Vaccination Exam
Which of the following patients is a candidate for recombinant zoster vaccine (RZV)? Select all that apply. -A 48-year-old male recently diagnosed with cancer who will start chemotherapy in two weeks -A 62-year-old female with autoimmune hepatitis controlled with prednisone 30 mg daily -A 68-year-old male with COPD treated with inhaled fluticasone/salmeterol -A 78-year-old female receiving anti-rejection drugs for a kidney transplant two years ago
-A 48-year-old male recently diagnosed with cancer who will start chemotherapy in two weeks -A 62-year-old female with autoimmune hepatitis controlled with prednisone 30 mg daily -A 68-year-old male with COPD treated with inhaled fluticasone/salmeterol -A 78-year-old female receiving anti-rejection drugs for a kidney transplant two years ago
Which of the following individuals is Tdap recommended? (select all that apply) -A 65-year-old female (caring for her newborn granddaughter) with no documentation of having received Tdap in the past -A 12-year-old female who completed the childhood DTaP series -A 30-year-old pregnant female of 32 weeks gestation
-A 65-year-old female (caring for her newborn granddaughter) with no documentation of having received Tdap in the past -A 12-year-old female who completed the childhood DTaP series -A 30-year-old pregnant female of 32 weeks gestation
Classify the following combinations as a precaution or contraindication to vaccination. -Anaphylaxis to a dose of vaccine and a subsequent dose of that vaccine -Moderate acute illness without fever and any vaccine -Severe immunosuppression and live attenuated vaccines -History of intussusception and rotavirus vaccine -Family history of seizures and MMRV vaccine
-Anaphylaxis to a dose of vaccine and a subsequent dose of that vaccine (Contraindication) -Moderate acute illness without fever and any vaccine (Precaution) -Severe immunosuppression and live attenuated vaccines (Contraindication) -History of intussusception and rotavirus vaccine (Contraindication) -Family history of seizures and MMRV vaccine (Precaution)
The primary vaccine coordinator at a practice site should be responsible for: (select all that apply) -Ensuring that staff is adequately trained -Administering all vaccines at the practice site -Ensuring that vaccines are stored and handled correctly
-Ensuring that staff is adequately trained -Ensuring that vaccines are stored and handled correctly
Match the potential adverse reaction to a vaccine with the category of reaction. -Pain at the injection site -Headache -Swelling at injections site -Fever -Redness at injection site -Anaphylaxis
-Pain at the injection site: local -Headache: systemic -Swelling at injections site: local -Fever: systemic -Redness at injection site: local -Anaphylaxis: allergic reaction
What is the threshold dose of prednisone at which a patient is considered immunosuppressed? -10 mg per day for 5 days or longer -20 mg per day for 3 months or longer -10 mg per day for 14 days or longer -20 mg per day for 5 days or longer -20 mg per day for 14 days or longer
20 mg per day for 14 days or longer
Temperature and freezer logs must be kept for a period of at least: -7 year -1 year -3 years -5 years
3 years
Which of the following patients is a candidate for varicella vaccine? -6-month-old who needs IIV4 simultaneously and again in 28 days -12-month-old who received MMR two weeks ago -5-year-old who received DTaP four weeks ago -37-year-old pregnant female
5-year-old who received DTaP four weeks ago
Which of the following patients should receive one dose of pneumococcal conjugate vaccine (PCV20)? -40-year-old with hypertension -12-year-old needing catch up for the 4th dose of the childhood PCV series -6-month-old receiving the 3rd dose of the childhood PCV series -65-year-old with diabetes who received PPSV23 5 years earlier
65-year-old with diabetes who received PPSV23 5 years earlier
For immunocompromised adults 19 years of age and older who receive both PCV15 and PPSV23, what is the minimum time interval recommended for separation of administration of the two vaccines? -8 weeks -1 year -No separation needed, simultaneous administration recommended -5 years
8 weeks
For which of the following individuals is live attenuated influenza vaccine (LAIV) recommended? -A 52-year-old patient with asthma -A 35-year-old pregnant patient -A 10-year-old patient with a fear of needles -A 6-month-old healthy infant
A 10-year-old patient with a fear of needles
Which of the following patients is the best candidate for hepatitis A vaccine? -A 6-month-old female presenting to the pediatrician for the 6-month wellness exam -A 15-month-old male also receiving a 3rd dose of hepatitis B vaccine -A 25-year-old male college student preparing to study abroad in Canada -A 45-year-old female daycare employee
A 15-month-old male also receiving a 3rd dose of hepatitis B vaccine
For which of the following patients is the human papillomavirus vaccine series indicated? -A 65-year-old female who has a sister with cervical cancer -A 50-year-old male with a history of genital warts -A 16-year-old female who recently became sexually active -A 5-year-old female who presents for a well child visit prior to entering school
A 16-year-old female who recently became sexually active
For which of the following individuals is inactivated influenza vaccine (IIV) NOT recommended? -A 62-year-old female who sneezes when in contact with feathers -A 2-month-old healthy infant -A 28-year-old female who is in her first trimester of pregnancy -A 68-year-old male who received a heart translate 6 years ago
