaccine The Vaccine for Children (VFC) program pays for which of the following? - CORRECT ANSWERS The vaccine What type of code is used to identify the diagnosis for a patient receiving a vaccine? - CORRECT ANSWERS ICD-10 Which of the following is the correct answer and reason for a 64-year old patient who asks you if it is better to get their shingles vaccine now or wait til it is covered by Medicare at 65 years? - CORRECT ANSWERS Now, because it must be covered at no cost be commercial insurance Which of the following requires no cost-share for the patient and is mainly for those 65 years and older? - CORRECT ANSWERS Medicare Part B The program which collects data regarding errors of vaccine handling and administration is called: - CORRECT ANSWERS VERP Which of the following is true regarding professional liability? - CORRECT ANSWERS Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination. The National Childhood Vaccine Injury Act of 1986 established national vaccine documentation requirements which include: - CORRECT ANSWERS Edition date of the Vaccine Information Statement (VIS) Which of the following is an example of a common vaccine administration error? - CORRECT ANSWERS Wrong vaccine, route, site, or dosage; or improperly prepared. lISs have been shown to increase immunization rates and reduce vaccine-preventable diseases by: - CORRECT ANSWERS Assisting in vaccination status assessment. Which of the following best describes how to roll with resistance? - CORRECT ANSWERS Change strategies to avoid arguing with patients. Which of the following best describes the preparation stage of the Transtheoretical Model of Health Behavior Change? - CORRECT ANSWERS Patients intend to take action in the next month to change their behavior. Which of the following best describes the definition of vaccine hesitancy? - CORRECT ANSWERS A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services. Which of the following statements best illustrates the affirmation skill in motivational interviewing? - CORRECT ANSWERS "Thank you for sharing your concerns with me, I enjoyed speaking with you today" Health literacy is considered a part of which domain of social determinants of health? - CORRECT ANSWERS Health care access Which setting best facilitates the delivery of a mass vaccination clinic for the general population? - CORRECT ANSWERS On-site community event After the routine administration of a vaccine, the pharmacy technician should send documentation of the vaccination to: - CORRECT ANSWERS The patient's primary care physician A potential advantage of accommodating walk-in vaccines, compared with only scheduling appointments, is that: - CORRECT ANSWERS It may allow greater flexibility and convenience for the patient Which of the following vaccines would be best delivered in a mass vaccination clinic? - CORRECT ANSWERS Influenza vaccine A pharmacy technician may perform which of the following roles? - CORRECT ANSWERS Ask patients to complete screening questionnaires When promoting a mass immunization clinic it is helpful to: - CORRECT ANSWERS Share appointment scheduling instructions, if applicable Which of the following functions should be performed prior to the mass vaccination clinic? - CORRECT ANSWERS Ordering of adequate inventory of vaccines and supplies Which of the following vaccines are best suited to a mass immunization clinic? - CORRECT ANSWERS Vaccines to address a pandemic pathogen Which of the following facility features is most important for maintaining the cold chain? - CORRECT ANSWERS Space for vaccine storage and temperature monitoring Which of the following statements is true when operating a mass vaccination clinic? - CORRECT ANSWERS If multiple vaccines are available, they should be administered at different stations Which of the following best describes immunization coalitions? - CORRECT ANSWERS Organizations that bring together vaccination stakeholders to improve vaccination rates Which of the following awareness campaigns is typically conducted in December? - CORRECT ANSWERS National Influenza Vaccination Week Which of the following statements is true regarding forming relationships with other immunization stakeholders? - CORRECT ANSWERS It can enhance your marketing efforts Which of the following is considered a print marketing strategy? - CORRECT ANSWERS Flyers and brochures Which of the following is a source of free print materials that can be used to market vaccination services? - CORRECT ANSWERS Infectious Diseases Society of America Which of the following activities should only be performed by a pharmacist? - CORRECT ANSWERS Decide whether a patient needs a vaccine. Which of the