Immunization questions
Which of the following is incorrect regarding vaccine storage? A Cholera vaccine must be stored in the refrigerator. B MMR vaccine can be stored in the refrigerator. C MMR vaccine can be stored in the freezer. D Vivotif must be stored in the refrigerator. E MMRV vaccine must be stored in the freezer.
A Vaxchora is oral cholera vaccine that must be stored in the freezer prior to reconstitution with water
What type of refrigerator does not have reliable temp control?
A small fridge with freezer compartment in the top of the fridge
29 yo, first pharmacist job in hospital since finishing school. She completed Hep B series during pharmacy school. Mom reports she is the only child who did not contract chickenpox. What vaccines should she get now? A. Flu, seasonally B. Tdap, if no record of previous booster C. Varivax D. Cervarix E. Hib vaccine
A, B, C Unusual not to have contracted chickenpox, must if it is the case, recommended to get vaccine. It has been out since '95
A child with sickle cell disease has not been vaccinated for meningococcal disease. Which of the following is true regarding meningococcal disease/vaccine? (Select ALL that apply.) A Quadrivalent meningococcal vaccines include Menactra and Menveo B The damage to the spleen caused by sickle cell disease puts this patient at risk for meningococcal disease. C This patient should receive Trumenba or Bexsero once he turns 10 years old. D Under current recommendations this patient will require repeated vaccination (boosters) every 5 years. E Meningococcal vaccine is a routine childhood series given to all infants.
A, B, C, D
Which of the following patients should receive pneumovax 23 before age 65? A. Diabetes B. Asthma C. Smokes D. Heart failure E. History of meningitis
A, B, C, D These patients are considered immunocompetent but at higher risk for pneumococcal disease
Which of the following groups ages 6 - 64 years should receive Prevnar 13 followed by Pneumovax 23 at least 8 weeks later and then Pneumovax 23 again 5 years after the first dose? (Select ALL that apply.) A A patient with HIV infection. B A patient with chronic renal failure undergoing hemodialysis 3 times weekly. C A solid organ transplant recipient. D A patient with heart failure. E A patient with multiple myeloma about to begin treatment.
A, B, C, E
Which of the following statements are correct concerning the prevention of typhoid? (Select ALL that apply.) A Vivotif is a capsule formulation, and requires refrigeration. B Typhoid is transmitted by mosquitos; attempt to reduce exposure. C Typhoid vaccine comes as oral capsules or as an IM injection. D Typhoid vaccine is mostly a concern for travelers to the United States. E Vaccination must be completed within 24 hours of travel to be effective
A, C
AD is a 12 month old female with sickle cell disease who is at the clinic for a routine visit. She will receive her 4th dose of pneumococcal vaccine. Which of the following statement/s is/are accurate regarding the vaccine she will receive today? (Select ALL that apply.) A She will receive Prevnar 13 B She will receive Pneumovax 23 C She will receive pneumococcal conjugate vaccine, 13-valent D She will receive pneumococcal polysaccharide vaccine, 23-valent E She will receive Prevnar 23
A, C When she is > 2 years old she can receive polysaccharide form
Which of the following could interfere with the effectiveness of a dose of Zostavax? (Select ALL that apply.) A Acyclovir B Denavir C Valtrex D MMR given 2 weeks prior to the Zostavax E Oseltamivir
A, C, D Antivirals against herpes virus within 24 hours before or 14 days after
Which vaccines contain hepatitis B vaccine only? (Select ALL that apply.) A Engerix-B B Twinrix C Havrix D Pediarix E Recombivax-HB
A, E
What does the "a" in DTaP stand for?
Acellular, meaning that the pertussis component of the vaccine contains only part of the organism.
Sickle cell disease patients are considered ______ and render both forms of meningococcal vaccine which are?
Asplenic Quadrivalent (ACWY) and serogroup B vaccines
Select the group of patients which the hepatitis B vaccine is recommended. A. 66 yo with HF and 35 yo with history of IV drug use B. 58 yo with diabetes, 39 yo on dialysis and infant both 12 hours ago C. 44 yo with HIV, 31 yo surgery resident D. 39 yo with cirrhosis, 18 yo leaving for college E. 52 yo post splenectomy, 28 yo with multiple sexual partners
B *recommended in: infant w/in 24 hours of birth, all healthcare workers exposed to blood on job, chronic liver disease, diabetes, HIV, end-stage renal disease, multiple sexual partners, IV drug user*
Which of the following is not a live vaccine? A Vaxchora B Typhim Vi C Flumist D RotaTeq E Yellow fever vaccine
B -Both rotavirus vaccines (RotaTeq and Rotarix) and the cholera vaccine are live, oral vaccines. -Vivotif is the oral, live typhoid vaccine. -Yellow fever vaccine (YF-VAX) is given SC and is contraindicated with severe egg or gelatin allergy. -Typhim Vi is the polysaccharide typhoid vaccine, it is inactivated and and is given IM.