A 2-month-old healthy infant
Which of the following individuals is a mumps vaccine recommended? -A 65-year-old who is healthy and has no record of every receiving a dose of MMR A 12-year-old who received a single dose of MMR at age 12 months and has been taking prednisone 40 mg daily for the past month for inflammatory bowel disease -A 26-year-old female who received a single dose of MMR at age 12 months and is pregnant -A 22-year-old female who received a single dose of MMR and just accepted a position as a nurse on a general surgery unit
A 22-year-old female who received a single dose of MMR and just accepted a position as a nurse on a general surgery unit
For which of the following patients should the influenza vaccine be delivered in a medical setting under supervision of a healthcare provider experienced in recognition and management of severe allergic reactions? -A 30-year-old man with a history of wheezing and vomiting after eating eggs -A 50-year-old woman with asthma -A 44-year-old man that experienced hives after eating eggs -A 24-year-old woman with no co-morbidities
A 30-year-old man with a history of wheezing and vomiting after eating eggs
For which of the following patients should the influenza vaccine be delivered in a medical setting under supervision of a healthcare provider experienced in recognition and management of severe allergic conditions? -A 44-year-old man that experienced hives after eating eggs -A 30-year-old man with a history of wheezing and vomiting after eating eggs -A 50-year-old woman with asthma -A 24-year-old woman with no co-morbidities
A 30-year-old man with a history of wheezing and vomiting after eating eggs (The influenza vaccine (any formulation otherwise appropriate for age and health status) should be delivered in a medical setting if the patient has had any symptoms of an anaphylactic reaction after eating eggs. If the reaction is only hives, these extra precautions are not required.)
For which of the following individuals would it be acceptable to use live attenuated influenza vaccine? -A 13-year-old girl with asthma -A 50-year-old construction worker with type 2 diabetes -A 48-year-old healthy mechanical engineer whose spouse has type 2 diabetes -A 19-month-old healthy child
A 48-year-old healthy mechanical engineer whose spouse has type 2 diabetes
Following the ACIP guidelines, for which of the following individuals is recombinant zoster vaccine recommended? -A 45-year-old patient recovering from shingles rash -A 52-year-old patient with active shingles rash lesions -A 35-year-old patient with an anaphylactic reaction to neomycin -A 60-year-old patient who had chickenpox at age 7
A 60-year-old patient who had chickenpox at age 7
Which of the following individuals has a risk factor for poor response to the hepatitis B vaccine series? -A newborn infant who is apparently healthy -A 16-year-old female with asthma -A 21-year-old paramedic -A 66-year-old male who is waiting for a cadaveric kidney transplant
A 66-year-old male who is waiting for a cadaveric kidney transplant
Which of the following is a CDC best practice in regards to vaccine storage and handling? -Refrigerator and freezer temperatures only need to be monitored once daily even if the temperature-monitoring device does not have a maximum/minimum display -A bio-safe glycol-based or buffered thermometer should be used to monitor the temperature of the refrigerator -Refrigerated vaccines should be kept on the top shelf of the refrigerator -One pharmacy employee should be designated to be in charge of storage and handling in case of a temperature related emergency
A bio-safe glycol-based or buffered thermometer should be used to monitor the temperature of the refrigerator
Which of the following is NOT a permanent contraindication to vaccination? -For rotavirus vaccine, severe combined immunodeficiency or history of intussusception -Severe allergic reaction to a vaccine component or following a prior dose -A condition which would compromise the ability of the vaccine to produce immunity or protection from infection -Encephalopathy not due to another identifiable cause occurring within 7 days of pertussis vaccination
A condition which would compromise the ability of the vaccine to produce immunity or protection from infection
Which is true about the incidence of measles in the U.S.? -Measles incidence is usually around 200 cases annually -A majority of cases are a result of importation in unvaccinated populations -A 2-dose series is required for anyone born before 1957 when traveling -When traveling international with an infant, do not worry about their vaccine status
A majority of cases are a result of importation in unvaccinated populations
Vaccination is a form of [ ] immunity -Passive -Active
Active
[ ] immunity is protection produced by the person's own immune system -Passive -Active
Active
Which of the following is an example of passive immunity? -Administration of a live attenuated viral vaccine -Administration of a recombinant immunogenic protein -Administration of high titer immune globulin -Infection with natural disease
Administration of high titer immune globulin (Active immunity is protection that is produced by the person's own immune system. One way to acquire active immunity is to survive infection with the disease-causing form of the organism. Another way to produce active immunity is by vaccination. The example of administration of immune globulin is an example of passive immunity.)