following statements would be appropriate for a pharmacy technician to make? - CORRECT ANSWERS "We are now offering herpes zoster vaccines in the pharmacy" Preparing a vaccine for administration may include which of the following tasks? - CORRECT ANSWERS Selecting the needle for administering the vaccine Which of the following is true about the pharmacy technicians' role in managing vaccine inventory? - CORRECT ANSWERS Expiration dates and beyond use dates should be checked at least weekly Which of the following statements is true regarding how pharmacy technicians can gather information about a patient's vaccination history? - CORRECT ANSWERS Pharmacy technicians can review electronic health records Which of the following best describes a public health department? - CORRECT ANSWERS A department which helps prevent the start and spread of disease Which of the following issues affecting international access to vaccines is best aligned to efforts by pharmacist volunteers? - CORRECT ANSWERS Suboptimal levels of health care providers Which of the following is a law or program that may grant immunity from civil liability during emergencies for covered activities? - CORRECT ANSWERS U.S. Public Readiness and Emergency Preparedness Act Which of the following is a government-run volunteer organization for medical and public health professionals? - CORRECT ANSWERS Medical Reserve Corps Which if the following is a non-governmental organization that participates in disaster relief efforts? - CORRECT ANSWERS Red Cross What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb? - CORRECT ANSWERS Fixed 1-inch needles are acceptable for patients weighing 60 kg (132 lb) or less. HZV, MMR, rabies, typhoid, varicella, or yellow fever vaccine should not be administered to a patient with a history of anaphylaxis to: - CORRECT ANSWERS Gelatin 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? - CORRECT ANSWERS 1) Tdap 2) Td 4 weeks later 3) Td 6-12 months later Td booster every 10 years after 3rd dose Candidate for PPSV23? - CORRECT ANSWERS All adults 65+ years Immunocompromised (alcoholism, chronic liver; heart; lung disease, diabetics, cochlear implants, CSF leak) patients ages 19-64 Children with asthma only if theyre treated with high dose corticosteriods 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. - CORRECT ANSWERS Pertussis Which of the following vaccines may be administered to males and females aged 9 through 26 years to reduce the likelihood of acquiring genital warts? - CORRECT ANSWERS 9vHPV Which of the following key questions is important to ask a patient before administering IIV? - CORRECT ANSWERS Are you sick today? *Mild illness is okay, but moderate to severe acute illness need to be resolved before getting vaccine. Live attenuated vaccines.. - CORRECT ANSWERS produced by weakening the virus or bacteria to reduce the likelihood that it can cause disease end to produce more persistent, longer-lasting immunity than inactivated vaccines must replicate in order for the body to produce an immune response could cause disease in immunocompromised patients Circulating antibodies may interfere with a live attenuated vaccine's ability to replicate. Inactivated vaccines... - CORRECT ANSWERS are produced by killing the virus/bacteria includes polysaccharide vaccines (conjugated [protein altered] or unconjugated), toxoids, or cellular vaccines Which type of vaccine involves stimulation of B cells without the assistance of T helper cells? - CORRECT ANSWERS A pure polysaccharide *not recommended for children <2 because of their immature immune system Conjugated vaccines.. - CORRECT ANSWERS provide longer lasting protection the immune response that changes to a T cell mediated response allows children <2 to form an immune response T/F Both live attenuated vaccines and recombinant vaccines mimic natural infection and involve T cells in the immune response. - CORRECT ANSWERS True The incubation period for influenza can range from: - CORRECT ANSWERS 1-4 days 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? - CORRECT ANSWERS 6 weeks The monitoring system that health care providers should use to report serious adverse events after vaccination is: - CORRECT ANSWERS VAERS Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9? - CORRECT ANSWERS 11 or 12 year olds *if series has not been started by age 15, then a 3 dose series is needed *3 dose series recommended for immunocompromised patients *1st/2nd dose- given at 0 and 6-12 months *if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed Why should refrigerated vaccines be stored in the middle of the refrigerator? - CORRECT ANSWERS because the temperature in the middle