APhA Immunization Course: 2023

Module 28: Which of the following statements would be appropriate for a pharmacy technician to make?

"We are now offering herpes zoster vaccines in the pharmacy."

Module 17: Refrigerated vaccines should be maintained at temperatures between:

35°F and +46°F

Module 14: Which of the following patients is eligible to receive their first dose of the rotavirus vaccine?

A 10-week-old presenting to the pediatrician for their 2-month well check.

Module 29: Which of the following best describes a public health department?

A department which helps prevent the start and spread of disease.

Module 19: In a patient experiencing anaphylaxis, pharmacists should administer epinephrine:

As a first-line treatment

Module 4: 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?

Assess

Module 6: Options to increase influenza vaccine effectiveness include:

Avoid vaccination in July and August to minimize chances of suboptimal immunity later in the season.

Module 24: Which of the following best describes how to roll with resistance?

Change strategies to avoid arguing with patients.

Module 7: 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.

Give PCV15 now, then give PPSV23 one year later.

Module 24: Health literacy is considered a part of which domain of social determinants of health?

Health care access

Module 26: Which of the following statements is true when operating a mass vaccination clinic?

If multiple vaccines are available, they should be administered at different stations.

Module 25: Which of the following vaccines would be best delivered in a mass vaccination clinic?

Influenza vaccine

Module 20: A standing order or protocol should include information about:

Managing medical emergencies that may occur after administration of a vaccine.

Module 15: Which COVID-19 vaccination has 2 doses administered 28 days apart?

Moderna

Module 27: Which of the following best describes immunization coalitions?

Organizations that bring together vaccination stakeholders to improve vaccination rates

Module 10: The whooping cough associated with pertussis occurs in this stage of disease:

Paroxysmal

Module 21: Which of the following is true regarding professional liability?

Pharmacists should educate and inform patients and their caregivers about the benefits and risks of vaccination.

Module 14: Which disease state(s) can potentially lead to meningitis?

Polio and Haemophilus influenzae

Module 29: Which of the following issues affecting international access to vaccines is best aligned to efforts by pharmacist volunteers?

Suboptimal levels of health care providers

Module 25: After the routine administration of a vaccine, the pharmacy technician should send documentation of the vaccination to:

The patient's primary care physician.

Module 23: The Vaccine for Children (VFC) program pays for which of the following?

The vaccine

Module 11: Which of the following correctly describes current ACIP recommendations?

The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age.

Module 29: Which of the following is a law or program that may grant immunity from civil liability during emergencies for covered activities?

U.S. Public Readiness and Emergency Preparedness Act

Module 21: The program which collects data regarding errors of vaccine handling and administration is called:

VERP

Module 26: Which of the following vaccines are best suited to a mass immunization clinic?

Vaccines to address a pandemic pathogen

Module 3: Which of the following vaccines listed is a live attenuated vaccine?

Varicella (VAR)

Module 9: A 25-year-old female comes to the pharmacy inquiring about the 9vHPV series. What would be the recommended vaccination series?

3 doses administered intramuscularly at 0, 1-2, 6 months

Module 22: Which of the following is NOT a benefit of a reminder and recall system?

Incentivizes patients to make a primary care appointment.

Module 19: Which of the following over-the-counter medications may be recommended to treat systemic reactions after vaccination?

NSAIDs and acetaminophen

Module 26: Which of the following functions should be performed prior to the mass vaccination clinic?

Ordering of adequate inventory of vaccines and supplies

Module 28: Which of the following statements is true regarding how pharmacy technicians can gather information about a patient's vaccination history?

Pharmacy technicians can review electronic health records.

Module 1: 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?

Prevention

Module 29: Which of the following is a non-governmental organization that participates in disaster relief efforts?

Red Cross

Module 24: Which of the following statements best illustrates the affirmation skill in motivational interviewing?

"Thank you for sharing your concerns with me, I enjoyed speaking with you today"

Module 20: Which of the following best describes a standing order?

A preapproved document signed by a collaborating physician who authorizes the pharmacist to administer a vaccine.

Module 19: Which of the following is considered a systemic symptom of anaphylaxis?

Diarrhea and vomiting

Module 21: The National Childhood Vaccine Injury Act of 1986 established national vaccine documentation requirements which include:

Edition date of the Vaccine Information Statement (VIS)

Module 22: Which statement is true regarding gloves and handwashing?

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.

Module 28: Which of the following is true about the pharmacy technicians' role in managing vaccine inventory?

