Competency
What is the recommended childhood immunization schedule for polio vaccine? Option A 1 month, 2 months, 4 months, and 6 months. Option B 2 months, 4 months, 6-18 months, and 4-6 years. Option C 2 months, 4 months, 6 months, and 12 months. Option D 2 months, 6 months, 12-18 months, and 11-12 years.
b
Which modern vaccine contains weakened virus? Option A Hepatitis B. Option B MMR. Option C Polio. Option D Rabies.
b
Which person should not be given Ty21a today? Assume that all are susceptible to typhoid fever and are traveling to a typhoid-endemic area. Option A A 6 year old with a runny nose, itchy eyes, and no fever. Option B A woman with abdominal pain and persistent diarrhea. Option C A man who uses a corticosteroid inhaler daily for his asthma. Option D A woman who completed chemotherapy for breast cancer 4 months ago.
b
Which statement is correct about pneumococcal polysaccharide vaccine (PPSV23)? Option A PPSV23 is licensed for use in infants and children. Option B PPSV23 vaccine is inactivated. Option C PPSV23 contains antigen from one serotype of S. pneumoniae. Option D Pneumovax 23 and Prevnar are brands of PPSV23.
b
Which person has a valid contraindication to receiving varicella vaccine today? Option A A 29 year old who is breastfeeding a susceptible infant. Option B A 48 year old who finished a course of high-dose oral corticosteroids 6 weeks ago. Option C An HIV-infected 2 year old with a very low CD4+ T-lymphocyte count. Option D A healthy 15 year old who received VZIG 5 months ago.
c
Which statement is correct about PPSV23 vaccination in the Armed Forces? Option A Most members of the Armed Forces have up to a 60% increased risk for acquiring pneumococcal disease. Option B Pneumococcal vaccination is not routinely delivered to any Armed Forces recruits. Option C Service Members are given PPSV23 according to ACIP recommendations for people in the general population. Option D Pneumococcal vaccination is not administered routinely to any Service Members.
c
Which vaccine requires multiple doses before active immunity results? Option A MMR. Option B Smallpox. Option C Tetanus. Option D Varicella.
c
A woman cut her hand with a knife while slicing an apple. She cannot recall whether she ever had a tetanus shot, but thinks she may have had one dose. The wound is cleaned and sutured. What additional treatment is needed to prevent tetanus? Option A No further treatment is needed. Option B Td booster dose and TIG today. Option C Td primary series, with first dose today. Option D TIG and Td primary series, with first dose today.
C
How effective are 2 doses of Ixiaro at preventing Japanese encephalitis when the doses are administered according to the recommended schedule? Option A Almost 80%. Option B About 90%. Option C About 95%. Option D Nearly 100%.
C
Why is it possible that there could be a higher rate of certain adverse events following smallpox vaccination in the 21st century than when the vaccine was administered in the 20th century? Option A Vaccination administration workers in the past were more experienced in smallpox vaccine administration techniques. Option B Smallpox vaccine that is being used today was kept in storage for many years and its current safety is not well established. Option C There are more people who have diseases or conditions that compromise their immune function in the 21st century. Option D There are more secondary bacterial infections that are resistant to commonly used antibiotics.
c
A patient calls and reports that she has a headache and muscle pain. She received her first dose of Ixiaro 2 days ago. You should advise her that Option A this is a moderate adverse event and she should not receive a second dose. Option B this indicates a delayed allergic reaction and she should be seen right away. Option C this indicates a possible neurologic reaction and she should be seen right away. Option D this is a common side effect and an over-the-counter medication can be taken relieve the discomfort.
d
A vial of vaccine that is supposed to be maintained at 2°C to 8°C is placed in the freezer overnight. You remove the frozen vaccine in the morning. What would be the correct action for you to take? Option A Discard the vial and report the loss to the vaccine coordinator. Option B Place the vaccine in the refrigerator on a front shelf. Option C Allow the vaccine to thaw and then use it as soon as possible. Option D Immediately notify the vaccine coordinator or immediate supervisor.
d
A woman has been bitten by a rabid fox. She is currently receiving chemotherapy for breast cancer. The correct schedule for this woman is Option A days 0 and 3. Option B days 0, 7, and 21 to 28. Option C days 0, 3, 7, and 14. Option D days 0, 3, 7, 14, and 28.
d
An 18-year-old pregnant woman was exposed to a confirmed case of measles 2 days ago. What action should be taken? Option A No action, except to advise the woman that she is likely to develop measles. Option B Administer measles vaccine within 72 hours. Option C Administer measles vaccine immediately. Option D Refer the woman to a healthcare provider to discussion administration of IG.