A mother is considering vaccination for her young son, but some commercials that she recalls lead her to believe this vaccine is for prevention of cervical cancer, and does not see how this will benefit her son. How do you explain to this mother the importance of this vaccine for her son? -Yes, this does prevent cervical, vulvar, and vaginal cancer in women; however, it also protects against genital warts, anal cancer, as well as other cancer strains in men -There are benefits for protection for him contracting strains of virus as well as spreading the virus to others -This is the most common sexually transmitted infection -All of the above
All of the above
Hepatitis B is a virus spread by parenteral routes including blood transfusions, sharing of needles, sexual contact, and mother to neonate. Which is true about hepatitis B? -Renal failure will decrease response to hepatitis B vaccine -Patients with diabetes are at an increased risk of hepatitis B due to sharing of diabetes supplies including blood glucose meters -Using needles which are not long enough will decrease response rates to the vaccine -Death commonly occurs as a result of cirrhosis and hepatocellular carcinoma -All of the above
All of the above
Which of the following is a valid contraindication to vaccination? -Allergies to products not in vaccine -Syncope after a previous vaccination -Minor acute illness -Anaphylaxis after a previous dose or vaccine component
Anaphylaxis after a previous dose or vaccine component
Which of the following is a contraindication to receipt of routine vaccines? -Patient is taking an antibiotic -Anaphylaxis to a previous dose -Patient is brestfeeding -Allergy to penicillin
Anaphylaxis to a previous dose
Which of the following scenarios are healthcare professionals encouraged to use Vaccine Adverse Event Reporting System (VAERS) for reporting? -Serious adverse reactions for which causation is firmly established -Any clinical significant adverse event after vaccination -Only adverse reactions that have not been previously reported -Only serious, life-threatening adverse reactions
Any clinical significant adverse event after vaccination
How should the disposal of sharps containers be handled? -They are of little concern because of the puncture-proof nature of the containers -Dispose routinely with the regular garbage pickup -Arranged with the local waste management company -Done when the container is full to the top
Arranged with the local waste management company
For how long after completing chemotherapy or radiation must a person wait before receiving a live vaccine? -At least 3 months -No waiting period needed -At least 4 weeks -At least 6 months
At least 3 months
What is the correct interval between two live vaccines? -At least 4 weeks -At least 4 months -No interval needed -At least 4 days
At least 4 weeks
Which type of cells replicate upon re-exposure to an antigen to reestablish protection? -B-cells -T-cells
B-cells
Which of the following skills is among the standards of practice among immunizing pharmacists? -Advanced cardiac life support -Emergency medical technician -First aid training -Basic life support (BLS)
Basic life support (BLS)
Which of the following is a meningococcal serogroup B vaccine? -Bexsero -Boostrix -Engerix-B -Menveo
Bexsero
Which of the following is specifically listed as a VAERS reportable event for tetanus vaccine? -Brachial neuritis -Thrombocytopenic purpura -Chronic arthritis -Encephalopathy
Brachial neuritis
Which of the following is the appropriate schedule for polio immunization in the United States? -Childhood immunization series with IPV at 2, 4, 6-18 months of age -Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age with a booster dose every 10 years -Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age -Not used anymore because disease is almost eradicated
Childhood immunization series with IPV at 2, 4, 6-18 months, and 4-6 years of age
Which of the following is likely benefit of annual influenza immunization of school-aged children? -Changes resistance patterns in influenza viruses -Causes school absenteeism around immunization time that will be offset by the decrease in absenteeism during peak influenza season -Decreases the magnitudes of influenza epidemics in the community -Dramatically decreases the high rates of mortality of influenza in this population
Decreases the magnitudes of influenza epidemics in the community
Which of the following statements is true? -Immunizers must finish the hepatitis B vaccine series prior to providing immunizations -Employees do not have the right to decline hepatitis B vaccination -Employers must offer the hepatitis B vaccine series to immunizing employees free of charge