What is true regarding the zostavax vaccine? A. Store unused powder in fridge B. Store unused powder in freezer C. Once reconstituted the vaccine must be used within 30 min or discarded D. Diluent must be stored in fridge only E. Vaccine is adminsted IM or SC
B, C *diluent in fridge or room temp and only given SC*
Which of the following should receive Bexsero? A. 6 yo w/ sickle cell disease B. 19 yo college campus during a meningitis serogroup B outbreak C. 25 yo with HIV D. 10 yo with sickle cell disease E. 38 yo person traveling to meningitis belt of Africa
B, C, D -Indicated for > 10 yo -Recommended for patients with asplenia, sickle cell disease, HIV or during outbreak -MenACWY vaccine but *not* the MenB vaccine is recommended for travelers to meningitis belt
Which of the following statements concerning the recombinant vaccine Flublok are correct? (Select ALL that apply.) A If a patient wishes to receive Flublok and they have had a severe reaction to eggs (anaphylaxis) they cannot receive Flublok in the pharmacy. B Flublok is produced with recombinant DNA techniques and is completely free of egg products. C Flublok is given subcutaneously. D Flublok is preferred in children < 8 years old. E Flublok is approved for use in patients 18 years and older.
B, E
Which are true regarding steroid-induced immunosuppression A. Beclomethasone inhaler BID for at least 4 weeks B. HIV patient C. Adult who received 4 mg dexamethasone daily for past 3 weeks D. 11.8 kg receiving 30 mg prednisolone for 22 days E. Triamcinolone intra-articular injection
C, D
A pharmacist is preparing an injection for a male patient, 63 years old, who weighs 280 pounds. The pharmacist is going to administer the Zostavax vaccine. Which of the following statements concerning Zostavax injection is correct? (Select ALL that apply.) A Use a needle at least 1.5" long. B The vaccine must be reconstituted prior to use with sterile or bacteriostatic water. C Zostavax will help protect the patient against developing a herpes zoster outbreak. D Zostavax is recommended in patients who have had shingles before. E This vaccine is administered subcutaneously in the fatty tissue over the triceps.
C, D, E
Mother of 11 mo son asks if he will receive thimerosal from vaccines. Select correct statements. A. Children whose parents do not wish to vaccinate will be okay if they live in urban centers where they are protected from herd immunity B. While it is true thimerosal is contained in most childhood vaccines, it is not linked to autism C. Instruct mother to avoid vaccines in her children D. Thimerosal may be present in multi-dose influenza vaccines and can be avoided upon request E. A link between vaccines and autism has show to be invalid. pharmacist should promote vaccines to reduce disease spread.
D, E *not in many childhood vaccines, but some multi dose vials have trace amount*
Which of the following vaccine names is not correctly matched? A Adacel = tetanaus diphtheria pertussis vaccine B Fluad = Influenza vaccine C Trumenba = Meningococcal serogroup B vaccine D Vaxchora = Cholera vaccine E Hiberix = Hepatitis B vaccine
E Hiberix is a H. influenzae type B vaccine.
Exposure to which of the following commonly requires administration of immune globulin at the time of vaccination? A Pertussis B Cholera C Epstein-Barr virus D HPV E Rabies
E Immune globulin is a form of passive immunity that is given for quick protection, since it takes 2 weeks for protective antibodies to be made. Rabies vaccine is not a routine vaccine, so nearly all patients will require rabies IgG to be given with the first dose of rabies vaccine (Rabavert) to protect the patient until antibody production is underway.
The MMR vaccines provides passive immunity (T/F)
FALSE Active immunity
Receiving a live vaccine before a tuberculin skin test can cause what?
False-negative result, leading to untreated tuberculosis, which is a public health issue
Vaqta generic name?
Hepatitis A vaccine Havrix is other brand name
Fluad is?
High-dose for > 65 yo
Where can a pharmacist who runs out of VIS forms get copies?
Immunization Action Coalitions website CDC website
A 62 year old male underwent a splenectomy secondary to refractory thrombocytopenia. Which vaccine should he receive at least 2 weeks before this procedure?
Menactra (meningococcal vaccine) *not menhibirix, used for kids 6 weeks to 18 months*
What is Bexsero?
Meningococcal vaccine, Group B
How is the shingles and chickenpox vaccine given?
Mix diluent with powder, draw it up and vaccine must be used quickly, NOT stored Given SC
The CDC does not recommend using acetaminophen before or at vaccination as it may decrease immune response; it can be used afterwards if needed for mild pain and/or fever. (T/F)
TRUE
If a patient has an anaphylactic reaction to a vaccine, where is it reported?
VAERS (vaccine adverse events reporting system)