d
For which person would typhoid fever vaccine be indicated? Option A A person who prepares and handles food in a restaurant. Option B A person who works in a hospital microbiology laboratory. Option C A Service Member being stationed in Western Europe. Option D A person traveling to the Indian subcontinent.
d
What is the correct action to take if, after dipping the bifurcated needle into the smallpox vaccine vial, you do not see a droplet of vaccine between the prongs? Option A Assume that there is sufficient vaccine on the prongs and vaccinate. Option B Begin again with a new sterile needle. Option C Gently roll the vaccine vial between your hands and re-dip the needle. Option D Re-dip the needle perpendicularly into the vial.
d
Which person has the most significant risk factor for a severe immune system-related smallpox vaccine complication? A person who Option A is younger than 18 years of age. Option B has undergone PPD testing within the past 3 to 5 days. Option C has received varicella vaccine within the past 28 days. Option D has had sexual contact with a person who is HIV-positive.
d
Which person should not receive ViCPS today? Assume that all are susceptible to typhoid fever and are traveling to a typhoid-endemic area. Option A A woman who is 8 months pregnant. Option B A 4 year old who is taking antibiotics for a bladder infection. Option C A person who is allergic to gelatin. Option D A man who is a chronic carrier of S. typhi.
d
Which statement is correct about inactivated influenza vaccine according to its Vaccine Information Statement (VIS)? Option A Influenza is a disease that mainly infects people older than 50 years of age and people who have chronic medical conditions. Option B Inactivated influenza vaccine provides protection against most infectious respiratory viruses in healthy adults under the age of 50. Option C Inactivated influenza vaccine should not be given to anyone whose immune system is weakened because of HIV, long-term steroid use, or cancer treatment. Option D Influenza vaccine is kept up-to-date each year by replacing at least one of the vaccine virus strains with a strain currently causing illness.
d
Which statement is correct about polio vaccination administration in the Armed Forces? Option A Polio vaccine is not routinely administered to Armed Forces recruits. Option B A dose of polio vaccine is given only to Armed Forces personnel who are at risk for exposure in areas in which wild poliovirus is endemic or epidemic. Option C Polio vaccine is administered only to Armed Forces personnel who are previously unvaccinated or who received only one or two prior doses of vaccine. Option D All military accessions, officer candidates, and Reserve component personnel on initial active duty receive a booster dose of polio vaccine.
d
Which vaccine will result in the best immune response because it is similar to the natural disease? Option A Hepatitis A. Option B Pneumococcal. Option C Tetanus. Option D Varicella.
d
Is the following statement true or false? Children who receive their first dose of Hib vaccine when they are 7 months of age or older still need at least four doses of vaccine.
false Children 7 months of age or older when they receive their first dose do not need all four doses and may only need one dose, depending on their age. Children with lapsed schedules also may not need all four doses.
A multidose vial of anthrax vaccine is removed from the freezer. After thawing, the vial is shaken thoroughly to evenly suspend the vaccine during withdrawal. After administering the needed doses of anthrax vaccine, the vial is labeled with the date, refrozen, and discarded after 30 days.
no
A single-dose vial of zoster vaccine is stored in the freezer. It is then reconstituted with room temperature diulent and placed in the refrigerator. The next day, the vial is removed and the dose is drawn up and administered.
no
A vial of human papillomavirus vaccine is removed from the freezer. The vial is shaken well to evenly suspend the vaccine during withdrawal. After administering the vaccine the vial is disposed of in the sharps container.
no
For each person described, click on Yes if meningococcal vaccine is recommended for the person described, or on No if the vaccine is not recommended for the person. A 38-year-old college professor who teaches freshman English.
no
Multidose vials of inactivated influenza vaccine arrive at the administration site in an insulated container. The temperature in the shipping container has remained at 5°C during shipping. The vaccine is stored overnight in the refrigerator. The next morning, the vaccine is placed in an insulated container with chilled coolant packs for transport to a senior citizen center. Each vaccine vial is taken from the insulated container and shaken well before the vaccine is withdrawn. Withdrawn doses are immediately injected. The multidose vials that are not used are transported back to the administration site in the insulated container, which contains chilled coolant packs. Open vials are dated and all vials are placed back into the refrigerator.