Expiration dates and beyond use dates should be checked at least weekly.

Module 17: Why is it important to preserve the cold chain for vaccines?

Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency.

Module 5: 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?

Give 1 dose now as a catch up

Module 22: Which vaccine is required by OSHA to be offered to all employees with potential exposure to bloodborne pathogens?

Hepatitis B vaccine

Module 14: 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?

IPV

Module 20: An important benefit of standing orders and protocols is that they:

Improve patient access to vaccines and efficiency of services.

Pretest: Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine?

Inactivated polysaccharide vaccine

Module 7: How is streptococcus pneumoniae primarily transmitted?

Respiratory droplets or secretions

Module 28: Preparing a vaccine for administration may include which of the following tasks?

Selecting the needle for administering the vaccine.

Module 26: When promoting a mass immunization clinic it is helpful to:

Share appointment scheduling instructions, if applicable.

Module 1: Which of the following diseases have been eradicated worldwide, allowing vaccination to be discontinued?

Smallpox

Module 13: Which of the following is the primary reason we have measles outbreaks in the U.S.?

Unvaccinated people with measles coming to the U.S.

Pretest: Which of the following vaccines listed is a live attenuated vaccine?

Varicella (VAR)

Module 10: What is the recommended timing for Tdap during pregnancy?

27-36 weeks

Module 27: Which of the following is considered a print marketing strategy?

Flyers and brochures

Module 17: The cold chain for vaccines:

Must be maintained from manufacture until the vaccine is administered to the patient.

Pretest: Which of the following is true regarding risk for COVID-19?

Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications

Module 18: When administering a subcutaneous injection, pharmacists should:

Pinch a fold of skin over the triceps muscle

Pretest: Which of the following is true regarding the use of mRNA in vaccine technology?

mRNA is the genetic blueprint that tells your body how to make a particular protein subunit of a virus which, after being produced, leads to immune response

Module 24: Which of the following best describes the definition of "vaccine hesitancy"?

A delay in the acceptance of, or refusal of, a vaccination despite availability of vaccination services.

Module 12: What is youngest age that hepatitis B vaccine is recommended in infants and children?

At birth

Module 28: Which of the following activities should only be performed by a pharmacist?

Decide whether a patient needs a vaccine.

Module 9: 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?

HPV antibody test results

Module 12: Post-vaccination testing for hepatitis b immunity is recommended for which of the following?

Health-care workers

Module 27: Which of the following statements is true regarding forming relationships with other immunization stakeholders?

It can enhance your marketing efforts

Module 25: Which setting best facilitates the delivery of a mass vaccination clinic for the general population?

On-site community event

Module 11: Which of the following complications are correctly matched to the associated condition?

Postherpetic neuralgia-herpes zoster

Module 16: The first step in AHRQ's "SHARE" approach to vaccines is to:

Seek your patient's participation in a discussion.

Module 16: Vaccine hesitancy is defined as:

The delay in acceptance or refusal of a vaccination despite the availability of vaccination services.

Module 18: When administering an intramuscular injection, pharmacists should:

Use a 22- to 25-gauge needle.

Module 15: A contraindication to receiving a COVID-19 vaccination includes:

A known (diagnosed) allergy to a component of a COVID-19 vaccine.

Module 18: When reconstituting a vaccine for injection, pharmacists should:

Always refer to the vaccine's package insert for specific information.

Module 16: A simple way to communicate information about risks and benefits of vaccines to all patients is to:

Give them Vaccine Information Statements

Module 12: Which of the following vaccines contains a synthetic adjuvant?

Heplisav

Module 27: Which of the following awareness campaigns is typically conducted in December?

National Influenza Vaccination Week

Pretest: The whooping cough associated with pertussis occurs in this stage of disease:

Paroxysmal

Module 20: Which of the following statements about standing orders and protocols is true?

Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations.

Module 3: Which of the following statements is false regarding polysaccharide and conjugated vaccines?

The conjugate protein used, such as diphtheria, can also provide adequate protection against itself in addition to the polysaccharide.

Module 5: Based on the adult immunization schedule, at what age is the live attenuated influenza vaccine (LAIV) no longer recommended?

50 years

Module 18: When preparing vaccines for administration, pharmacists should:

Always use aseptic technique.

Module 22: The OSHA Exposure Control Plan is used by employers to achieve what goal?

Create a process of controls that aims to eliminate or minimize employee's potential exposure to bloodborne pathogens in the workplace.

Module 4: 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:

Create a reminder and recall system.