Employers must offer the hepatitis B vaccine series to immunizing employees free of charge
Which of the following is true regarding bloodborne pathogen exposure and immunizations? -Providing immunizations is a high risk activity for exposure -The FDA is the main authority providing guidance on minimizing exposure -Every pharmacy providing immunizations must have a bloodborne pathogen exposure control plan -No extra immunizations or training need to be offered to employees that provide immunizations
Every pharmacy providing immunizations must have a bloodborne pathogen exposure control plan
Anaphylaxis generally will not occur until 1-2 hours after administration of a vaccine -True -False
False
Chemically linking (conjugate) a protein to a polysaccharide vaccine makes the vaccine less potent -True -False
False
If a patient has a history of contact dermatitis from neomycin, they cannot receive vaccines that contain neomycin -True -False
False
If the date on the label of a vaccine or diluent has a specific month and year, the vaccine can be used only until the first day of the month listed. -True -False
False
In general, the first dose of an inactivated vaccine usually provides protection -True -False
False
Per OSHA (Occupational Safety and Health Administration), bloodborne pathogens training must be completed every 2 years for immunizers -True -False
False
Polio is currently considered eradicated worldwide. -True -False
False
Increasing the interval between doses of a multi-dose vaccine diminishes the effectiveness of the vaccines. -True -False
False (Available data indicate that intervals between doses that are longer than those routinely recommended do not affect seroconversion rates or titer when the schedule is completed. It is not necessary to restart the series or add doses because of an extended interval between doses. The only exception to this is the oral typhoid vaccine.)
Which of the following influenza vaccines is produced using no eggs and no influenza virus? -Flumist (LAIV4) -Fluzone High-Dose (HD-IIV4) -Afluria (IIV4) -Flublok (RIV4)
Flublok (RIV4)
Which combination of vaccines can be administered at the same visit? -Prevnar 12 and Menactra -Varivax and smallpox -Fluzone and Shingrix -Prevnar 13 and Pneumovax 23
Fluzone and Shingrix
Which of the following is a contraindication to receipt of the rotavirus vaccine? -History of anaphylaxis to eggs -History of intussusception -History of Guillian-Barre Syndrome -Receipt of another live attenuated vaccine on the same day
History of intussusception
Which manifestation of anaphylaxis is epinephrine used to treat? -Decreased oxygen saturation -Arrhythmias -Hemorrhage -Hypotension
Hypotension
Which of the following are inactivated vaccines? -LAIV, PCV20, RZV -IIV4, PPSV23, Tdap -MMR, Tdap, IIV4 -Hepatitis B, Hib, MMR
IIV4, PPSV23, Tdap
Joseph, a healthy 55-year-old male, is employed as a pharmacist at a chain pharmacy. The chain pharmacy will be implementing a corporate immunization program this October. Joseph wants to make sure he is up-to-date on his immunizations before the program begins. He has received no vaccinations since childhood. Which of the following vaccines are recommended to this patient? -RZV, LAIV, Hepatitis B -RZV, Td, PPSV23, Hepatitis A -IIV4, Td, 9vHPV, PPSV23 -IIV4, Tdap, Hepatitis B, RZV
IIV4, Tdap, Hepatitis B, RZV
Which of the following antibody classes is the mediator of allergy and anaphylaxis? -IgA -IgE -IgG -IgM
IgE
Which of the following antibody classes is the mediator of allergy and anaphylaxis? -IgG -IgM -IgA -IgE
IgE
Which type of vaccine CANNOT causes disease from infection, even in an immunodeficient person? -Live attenuated -Inactivated
Inactivated
Which type of vaccine produces mostly a humoral response? -Live attenuated -Inactivated
Inactivated
Which of the following is an advantage of immunization in nontraditional settings, such as a pharmacy? -Higher cost of immunization to the patient -Increased access and convenience for the patient -Consolidated immunization records for the patient -Decreased public awareness regarding vaccinations
Increased access and convenience for the patient
Which of the following describes the benefits of using standing orders for immunization? -Is generally perceived as substandard practice by immunization policy making bodies -Limits liability of all healthcare providers -Increases immunization coverage among adults in a variety of practice settings -Makes immunization less costly
Increases immunization coverage among adults in a variety of practice settings
In general, which of the following is true? -Increasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine -Decreasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine
Increasing the interval between doses of a multi-dose vaccine does not diminish the effectiveness of the vaccine
Which of the following is the appropriate timing for influenza vaccine administration? -Live attenuated influenza vaccine (LAIV) can be administered as early as August, but inactivated influenza vaccine (IIV) should not be administered earlier than October 15 -Influenza vaccine should be administered no sooner than September or October and should continue throughout the season -Influenza vaccine should be administered only from October 15 until December 31 -Influenza vaccine should be administered as soon as the clinician has a vaccine supply but should stop no later than October 31
Influenza vaccine should be administered no sooner than September or October and should continue throughout the season
Which of the following most accurately describes the federally-mandated training for employees with blood and body fluid exposure? -Initial training and annual retraining are required for bloodborne pathogens -Use of safer injection devices may be included in initial training only -A handout alone can be used for retaining -A standardized training program must be delivered to all employees regardless of exposure risk
Initial training and annual retraining are required for bloodborne pathogens
Most, but not all, states allow student pharmacist interns to administer vaccines. Which of the following is/are true in regards to student pharmacist immunization? -An intern can delegate administration of a vaccine to a technician -Interns who provide immunizations must be current in CPR and blood borne pathogens training -Interns do not need to complete a certification course if the supervising pharmacist is certified -None of the above are true
Interns who provide immunizations must be current in CPR and blood borne pathogens training
The liquid diluent for recombinant zoster vaccine (RZV): -Is distilled water -Is 0.9% sodium chloride -Should be stored in the freezer -Is AS01B adjuvant suspension
Is AS01B adjuvant suspension
Which of the following is true regarding the use of Haemophilus influenzae type b vaccine? -Is a polysaccharide vaccine conjugated to a protein to improve immunogenicity in infants -Is indicated in patients with COPD -Is administered as a single dose to infants with a repeat dose prior to entering school -All of the above
Is a polysaccharide vaccine conjugated to a protein to improve immunogenicity in infants
Which type of vaccine usually produces immunity with one dose? -Live attenuated -Inactivated
Live attenuated
Which types of vaccine should NOT be given to patients with immunodeficiency? -Live attenuated -Inactivated
Live attenuated
Which of the following vaccines is contraindicated for a pregnant women? -Inactivated influenza vaccine (IIV) -23-valent pneumococcal polysaccharide vaccine (PPSV23) -Tetanus, diphtheria, pertussis vaccine (Tdap) -Live attenuated influenza vaccine (LAIV)
Live attenuated vaccine (LAIV) (Tdap is specifically recommended for pregnant women more than 20 weeks' gestation. PPSV23 is not indicated to be given to pregnant patients, but is not necessarily contraindicated either (would likely wait when indicated until patient is postpartum). IIV is indicated for pregnant patients.)
Which of the following vaccines is administered via the subcutaneous route? -Hepatitis B -MMR -Td -IIV4
MMR
The recommendations for prevention of vaccine preventable diseases made by the Advisory Committee on Immunization Practices (ACIP) are published in which of the following? -The Annals of Internal Medicine -Morbidity and Mortality Weekly Report (MMWR) -Immunofacts -The New England Journal of Medicine (NEJM)
Morbidity and Mortality Weekly Report (MMWR)
Which of the following is/are true regarding live attenuated vaccines? -More than one live attenuated vaccine can be given at the same visit -They are stronger versions of the "wild" virus -Live attenuated vaccines generally have milder reactions versus inactivated vaccines -All of the above
More than one live attenuated vaccine can be given at the same visit (Live vaccines are an attenuated (weakened) form of the "wild" virus. The vaccine must replicate to produce an immune response. The immune response is virtually identical to natural immunity and usually will produce immunity with one dose (except those administered orally). Severe reactions are possible and they are fragile and must be stored and handled carefully. More than one live attenuated vaccine can be given during the same visit. However, after that, live vaccines must be separated by a minimum of 28 days.)