yes
Which person has a valid contraindication or precaution to receiving PPSV23 today? Option A A 70 year old who is hospitalized with acute bronchitis. Option B A 43 year old who states she is allergic to penicillin. Option C A 23 year old who has had a previous infection with AIDS-related pneumoccocal pneumonia. Option D A 65 year old who thinks he may have received PPSV23 10 years ago.
a
Which person has a valid contraindication to receiving meningococcal vaccine today? Option A Someone hospitalized with acute bronchitis. Option B Someone who is allergic to penicillin. Option C Someone taking antibiotics for a sinus infection. Option D Someone who received a prior dose of meningococcal vaccine less than 10 years ago.
a
Which person should have rubella immunization delayed or have follow-up serological testing to confirm rubella immunity? Option A A 28 year old who received immune globulin 2 weeks ago for hepatitis B. Option B A 33 year old taking low dose inhaled steroids for asthma. Option C A 44 year old who completed chemotherapy 6 months ago. Option D A 50 year old who needs measles vaccine today.
a
You are screening a 32-year-old woman who is 6 months pregnant. She had 3 doses of Td as an adolescent and a booster dose just over 10 years ago. Would it be acceptable, to give Tday today? Option A Yes. Option B No, give Tdap after delivery. Option C No, give Td today.
a
You are screening people before administering Td vaccine. Which person has a valid contraindication to Td vaccine today? The person who Option A had hives and difficulty breathing after a prior dose of Td. Option B is 8 months pregnant and will giving birth at home. Option C has a sore throat and runny nose with a temperature less than 101°F. Option D is immune suppressed because of HIV infection.
a
A pregnant woman was vaccinated against measles as a child. What type of immunity against measles will her newborn have at birth? Option A Active immunity. Option B Passive immunity. Option C Placental. Option D Maternal.
b
The dose for M-M-R II is Option A 0.1 mL Option B 0.5 mL. Option C 1 mL. Option D 5 mL.
b
There are an estimated 27 million people in the United States who have atopic dermatitis. Why should these people not receive smallpox vaccine, unless they have been exposed to smallpox virus or are a contact of a person with smallpox? These people are at Option A risk for inadvertent inoculation with smallpox, if they come into contact with other people who also have been vaccinated. Option B risk for eczema vaccinatum, a severe reaction to smallpox vaccine. Option C risk for progressive vaccinia because they also are likely to have immune system defects. Option D increased risk for Steven's-Johnson syndrome if erythema multiforme develops.
b
Fill in the number of milliliters (mL) in one dose of MMR vaccine, and click on "Submit." Number of mL = mL
0.5
Fill in the number of milliliters (mL) in one dose of intramuscular inactivated influenza vaccine for people 3 years of age or older, and click on "Submit".
0.5
Fill in the blanks below with the correct dose in micrograms and the number of mL of vaccine for each person described. Engerix-B for a 5 year old.
10, 0.5
How many doses of rubella vaccine or MMR vaccine are recommended for children 1 year of age and older?
2
Four people are in the immunization clinic. All have been screened and hepatitis A vaccine is recommended. They have read the hepatitis A VIS form, and you have answered their questions. Now it is time to draw up the correct dosage and amount of vaccine. Fill in the correct dose and number of mL of vaccine to give to each person. You are giving Vaqta to an 18 year old. Dose = Units Number of mL = mL
25, 0.5
Which person would be at greatest risk for development of myopericardiditis following smallpox vaccination? Option A 55-year-old woman with congestive heart failure. Option B 20-year-old man with diabetes and who smokes. Option C 37-year-old woman whose father died after a heart attack at age 42. Option D 67-year-old man with high cholesterol and high blood pressure.
A
Primary vaccination with anthrax vaccine consists of six doses. The first three are given at 0 weeks, weeks, The next three doses are given at months, months, and months.
4, 6, 12, 18
You are giving Vaqta to a 25 year old.
50, 1
The recommended dose for M-M-R II is: Option A 0.1 mL. Option B 0.5 mL. Option C 1 mL. Option D 5 mL.
B
Is the statement below True or False? Meningococcal conjugate vaccine is administered subcutaneously.
False Meningococcal conjugate vaccine is administered intramuscularly. However, the polysaccharide is administered subcutaneously.
The healthy 38-year-old father of a 15 year old who has asthma.