Module 19: An adverse event that is considered a systemic reaction to a vaccine is:

Fever

Module 6: Counseling on vaccine safety should include:

Fever, chills, malaise could occur within 6-12 hours post vaccination and may last up to 1-2 days.

Module 7: Which of the following is TRUE for the 23-valent pneumococcal polysaccharide vaccine (PPSV23)?

PPSV23 should not be given to children less than 2 years of age

Module 24: Which of the following best describes the preparation stage of the Transtheoretical Model of Health Behavior Change?

Patients intend to take action in the next month to change their behavior.

Module 8: An adolescent received his first meningococcal conjugate quadrivalent (MenACWY) vaccine at age 13 years, when should he receive his booster dose?

16 years

Module 10: DTaP is recommended to be administered using which of the following schedules?

2, 4, 6, 12-15 months, 4-6 years

Module 13: Which of the following individuals are contraindicated from receiving the MMR vaccine?

23-year-old in her 3rd trimester

Module 21: IISs have been shown to increase immunization rates and reduce vaccine-preventable diseases by:

Assisting in vaccination status assessment.

Module 6: Which of the following symptoms are usually associated with influenza?

Chills

Module 9: Which of the below statements regarding Human papillomavirus (HPV) serotypes is true?

High risk serotypes are estimated to cause 99% of cervical precancers

Module 5: Which of the following vaccines is not recommended during pregnancy?

Human papillomavirus vaccine (HPV)

Module 3: Pneumococcal polysaccharide vaccine (PPSV23) is best categorized as what type of vaccine?

Inactivated polysaccharide vaccine

Module 27: Which of the following is a source of free print materials that can be used to market vaccination services?

Infectious Diseases Society of America

Module 11: Which of the following is true regarding the recombinant herpes zoster vaccination?

It is indicated for prevention of herpes zoster and its complications in patients ≥50 years of age.

Module 9: 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?

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.

Module 5: Which of the following is TRUE of the emergency use authorization process?

Manufacturers must include a plan for safety monitoring

Module 2: Which of the following is an example of passive immunity?

Maternal antibodies

Module 15: Documentation requirements for COVID-19 vaccinations include:

Report administration data to your jurisdiction's system (e.g., IIS) within 72 hours after administration.

Module 18: To prevent errors of vaccine administration, pharmacists should:

Select the appropriate needle length.

Module 16: If patients believe that influenza vaccines can cause influenza because they were ill after receiving the vaccine last year, pharmacists should educate them that:

Some people experience systemic reactions to influenza vaccine that include mild flu-like symptoms

Module 15: Which of the following is true regarding 3rd dose and booster doses for COVID-19?

The third dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines.

Module 13: 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?

Yes, since there is a declared mumps outbreak.

Module 17: Which of the following vaccines must be frozen?

Zostavax

Module 21: Which of the following is an example of a common vaccine administration error?

Wrong vaccine, route, site, or dosage; or improperly prepared.

Module 23: What type of code is used to identify the diagnosis for a patient receiving a vaccine?

ICD-10

Module 25: A potential advantage of accommodating walk-in vaccines, compared with only scheduling appointments, is that:

It may allow greater flexibility and convenience for the patient.

Module 23: According to the Affordable Care Act, which of the following must be covered without cost-share to the patient?

An ACIP routinely recommended vaccine.

Module 19: Generalized urticaria following a vaccine is considered:

An allergic reaction

Module 7: For which of the following conditions are both PCV13 and PPSV23 recommended?

Asplenia

Module 15: Which if the following is true regarding transmission of SARS-CoV-2?

Infected individuals who may be presymptomatic, asymptomatic, or symptomatic can transmit the virus.

Module 1: The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as:

Integral to increasing vaccination rates

Module 5: Which of the following vaccines is contraindicated for an adult patient with HIV and a CD4 count <200 mm2?

Measles, mumps, rubella (MMR)

Module 23: 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 till it is covered by Medicare at 65 years?

Now because it must be covered at no cost by commercial insurance.

Module 26: Which of the following facility features is most important for maintaining the cold chain?

Space for vaccine storage and temperature monitoring

Module 12: ACIP recommends the hepatitis A vaccine be administered to all children starting at which age?

12 months

Module 13: 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?

2

Module 25: A pharmacy technician may perform which of the following roles?

Ask patients to complete screening questionnaires.

Module 22: 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?

Create a network with local physicians to refer patients to the new immunization program.

Module 20: Which of the following organizations provides standing order templates?