does not fluctuate as much. A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines? - CORRECT ANSWERS Hep A, IPV, MMR, Rabies, smallpox, varicella, zoster, influenza 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? - CORRECT ANSWERS Orange-indicates theres a precaution for the vaccine * Yellow-vaccine recommended according to routine schedule Purple-recommended for people with an additional risk factor for which the vaccine would be indicated Yellow/black- vaccine recommended, additional doses may be necessary based on medical condition White-no recommendation Red-vaccine is contraindicated 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: - CORRECT ANSWERS Immediate protection *its passive immunity so its short-lived, but provides protection right away Contraindication of HZV - CORRECT ANSWERS HZV is a live vaccine so its contraindicated in immunocompromised patients, pregnant women, and those who have experienced a severe allergic reaction to the vaccine components (neomycin, gelatin) Viruses associated with the development of cancer: - CORRECT ANSWERS HPV and Hep B There should be a flat hard surface in the area where vaccines will be administered to ensure: - CORRECT ANSWERS there is space to perform CPR 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? - CORRECT ANSWERS Td or Tdap According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient? - CORRECT ANSWERS 5/8 in needle at 45 degrees in the outer upper arm (SC) How often are the Healthy People targets for vaccination rates updated? - CORRECT ANSWERS every 10 years Which of the following patients is a candidate for both MenACWY and MenB vaccines? - CORRECT ANSWERS A 10 year old who just had his spleen removed *MenA can be administered at 2months, MenB not recommended until 10 yrs HIV infection and being in the military are risk factors for MenA What must be documented for VIS? - CORRECT ANSWERS -patient name -date vaccine was administered -vaccine manufacturer, lot number -name, address, title of the administer -date printed on VIS -date VIS was given to patient or guardian *signatures of patient/guardian not required by federal law, but some employers/companys may require signatures Who should receive MMR vaccine? - CORRECT ANSWERS 2 dose series at 12-15 months and 4-6 years *no additional doses needed MMR is a live vaccine, not recommended until 12 months old Adults w/o immunity evidence (being born before 1957, documentation of MMR vaccine, lab evidence of disease) should receive one dose Healthcare professionals should receive 2 doses 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? - CORRECT ANSWERS Do not have to start series over (oral typhoid is the exception) *Increasing the interval between doses of a multi-dose vaccine series does not diminish the ultimate effectiveness of the vaccine, but it does delay protection for the patient. Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb? - CORRECT ANSWERS SC at 45 degree angle *weight of patient does not matter in regards to route of administration HPV vaccine is recommended for.. - CORRECT ANSWERS Both males and females ages 9-26 years *routinely recommended for 11 or 12 years of age 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? - CORRECT ANSWERS One dose during flu season *influenza vaccine can be given beginning at 6 months 6 months-8 years who have not previously been vaccinated need 2 doses, 4 weeks apart 9 years-one dose during flu season 6 months-2 years 0.25mL dose 3+ years- 0.5mL dose 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? - CORRECT ANSWERS Tdap MCV4 HPV Hep B influenza vaccine if flu season True regarding varicella-containing vaccines: - CORRECT ANSWERS HZV (Zostavax) contains 14 times more antigen than varicella vaccine the greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis? - CORRECT ANSWERS Rabies *it affects the CNS If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza? - CORRECT ANSWERS Hives only-can receive vaccine If patient experienced anaphylaxis or required an epi pen -CAN still receive vaccine but it must be in a medical setting where they can be supervised by medical professionals to assist with any complications The childhood/adolescent and adult immunization schedules are updated and published annually during which months? - CORRECT ANSWERS once a year at the end of January or early February How is the live, cholera vaccine administered? - CORRECT ANSWERS single oral dose at least 10 days prior to potential exposure *should not eat/drink for 1 hour before or after vaccine RotaTeq (RV5) should be administered as a: - CORRECT ANSWERS 3-dose series at 2,4,6 months Rotarix (RV1) should be administered