LAIV/TIV
For each person described, click on Yes if the person should be revaccinated with PPSV23 today, or on No if the person should not be revaccinated with PPSV23 today. In all cases, assume that there are no valid contraindications to vaccine administration and that each person has received only one previous dose of PPSV23. A 46 year old who has chronic liver failure caused by alcoholic cirrhosis, and who received PPSV23 5 years ago. button Yes button No
No This person does not need revaccination with PPSV23 at this time. People with certain chronic medical conditions who are immunocompetent should receive a single revaccination at age 65, if 5 or more years have elapsed since the previous dose.
An 18-year-old Armed Forces recruit needs varicella vaccination and a PPD. What is a correct way to administer these injections? Option A Administer the PPD and varicella vaccine simultaneously. Option B Administer varicella vaccine today and the PPD in 72 hours. Option C Administer the PPD today and varicella vaccine in 4-6 weeks. Option D Administer varicella vaccine today and the PPD in 4-10 days.
The answer is A
Is the statement below True or False? The Advisory Committee on Immunization Practices (ACIP) recommends that combined measles, mumps, and rubella vaccine be given whenever a person needs mumps vaccine.
True
For each person described, click on Yes if meningococcal vaccine is recommended for the person described, or on No if the vaccine is not recommended for the person. A healthy 12-year-old girl.
Yes
In the Armed Forces, which personnel are required to have measles immunity? Option A All personnel. Option B Only recruits. Option C Only healthcare workers. Option D Only personnel stationed or traveling outside the United States.
a
You have 75 Armed Forces members being stationed in Southeast Asia who are coming to the vaccine administration site to receive an injection of typhoid vaccine. While administering these injections, you want to maintain the correct temperature in the vaccine storage unit and ensure that the typhoid vaccine is effective when you administer it. Which option best safeguards both the vaccine you are going to administer and the temperature in the vaccine storage unit? Option A Freeze the needed number of multidose vials of typhoid vaccine the day before. In the morning, remove them from the freezer and place them in an insulated container. Option B Select the number of multidose vials or prefilled single-dose syringes needed from the storage unit and place them in an insulated container with chilled coolant packs. Option C Use only prefilled single-dose syringes and schedule all vaccine administration appointments for the same time so that the storage unit only needs to be opened once. Option D Use only multidose vials of typhoid vaccine and place them in the refrigerator door for rapid access. When a dose is needed, open and shut the door quickly.
b
Smallpox vaccine should NOT be administered simultaneously with which other vaccine? Option A Measles. Option B Yellow fever. Option C Varicella. Option D Typhoid.
c
What is the most correct and recommended method for administering anthrax vaccine? Option A Subcutaneously using a 0.5 mL syringe over the area of the triceps. Option B Subcutaneously using a tuberculin syringe over the deltoid muscle. Option C Intramuscularly using a tuberculin syringe into the deltoid muscle. Option D Intramuscularly into rotating anatomic sites using a 0.5 mL syringe.
c
A woman who will be 14 weeks pregnant at the start of influenza season.
tiv
Fill in the number of influenza vaccine doses that should be given each year to an adolescent or adult, and click on "Submit".
1
Fill in the blanks below with the correct dose in micrograms and the number of mL of vaccine for each person described. Recombivax HB for a 15 year old receiving 2 doses. Dose = mcg Number of mL = mL
10, 1
Fill in the blanks below with the correct dose in micrograms and the number of mL of vaccine for each person described. Recombivax HB for a 52 year old. Dose = mcg Number of mL = mL
10, 1
Four people are in the immunization clinic. All have been screened and hepatitis A vaccine is recommended. They have read the hepatitis A VIS form, and you have answered their questions. Now it is time to draw up the correct dosage and amount of vaccine. Fill in the correct dose and number of mL of vaccine to give to each person. You are giving Havrix to a 32 year old.
1440, 1
A Service Member received one dose of Twinrix before deployment to Afghanistan. It is now time for his second dose. You do not have Twinrix available. You do have single-antigen hepatitis A vaccine. How many doses of single-antigen hepatitis A vaccine will he need to receive to complete his primary series for hepatitis A?
2
Fill in the number of influenza vaccine doses that should be given this year to a 5 year old child with chronic asthma who has never received influenza vaccine. Click on "Submit". dose(s).
2
Four people are in the immunization clinic. All have been screened and hepatitis A vaccine is recommended. They have read the hepatitis A VIS form, and you have answered their questions. Now it is time to draw up the correct dosage and amount of vaccine. Fill in the correct dose and number of mL of vaccine to give to each person. You are giving Havrix to a 17 month old. Dose = Units Number of mL = mL
720, 0.5
A 23 year old receives a first dose of Recombivax HB 1 mL (10 mcg) and a second dose 3 months later. The minimum interval between the second and third doses in this case is weeks.