Refrigerator and freezer temperature(s): -Must be checked three times daily -Logs should be posted near the pharmacist work station -Logs must be kept on hand for 7 years -Must be maintained between +35 and +46F and -58 and +5F respectively
Must be maintained between +35 and +46F and -58 and +5F respectively
Which of the following describes a limitation of the quadrivalent meningococcal conjugate vaccine? -No protection from serogroup B -Associated with a high risk of Guillain-Barre syndrome -Requires multiple doses to induce protection from infection -Licensed only for use in young children up to 7 years
No protection from serogroup B
All women should optimally receive one dose of Tdap when? -Pregnant women should not receive the vaccine -Optimally between 27 and 36 weeks gestation of their first child -After the birth of their first child -Optimally between 27 and 36 weeks gestation of each pregnancy
Optimally between 27 and 36 weeks gestation of each pregnancy
Which of the following is an appropriate response to a patient who tells you that she is concerned that she will get influenza from the inactivated influenza vaccine (IIV)? -Although the injectable influenza vaccine is a live attenuated viral vaccine, it has never been known to cause influenza in a vaccinated individual -The influenza vaccine will not cause influenza if the circulating strain matches those contained in the current vaccine -Injectable influenza vaccine rarely causes influenza in those who receive the vaccine, but the illness is very mild -Other than a higher incidence of sore arm, influenza vaccine has a side effect profile similar to placebo
Other than a higher incidence of sore arm, influenza vaccine has a side effect profile similar to placebo
[ ] immunity is protection by products produced by another animal or human and transferred to another human -Passive -Active
Passive
Which of the following is an advantage of passive immunity compared to active immunity? -Passive immunity is long-lasting -Passive immunity develops in response to infection or after giving a vaccine or toxoid -Passive immunity does not interfere with the development immune responses from live vaccines -Passive immunity protects almost immediately
Passive immunity protects almost immediately (Passive immunity is the transfer of antibody produced by one human or other animal to another. Passive immunity provides protection against some infections, but this protection is temporary. The antibodies will degrade during a period of weeks to months, and the recipient will no longer be protected. The most common form of passive immunity is that which an infant receives from its mother. Passive immunity can also be received by injection.)
Which of the following can be done to prevent vaccine storage problems? -Utilize a multi-outlet power strip to plug-in both the freezer and refrigerator -Place containers of water labeled "do not drink" into refrigerator to stabilize temperatures -Utilize extension cords to plug into an outlet that is rarely utilized -Plug in both the refrigerator and freezer into one outlet
Place containers of water labeled "do not drink" into refrigerator to stabilize temperatures
Which process correctly describes cocooning against pertussis? -Process of vaccinating close contacts including mother, father, siblings, grandparents, and out of home care providers -Taking long naps with a newborn -Infant vaccine series begins at 2 months and continues at 4, 6, 15-18 months, and a booster at 4-6 years -Wrapping infant tightly in a blanket to act as a protective barrier
Process of vaccinating close contacts including mother, father, siblings, grandparents, and out of home care providers
Which of the following describes the role of helper T cells in mounting an immune response to a vaccine? -Directly kills infected cells -Produce cytokines that stimulate B cells to produce antibodies -Produces large amounts of antigen specific antibodies -Present antigen to antibodies
Produce cytokines that stimulate B cells to produce antibodies (Mature B cells develop into plasma cells and become professional antibody secreting cells.)
Which of the following describes the Vaccine Injury Compensation Program? -Protects the immunization provider and vaccine manufacturer from personal liability -Absolves the immunization provider from personal negligence -Covers all licenses vaccines -Requires that the injured party prove negligence
Protects the immunization provider and vaccine manufacturer from personal liability
The Countermeasures Injury Compensation Program (CICP): -Reviews all of the adverse effects submitted through the VAERS program -Was established from the National Childhood Vaccine Injury Act -Provides benefits to seriously injured individuals that resulted from using certain antivirals -Reimburses pharmacies the cost of expired or unused vaccines
Provides benefits to seriously injured individuals that resulted from using certain antivirals
Sam is a 48-year-old healthy male presenting to a pharmacy wondering if he would be able to get the recombinant zoster vaccine (RZV). You explain the guidelines to Sam; which explanation is correct? -RZV is currently indicated only in patients over age 65 as that is what is covered by insurance -RZV is effective in reducing the incidence of shingles and is indicated in immunocompetent patients aged 50 and older -RZV is a live vaccine and can only be administered alone at least 60 days between any other vaccine -RZV is a subcutaneous injection and one can expect injection site pain for up to 2 weeks post-injection