as a: - CORRECT ANSWERS 2 dose oral series at 2 and 4 months Diagnosis-based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWERS identifies patients in need of vaccines based on the presence of a particular diagnosis. ex: diabetes Procedure based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWERS involves assessing vaccine needs based on a patient's receipt of a surgical, medical, or pharmacy-based procedure. ex: splenectomy Occurrence based screening to identify people at risk for vaccine-preventable diseases: - CORRECT ANSWERS takes advantage of an event, such as a hospital admission, clinic visit, or emergency department visit to identify people who need to be vaccinated ex: discharge counseling Live attenuated vaccines (11) - CORRECT ANSWERS Cholera HZV LAIV MMR MMRV Rotavirus TB (BCG) Typhoid (Ty21a) Vaccinia (smallpox) Varicella Yellow Fever *all others are inactivated For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines? - CORRECT ANSWERS No minimum interval between doses *IIV is inactivated HZV is live inactivated do not interfere with live Interval between 2 live vaccines NOT given simultaneously: - CORRECT ANSWERS 4 weeks Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations? - CORRECT ANSWERS Lower than expected efficacy in 2013-2016 Epi doses: - CORRECT ANSWERS 1:1000 w/v 1mg/mL based on weight: 0.01mg/kg/dose max dose: 0.5mg/dose dose 5-15min for up to 3 doses The majority of vasovagal syncope cases occur withinin: - CORRECT ANSWERS 15min of vaccination Which of the following diseases has been successfully eradicated worldwide through vaccination efforts? - CORRECT ANSWERS smallpox In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age? - CORRECT ANSWERS HPV How do vaccines evoke an immune response? - CORRECT ANSWERS The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B cells. What to do in case of anaphylaxis: - CORRECT ANSWERS Do not offer water (do not want anything in the throat) check BP and pulse to see if it is decreasing (decreasing means less blood flow and more likely to faint) Administer epi pen when patient is wheezing and difficulty in breathing, give second dose if wheezing continues IM is more prompt than SC True allergic reaction: - CORRECT ANSWERS immediate hypersensitivity with itching, hives, redness, or symptoms of anaphylaxis False allergic reaction: - CORRECT ANSWERS fever, GI upset, red eyes, neurological events Can a women receive the flu vaccine if she is pregnant? - CORRECT ANSWERS Yes, but it has to be the inactivated flu vaccine only during flu season What vaccine should women get every pregnancy? - CORRECT ANSWERS Tdap, after 20 weeks of pregnancy What individuals are at an increased risk of adverse effects from live vaccines - CORRECT ANSWERS Immunocompromised Minimum interval when a PPD skin test is followed by a live vaccine - CORRECT ANSWERS Administer vaccine after PPD skin test has been read Minimum interval when a live vaccine is followed by a PPD skin test - CORRECT ANSWERS 28 days Minimum interval when blood product is given before live vaccine - CORRECT ANSWERS minimum varies (have to look up) Minimum interval for live vaccines followed by blood products - CORRECT ANSWERS 2 weeks Minimum interval for inactivated vaccines and antibodies - CORRECT ANSWERS no minimum Minimum interval for two live vaccines, if not simultaneous - CORRECT ANSWERS 28 days 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? - CORRECT ANSWERS 5th dose of DTaP 4th dose of IPV 2nd dose of MMR 2nd dose of varicella PCV13 Hib Hep A Hep B Purpose of adjuvants - CORRECT ANSWERS it strengthens the response to the antigen and the immune response is much greater because the adjuvant results in an inflammatory response *adjuvants are added to recombinant vaccines The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases? - CORRECT ANSWERS MMR Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated? - CORRECT ANSWERS 1) perceived susceptibility to a disease 2) perceived seriousness of a disease 3) perceived vaccine benefits 4) perceived vaccine barriers (e.g., adverse effects, access) 5) social influence (e.g., recommendation from a health care provider) In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to: - CORRECT ANSWERS quiet activites and comfort them *Can use acetaminophen/ibuprofen for discomfort Aspirin is not recommended During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines? - CORRECT ANSWERS Assess After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every: - CORRECT ANSWERS every 10 years 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? - CORRECT ANSWERS one dose of Tdap 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? - CORRECT ANSWERS 2nd Hib Rotavirus DTaP PCV13 IPV *3rd Hep B at 6 months too young for flu vaccine MMR/varicella are live and recommend at 1 year 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? - CORRECT ANSWERS 3 dose series at 0, 1, and 6 months At what point during pregnancy is it recommended to administer the influenza vaccine? - CORRECT ANSWERS Any trimester Which of the following statements about pharmacy-based vaccination programs is true? Feedback - CORRECT ANSWERS Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians. Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities? - CORRECT ANSWERS Local Health Departments 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? - CORRECT ANSWERS Tdap if he has not received that and a Td booster every 10 years 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? - CORRECT ANSWERS PPSV23 HPV Influenza if flu season *PCV13 is for immunocompromised not asthma What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth? - CORRECT ANSWERS Passive Immunity *antibodies are provided from another source Acquired immunity: - CORRECT ANSWERS immunological memory *can be active or passive Active immunity: - CORRECT ANSWERS an antigen from an invading pathogen triggers an immune response Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines? - CORRECT ANSWERS Inactivated is killed so cannot cause influenza intranasal is live but modified so cannot cause disease No vaccine is 100% effective If illness does occur its often less severe in those who were vaccinated No evidence that Thimerosal has caused any short or long term harm Several vaccines on the same day in immunocompetent people will not overload their immune system people are exposed . to more antigens every day from food or bacteria than from vaccines If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine? - CORRECT ANSWERS 1-3 doses with 5 years between under age of 65 who are immunocompromised or asplenia-2 doses with 5 years apart Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction? - CORRECT ANSWERS Diphtheria Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb? - CORRECT ANSWERS IM at 90 degrees *weight of patient is irrelevant in regards to route of administration Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine: - CORRECT ANSWERS 2nd dose given at least 6 months after the first dose Adolescents should be routinely vaccinated with MCV4 on the following schedule: - CORRECT ANSWERS 1 dose at 11 or 12 years booster at 16 years 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? - CORRECT ANSWERS 5th dose DTaP *one time dose of Tdap at 7 years Td booster every 10 years 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? - CORRECT ANSWERS HZV-SC, 0.65mL dose IIV-IM, 0.5mL What is meant by the term "immunization neighborhood"? - CORRECT ANSWERS Immunization stakeholders collaborate to meet community immunization needs. Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations? - CORRECT ANSWERS Immunizations should become part of the patient's permanent record and should be kept for the patient's lifetime. All Medicare Part B enrollees are covered for which vaccines? - CORRECT ANSWERS both pneumococcal vaccines influenza vaccine All Medicare Part D enrollees are covered for which vaccines? - CORRECT ANSWERS Td/Tdap HZV Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine? - CORRECT ANSWERS Td or Tdap 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: - CORRECT ANSWERS If he has not had 2 doses of the flu vaccine then he needs 2 doses, 4 weeks apart According to the ACIP, which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary? - CORRECT ANSWERS Diagnosis of chickenpox/shingles by a health care provider. Born in U.S. before 1980 2 doses of varicella at least 4 weeks apart Vaccines as well as exposure to natural disease are both examples of which type of immunity? - CORRECT ANSWERS Active immunity How vaccines evoke an immune response: - CORRECT ANSWERS The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells. *Pure polysaccharide vaccines do not activate B 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? - CORRECT ANSWERS Should be quarantined in fridge/freezer and marked "do not use" and contact manufacturer for further instructions *RPh should document each step anytime theres a break in the cold chain Which vaccine does ACIP recommend for all college freshmen, aged 21 years or younger, living in dormitories, who have not been previously vaccinated? - CORRECT ANSWERS One dose of MCV4 Prior to the introduction of a vaccine, what was the leading cause of bacterial meningitis in children younger than 5 years of age? - CORRECT ANSWERS Hib