8
Which person has a valid contraindication to yellow fever vaccination and should not, under any circumstances, be given yellow fever vaccine? Option A A 40-year-old woman being treated with radiation and chemotherapy for breast cancer. Option B A 10-month-old, healthy infant. Option C A 50-year old man who received a corticosteroid injection last week for hip pain. Option D An 18-year-old student who also needs to receive live virus MMR vaccine today.
A
A healthy, 40-year-old man who is susceptible to varicella was exposed to VZV 3 days ago. What action is recommended to prevent or reduce the severity of varicella illness if this man is infected with VZV? Option A Administer both varicella vaccine and VZIG today. Option B Administer a dose of varicella vaccine today, followed by a second dose in 4 to 8 weeks. Option C Administer VZIG today, followed by a dose of varicella vaccine in 3 months and a second dose 4 to 8 weeks later. Option D Administer oral acyclovir if he develops a fever or maculopapular rash.
B
What type of vaccine are Menveo and Menactra? Option A Pure polysaccharide. Option B Conjugate polysaccharide. Option C Live attenuated. Option D Toxoid.
B
Which statement accurately describes yellow fever vaccine? Yellow fever vaccine is Option A a subunit protein vaccine. Option B a live attenuated viral vaccine. Option C an inactivated whole-cell viral vaccine. Option D a live attenuated bacterial vaccine.
B
A Service Member who works with animals needs pre-exposure rabies vaccination. The correct schedule for this is Option A days 0 and 3. Option B days 0, 7, and 14 to 21. Option C days 0, 7, and 21 to 28. Option D days 0, 3, 7, 14, and 28.
C
Which statement about Hib vaccine is accurate? Option A Hib vaccine is a live vaccine made of weakened Hib bacteria to which a protein carrier has been attached. Option B Hib vaccine may be given with other inactivated vaccines, but should not be given with live vaccines. Option C Hib vaccine is made by binding polysaccharide from the Hib bacteria capsule to a protein carrier. Option D Combined Hib vaccines can be given to adults; for example, to adults who need both hepatitis B and Hib vaccination.
C
What type of vaccine is Ixiaro? Option A Live attenuated vaccine. Option B Toxoid. Option C Conjugate vaccine. Option D Inactivated vaccine.
D
You have three persons to vaccinate. Click on Yes if varicella vaccine should be administered today, on No if varicella vaccine should not be administered today, or on It Depends if it would depend on the situation. Assume in all cases that the person is susceptible to varicella. A 34-year-old nurse who is trying to become pregnant.
Depends
You are running an influenza vaccine clinic and have both IIV and LAIV avaliable. Click on IIV if inactivated influenza vaccine is recommended or should be considered for the person described, on IIV/LAIV if either inactivated influenza vaccine or live attenuated influenza vaccine could be administered, or on Neither if neither vaccine is indicated. A healthy 29-year-old emergency medical technician.
LAIV/TIV
Here are two statements about measles vaccine. One is true and the other is false. Click on the true statement. Measles vaccine should be administered intramuscularly. Measles vaccine should be administered subcutaneously.
Measles vaccine should be administered subcutaneously.
For each scenario described, assume that all vaccine storage refrigerator and freezer temperatures are regulated within the recommended ranges. Click on Yes if the steps described reflect proper storage and handling of the vaccine prior to administration, or on No if the vaccine has not been properly stored and handled. A single-dose vial of meningococcal polysaccharide vaccine is reconstituted using the diluent provided and then placed back in the refrigerator. Four hours later, the vial is removed and the dose is drawn up and administered.
No
Here are two statements about Pediarix vaccine. One is true and the other is false. Click on the true statement. Pediarix can be used for people of all ages. Pediarix can be used for infants and children 6 weeks to 7 years of age.
Pediarix can be used for infants and children 6 weeks to 7 years of age.
For each person described, click on Yes if meningococcal vaccine is recommended for the person described, or on No if the vaccine is not recommended for the person. A new student enrolling in the Naval Academy.
Yes
For each person described, click on Yes if the person should be revaccinated with PPSV23 today, or on No if the person should not be revaccinated with PPSV23 today. In all cases, assume that there are no valid contraindications to vaccine administration and that each person has received only one previous dose of PPSV23. A 9 year old who had a heart transplant and received a dose of PPSV23 at 4 years of age.