RZV is effective in reducing the incidence of shingles and is indicated in immunocompetent patients aged 50 and older
Martha is a 68-year-old female seeking your advice regarding immunization. Her son and daughter-in-law are expecting their first child in the next few months. She has received no vaccinations since childhood. Which of the following vaccines should she receive today? -RZV, IIV4-HD, Tdap, PCV20 -LAIV, RZV, Hepatitis B -Td, 9vHPV, PPSV23 -IIV4-HD, MMR, MCV, Hepatitis A
RZV, IIV4-HD, Tdap, PCV20
Pharmacists are an integral part of increasing vaccination rates in the community. Which of the following would be the LEAST effective strategy for a pharmacist to employ? -Recommend that a patient return for a vaccine at a later time when it's less busy -Provide a strong recommendation to receive an eligible vaccine -Call the patient to remind them of immunizations that are due -Encourage all pharmacy staff to be up to date on immunizations
Recommend that a patient return for a vaccine at a later time when it's less busy
Which of the following methods describes how vaccines are covered under Medicare Part D? -As a medical benefit -Provider must submit a bill plus invoice documenting vaccine cost for reimbursement -With a universal copay for $10 for every patient enrolled -Reimbursement based on negotiated amount based on vaccine, dispensing fee, sales tax, and vaccine administration fee
Reimbursement based on negotiated amount based on vaccine, dispensing fee, sales tax, and vaccine administration fee
Rotavirus is a common childhood illness accounting for 1/3 of hospitalizations due to diarrhea. What is the appropriate vaccine recommendation for a 2-month-old child with a known history of latex allergy? -Rotarix at age 2 and 4 months -Rotarix at age 2, 4, and 6 months -Rotateq at age 2 and 4 months -Rotateq at age 2, 4, and 6 months
Rotateq at age 2, 4, and 6 months
Which of the following describe appropriate storage conditions for inactivated vaccines? -Are not affected by storage temperature -Are stored at room temperature -Should be stored in the freezer -Should be stored in the center of the refrigerator
Should be stored in the center of the refrigerator
How should you proceed if the vaccine arrives from the manufacturer under questionable conditions? -Place the vaccine in stock and use it first -Store the vaccine as recommended separately from other stock, label with "Do not use", and call the manufacturer's quality control office for advice -Repack the vaccine and return it to the manufacturer Store the vaccine as recommended separately from other stock and call the Centers or Disease Control and Prevention for advice
Store the vaccine as recommended separately from other stock, label with "Do not use", and call the manufacturer's quality control office for advice
Which of the following is true regarding best practices for vaccine preparation? -For large influenza clinics, it is good practice to draw up large quantities (15 doses) at one time -Multi-dose vials may be used for 7 days once opened -Manufacturer-filled syringes may be used for 48 hours once the sterile seal is broken -Syringes other than those filled by the manufacturer should be administered immediately
Syringes other than those filled by the manufacturer should be administered immediately
Which of the following is a contraindication to receiving live vaccines? -Taking prednisone 40mg by mouth daily for 21 days -Chronic liver disease -Diabetes -Allergy to penicillin
Taking prednisone 40mg by mouth for 21 days (Corticosteroids with a dose of 20mg or more per day or 2mg/kg or more (prednisone equivalent) for two weeks or greater would be a contraindication to receiving live vaccines. This does NOT include aerosols, alternate-day, short courses, or topical corticosteroids.)
Which of the following describes a difference between Tdap and DTaP? -DTaP has a lower dose of diphtheria toxoid for use in individuals less than 7 years -DTaP is used in children and adults for primary series -Tdap has a lower dose of diphtheria toxoid for use in individuals aged 10-11 years and older -Tdap should be used for all three doses of the primary tetanus-diphtheria series for adults
Tdap has a lower dose of diphtheria toxoid for use in individuals aged 10-11 years and older
A 13-year-old male and his mother go to the community pharmacy for a refill on his ADHD medication. His mother notices the pharmacy's immunization clinic sign and realizes her son has not seen his primary care provider for several years. She wonders if he is up-to-date with immunizations. He was up-to-date at his 4 to 6-year-old well child visit and has received no immunizations since. Which of the following vaccines are recommended for this patient? -IIV4, DTaP, Hepatitis B, MMR -PCV13, IPV, MMR, Tdap -LAIV, 9vHPV, Varicella, Td -Tdap, 9vHPV, MCV4, IIV4
Tdap, 9vHPV, MCV4, IIV4
Which of the following is the appropriate strategy for giving the Vaccine Information Statement (VIS) to patients? -The VIS should be given to the patients 1 week prior to the immunization visit to allow time to review -The VIS can be posted in the clinic for the patient to read while they wait -The VIS is required for only immunization of pediatric patients -The VIS should be given to the patient prior to immunization so the patient has time to review it and ask questions
The VIS should be given to the patient prior to immunization so the patient has time to review it and ask questions