Immunization Action Coalition

Pretest: Which of the following is true of the emergency use authorization process?

Manufacturers must include a plan for safety monitoring

Module 29: Which of the following is a government-run volunteer organization for medical and public health professionals?

Medical Reserve Corps

Module 23: Which of the following requires no cost share for the patient and is mainly for those 65 years and older?

Medicare Part B

Module 13: A young adult presenting with swelling of the parotid glands most likely has which of the following diseases:

Mumps

Pretest: A young adult presenting with swelling of the parotid glands most likely has which of the following diseases:

Mumps

Module 3: 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.

Adjuvants

Module 13: 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?

1 week

Module 8: The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with the meningococcal conjugated quadrivalent vaccine (MenACWY) in which of the following age groups?

11-12 years of age

Module 14: Although the primary series for Hib varies between 2-3 doses, all vaccines are recommended to have a booster dose at age:

12-15 months

Module 2: How long does it take for the immune system to provide protection by producing disease-specific antibodies and memory cells?

14 days

Module 5: 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?

16 weeks

Module 2: Children less than what age do not mount an adequate immune response to t-cell independent immunity?

2 years

Module 9: What percentage of HPV infections are cleared by the body and do not develop to CIN2 or CIN3?

70 %

Module 6: Which of the following patient scenarios regarding influenza vaccination is correct?

A 65-year-old patient with thimerosal allergy would be eligible to receive adjuvanted inactivated Fluad or high dose inactivated Fluzone.

Module 4: Which of the following statements best meets the definition of precaution?

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.

Module 8: Which of the following is a potential long term complication from meningococcal disease?

Amputations

Module 2: Which of the following is found in vaccines to evoke an immune response?

Antigens

Module 11: Which of the following are true regarding vaccine efficacy and safety for the live varicella vaccine and the recombinant zoster vaccine?

Both vaccines have over 90% effectiveness in prevention of disease after two doses.

Pretest: Which of the following symptoms are usually associated with influenza?

Chills

Module 12: Which of the following is a clinical feature of hepatitis B but not hepatitis A?

Chronic infection

Module 2: Why is spacing and timing of vaccines important?

Circulating antibodies may interfere with immune response

Module 8: What type of vaccine is meningococcal quadrivalent vaccine?

Conjugate

Module 4: 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?

Diagnosis-based screening

Module 10: Which of the following is the most common type of tetanus?

Generalized

Module 8: Which of the following scenarios is an appropriate shared clinical decision-making for meningococcal vaccine?

Healthy 16 year old who received meningococcal B vaccine

Module 1: Under the direction of the US Department of Health and Human Services, the Healthy People initiative has identified the following as a goal for 2030:

Increase the proportion of persons who are vaccinated annually against seasonal influenza

Module 16: Post-vaccination counseling for patients should include:

Information about adverse reactions that require contact with the health care system

Pretest: The National Vaccine Advisory Committee 2013 Standards for Adult Immunization Practice and the 2016 International Pharmaceutical Federation global report identify pharmacists as:

Integral to increasing vaccination rates

Module 6: Which of the following are true regarding the influenza virus?

It is transmitted through respiratory droplets that contain the virus.

Module 3: 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?

MMR and PCV13 may be administered simultaneously or at any interval between doses.

Module 1: Opportunities for Advocacy and Collaboration include:

Membership in state Immunization coalition to serve as an expert on policy and practice issues affecting pharmacy

Module 5: 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?

MenACWY

Module 15: Which of the following is true regarding risk for COVID-19?

Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications.

Module 7: A healthy 70-year-old female who received PPSV23 at 66-years of age is inquiring about pneumococcal vaccination. Her pneumococcal conjugate vaccine history is unknown. Which of the following should you recommend?

One dose of either PCV20 or PCV15.

Module 7: A 3-year old 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?

PPSV23

Module 4: 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?

Patient's age, current health, vaccine history, and allergies

Module 11: Which of the following is true regarding varicella zoster transmission?

Period of contagiousness: 1-2 days before rash to 4-7 days later.

Module 12: Which of the following is the reason for the most recent hepatitis A outbreaks?

Person-to-person transmission

Module 14: Which vaccination is NOT part of a combined antigen vaccine?

Rotavirus

Module 10: Which of the following vaccines is used as a booster every 10 years?

Td

Pretest: When storing vaccines in the refrigerator, pharmacists should:

Use water bottles to help stabilize temperatures

Module 17: When storing vaccines in the refrigerator, pharmacists should:

Use water bottles to help stabilize temperatures.