Yes
A woman who received her first dose of pre-exposure rabies vaccine yesterday calls to report redness and swelling at the vaccine injection site. She should be told that this is Option A common and will go away, and that she can take an over-the- counter pain reliever for the discomfort. Option B common, but that she should come back to the vaccine clinic for evaluation. Option C a sign of a mild allergic reaction and that she should take an antihistamine. Option D an immune reaction and that she should return to the vaccine clinic for evaluation.
a
Currently, anthrax vaccine is administered to people according to Option A their risk for exposure and the supply of vaccine. Option B how much contact they have with horses, sheep, or cows. Option C their request to be protected against anthrax infection. Option D their B. anthracis serum titer levels.
a
What is Td? Option A A toxoid vaccine made from altered tetanus and diphtheria toxins. Option B A live vaccine made from weakened tetanus and diphtheria bacteria. Option C A conjugate vaccine made from tetanus and diphtheria toxins. Option D A subunit vaccine made from small pieces of tetanus and diphtheria bacteria.
a
What is the correct dose and route for Ixiaro when given to those 3 years and older? Option A 0.5 mL intramuscularly. Option B 0.5 mL subcutaneously. Option C 1 mL intramuscularly. Option D 1 mL intramuscularly.
a
What is the correct dose for intradermal influenza vaccine? Option A 0.1 mL. Option B 0.2 mL. Option C 0.25 mL. Option D 0.5 mL.
a
What is the correct dose, schedule, and route of administration for Ty21a? Option A Four capsules taken by mouth on alternate days, each dose taken one hour before a meal. Option B Four capsules taken by mouth within a 48-hour period, each dose taken with food. Option C Four capsules taken by mouth over a 4-day period, each dose taken one hour before a meal. Option D Four capsules taken by mouth on alternate days, each dose taken with a hot liquid.
a
What is the recommended dose and route of administration for Hib vaccination of most adolescents and adults for whom the vaccine is indicated? Option A One 0.5 mL dose administered intramuscularly into the deltoid. Option B One 5 mL dose administered subcutaneously into the upper arm. Option C Two 0.5 mL doses separated by 2 months and administered subcutaneously into the upper arm. Option D Two 5 mL doses separated by 2 months and administered intramuscularly into the gluteus.
a
What type of adverse reaction are you most likely to see in adolescent and adult women after injection of measles vaccine? Option A Fever and rash. Option B Arthritis. Option C Low platelet count. Option D Swollen glands.
a
Which person should have varicella vaccination delayed? Option A A 40 year old who received a blood transfusion 10 days ago. Option B A 28 year old taking low-dose inhaled steroids for asthma. Option C A 44 year old who completed chemotherapy for breast cancer 3 months ago. Option D A 1 year old who needs to receive MMR vaccine today.
a
Which person should not receive meningococcal conjugate vaccine? Option A A 60-year-old woman traveling to West Africa. Option B A 19-year-old college freshman living in a dormitory. Option C A 28-year-old military recruit entering basic training. Option D A 14-year-old boy with sickle cell anemia.
a
Which person should not receive mumps vaccine today? Option A A 16 year old who received antibody-containing blood products 4 weeks ago. Option B A 32 year old who is being treated for asthma with an inhaler containing aerosolized corticosteroid. Option C A 7 year old who has a history of a severe allergic reaction after eating eggs. Option D An 18 year old who received live injected varicella vaccination 4 weeks ago.
a
Which statement is correct about the efficacy of smallpox vaccine and the duration of protection that it provides? Option A Partial protection against smallpox from smallpox vaccine may last 10 years or longer. Option B Smallpox vaccine given within 10 days after exposure to variola virus protects 95% of people from smallpox disease. Option C Smallpox vaccine given after exposure to smallpox virus will decrease the severity of the illness, but cannot prevent it. Option D If given at the first sign of illness, smallpox vaccine can decrease the severity of smallpox disease.
a
A previously unvaccinated adult will be traveling to a country in which exposure to wild poliovirus remains a threat. What is the minimum interval between which doses can be given if an accelerated schedule of IPV administration is needed? Option A 2 weeks. Option B 4 weeks. Option C 8 weeks. Option D 6 to 12 weeks.
b
An 8 year old is scheduled to receive MMR vaccine and a PPD. What is the correct way to administer these injections? Option A Administer the PPD today, then delay administration of MMR vaccine for at least 4 to 6 weeks. Option B Administer the PPD and MMR vaccine simultaneously. Option C Administer MMR vaccine today, then delay administration of the PPD for 72 hours. Option D Administer MMR today, then delay administration of the PPD for 4 to 10 days.