Which of the following is the reason that a second dose of measles vaccine is recommended for all college students? -Vaccine-induced immunity wanes over ten years and re-immunization provides a boost -Most children received a killed vaccine for their first dose -The measles vaccine used a decade ago was must less effective than the current formulation -The second dose provides another opportunity for seroconversion for those who failed to respond to the first dose
The second dose provides another opportunity for seroconversion for those who failed to respond to the first dose
Which of the following best describes immunization information systems (IISs)? -The value of the IIS is that it allows healthcare providers to access immunization records to facilitate clinical decision making -All children born in the U.S. have their immunizations recorded in an IIS -All IISs are used exclusively for tracking childhood immunizations -IISs are used only to measure immunization coverage rates
The value of the IIS is that it allows healthcare providers to access immunization records to facilitate clinical decision making
Why is the safety of vaccines held to a higher standard than for most medications? -They are administered to healthy people to prevent disease rather than to sick people to cure disease -The diseases prevented by vaccination are generally not life threatening -The risks associated with vaccines are perceived by the individual to be voluntary risks -The public is willing to accept a high degree of risk to avoid most infectious diseases
They are administered to healthy people to prevent disease rather than to sick people to cure disease
Which of the following is true regarding Vaccine Information Statements (VIS)? -The VIS can serve as the "informed consent" for vaccination -They are updated every month -They are meant to prevent questions to healthcare providers regarding vaccines -They are designed to provide information about vaccines, or, in the case of a minor, the child's parent or guardian about the risks and benefits of each vaccine
They are designed to provide information about vaccines, or, in the case of a minor, the child's parent or guardian about the risks and benefits of each vaccine
Which of the following is specifically listed as a VAERS reportable event for measles vaccine? -Chronic arthritis -Thrombocytopenic purpura -Brachial neuritis -Leukopenia
Thrombocytopenic purpura
Which of the following should be completed in all pharmacies that provide immunizations? -Training employees about bloodborne pathogens and the pharmacy's bloodborne exposure control plan -Wearing gowns, gloves, and goggles when giving vaccines -Recapping needles after immunizations are administered to prevent needlesticks -Posting an orange biohazard symbol on the refrigerator door that is used to store vaccines
Training employees about bloodborne pathogens and the pharmacy's bloodborne exposure control plan
Boosters are usually not necessary for live attenuated vaccines -True -False
True
In general, giving two or more vaccines on the same day (simultaneous administration) of all recommended vaccines is appropriate. -True -False
True
Live attenuated vaccines are contraindicated in patients who are pregnant -True -False
True
One of the Clinical Immunization Safety Assessment (CISA) project's main goal is to serve as a vaccine safety resource for consultation on clinical vaccine safety issues -True -False
True
Which of the following items should be included in immunization records for vaccines administered in the pharmacy? -Type of vaccine, date administered, vaccine manufacturer and lot number, and the VIS publication date with the date given to the patient/parent or guardian -Type of vaccine, date administered, site of administration, site of vaccine storage, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian -The date administered, site of administration, vaccine manufacturer and lot number, and the VIS publication date with the date given to the patient/parent or guardian -Type of vaccine, date administered, site administration, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian, and the initials and title of the practitioner administering the vaccine
Type of vaccine, date administered, site administration, vaccine manufacturer and lot number, VIS publication date with the date given to the patient/parent or guardian, and the initials and title of the practitioner administering the vaccine
Which of the following is a reporting system by the ISMP to report vaccine administration errors? -VERP -Medwatch -VAERS
VERP
Which of the following is true regarding the timing of immunization? -Vaccinate premature infants based on gestational age rather than chronological age -Vaccinate two weeks before elective splenectomy or after acute recovery from splenectomy -Vaccinate organ transplant patients three months after transplantation -Vaccinate cancer patients immediately upon completion of chemotherapy or radiation
Vaccinate two weeks before elective splenectomy or after acute recovery from splenectomy
Which of the following represents a true contraindication to measles vaccine? -Moderate to severe acute illness with or without fever -Vaccine candidate's mother is preganant -History of thrombocytopenia -Vaccine candidate is pregnant
Vaccine candidate is pregnant (True contraindications for measles vaccine include: pregnancy, severe allergic reaction, known severe immunodeficiency.)
Which of the following vaccines should be stored frozen? -Recombinant zoster vaccine -Pneumococcal polysaccharide vaccine -Human papilloma virus vaccine -Varicella vaccine
Varicella vaccine