b
For which person is Hib vaccine LEAST likely to be recommended? Option A A woman with cancer who will be getting a chemotherapy. Option B A pediatrician who does volunteer work in developing countries. Option C A man who has an asymptomatic HIV infection. Option D A Service Member who had her spleen removed after an accident.
b
What is the correct dose of anthrax vaccine? Option A 0.1 mL. Option B 0.5 mL. Option C 1 mL. Option D 1.5 mL.
b
What is the correct dose, schedule, and route of administration for ViCPS vaccine? Option A Two 0.5 mL doses separated by 2 weeks administered subcutaneously. Option B One 0.5 mL dose administered intramuscularly. Option C One 0.5 mL dose administered subcutaneously. Option D Two 0.5 mL doses separated by 1 week administered intramuscularly.
b
Which is the correct dose of IPV to administer to a child, adolescent, or adult? Option A 0.25 mL. Option B 0.5 mL. Option C 1 mL. Option D 2.5 mL.
b
Which person has a valid contraindication to receiving yellow fever vaccine or should check with his or her healthcare provider prior to receiving yellow fever vaccine today? Option A A 30 year old who is asymptomatically infected with the human immunodeficiency virus (HIV) and CD4+ count of more than 25%. Option B A 20 year old who had his thymus removed last year. Option C A 40 year old who uses an aerosolized corticosteroid inhalant medication daily. Option D A 50 year old who has a runny nose, slight sore throat, and temperature of 99.8°F.
b
Which person should not be given smallpox vaccine in a pre-outbreak setting? (Assume that there are no conditions or risk factors other than those listed.) Option A A 35 year old who is being treated for high blood pressure and high cholesterol, and whose father died of a heart attack at age 72. Option B A 50 year old who has been diagnosed with "mini-strokes," which all have resolved without any lasting damage. Option C A 28 year old who smokes cigarettes and says that she sometimes feels short of breath when she climbs stairs. Option D A 47 year old who has diabetes, and whose father, mother and sister also have diabetes.
b
Which statement about adverse reactions/events following mumps vaccination is true? Option A Mumps vaccine typically produces symptoms similar to a mild case of the disease, e.g., mild parotitis, fever, and CNS dysfunction. Option B When MMR vaccine is given, most adverse reactions are caused by the measles and rubella components, not the mumps component. Option C Allergic reactions to mumps vaccine can take up to 4 weeks to resolve. Option D Reactions to MMR vaccine include rash and joint symptoms.
b
Which statement accurately represents information contained in the yellow fever VIS? Option A You should check with your doctor before getting the vaccine if you are allergic to neomycin. Option B Nursing mothers should avoid or postpone travel to a yellow fever area, if possible. Option C The vaccine may cause severe nervous system reactions in approximately 1 per 10,000 doses. Option D You should not receive any other live vaccines at the same time as yellow fever vaccine.
b
Which statement would be most correct to give a woman who has just received her first routine anthrax vaccination? Option A If you develop a lump at the injection site, you need to report it to your primary healthcare provider immediately. Option B Up to 50% of people develop minor local reactions, but these reactions generally last only a few days. Option C You need to avoid conception for at least two months after you complete your anthrax vaccine series. Option D You most likely will experience nausea, a headache, chills and a low grade fever that will last about a week.
b
You have given a 2-month-old infant her first dose of DTaP. What is the recommended schedule for the remaining doses? Option A 3 months, 4 months, 6-12 months, and 15-18 months of age. Option B 4 months, 6 months, 15-18 months, and 4-6 years of age. Option C 6 months, 12 months, 15-18 months, and 4-6 years of age. Option D 6 months, 12 months, 4-5 years, and 11-12 years of age.
b
A child has an indication for both PCV13 and PPSV23. If PCV13 is given first, what is the minimal interval before PPSV23 can be given? Option A Two weeks. Option B Four weeks. Option C Eight weeks. Option D One year.
c
A healthy teen received her second dose of varicella vaccine two days ago. She calls the vaccine administration center complaining of redness, soreness, and swelling at the injection site. She has no fever and otherwise feels well. Which recommendation would be appropriate to include in your response to the woman about this adverse reaction? Option A Come to the vaccine administration site today to have your arm checked. Option B Take aspirin for discomfort, according to directions on the aspirin label. Option C Expect these symptoms to go away by themselves in a few days. Option D File a vaccine adverse event report noting these symptoms.
c
A healthy, 40-year-old man needs yellow fever vaccination for travel. He asks the person administering the vaccine how effectively the vaccine will protect him against yellow fever. Which response would be most correct? "For healthy men in their 40s, the vaccine has been shown to be Option A 65% to 75% effective after one dose." Option B 65% to 75% effective after one dose and a booster." Option C 99% to 100% effective after one dose." Option D 99% to 100% effective after one dose and a booster."
c
A person who has a single lesion on the face resulting from autoinoculation should Option A be referred to a physician who specializes in infectious diseases or dermatology. Option B have the facial lesion treated with a topical antiviral agent. Option C be told that the lesion will follow the same course of healing as the vaccination. Option D be instructed to cover his or her vaccination site with an occlusive dressing.
c
A woman forgot to tell you that she received MMR vaccine two weeks ago. You administered varicella vaccine today. What action should you take? Option A No action because these vaccines do not interfere with each other. Option B Repeat the dose of MMR vaccine in four weeks or do serologic testing. Option C Repeat the dose of varicella vaccine in four weeks or do serologic testing. Option D Repeat both vaccines, giving MMR vaccine today, followed by varicella vaccine in four weeks.
c
An 11-year-old boy needs to receive meningococcal vaccine. He has HIV infection. What is the correct schedule? Option A A single dose today and a booster dose at age 16. Option B A single dose today and no need for a booster dose. Option C Two doses given 2 months apart and a booster dose at age 16. Option D Two doses given 2 months apart and no need for a booster dose.
c
For which person would ViCPS be the preferred type of typhoid vaccine? One who Option A is traveling within an endemic area for more than 2 years. Option B has a severe allergy to latex. Option C is taking an antibiotic. Option D would prefer not to have an injection.
c
Four people receive anthrax vaccination today. Which person is vaccinated according to recommendations? Option A A person received one dose in his anthrax primary series 3 years ago. The dose he receives today is counted as his first booster dose. Option B Ten years ago, a person received six doses of anthrax vaccine according to schedule. He has received no booster doses since then. The primary series is restarted. Option C Two years ago, a person received two doses of anthrax vaccine at 0 weeks and 4 weeks. He receives the third dose in his primary series today. Option D A person was scheduled to receive his annual booster dose 12 months ago. Instead he received it 6 months ago. He receives another annual booster today.
c
Varivax is given to adults in two doses, separated by 4 to 8 weeks. What is the recommended amount of vaccine in each dose of Varivax? Option A 0.1 mL. Option B 0.25 mL. Option C 0.5 mL. Option D 1 mL.
c
What is the correct dose and route for administering LAIV? Option A 0.25 mL intranasally. Option B 0.5 mL subcutaneously. Option C 0.1 mL intranasally into each nostril. Option D 0.5 mL intramuscularly.
c
What is the expected progression of the skin site after primary vaccination with smallpox vaccine? Option A A papule, a pustule, a vesicle, a scab. Option B A vesicle, a papule, a pustule, a scab. Option C A papule, a vesicle, a pustule, a scab. Option D A pustule, a vesicle, a papule, a scab.
c
What is the recommended dose of YF-VAX? Option A 0.05 mL. Option B 0.25 mL. Option C 0.5 mL. Option D 1 mL.
c
Which describes correct procedure for primary smallpox vaccination with ACAM2000? Option A A bifurcated need is used to inject 0.00025 mL of smallpox vaccine into the subcutaneous tissue over the deltoid insertion. Option B A bifurcated needle holding a droplet of live vaccinia virus is jabbed 3 times into the skin over the deltoid insertion. Option C A bifurcated needle holding a droplet of live vaccinia virus is jabbed 15 times into the skin over the deltoid insertion. Option D The skin over the deltoid insertion is scratched with a bifurcated needle, then live variola virus is dropped onto the scratch.
c
Which measure is most important in preventing the most frequent adverse event following smallpox vaccination? Option A Holding the bifurcated needle at a 90o angle to the skin during vaccination. Option B Avoiding inadvertent subcutaneous injection of the vaccine. Option C Hand washing. Option D Thoroughly cleansing the skin site before vaccination.
c
Which person has a valid contraindication or precaution to receiving polio vaccine today? Option A A woman who is breastfeeding an unvaccinated baby. Option B A man who is allergic to penicillin. Option C A woman with diarrhea and a high fever. Option D A man who is immune deficient.
c
Which statement about indications for yellow fever vaccine is correct? Option A Susceptible people traveling to any country in South America or Africa should be vaccinated. Option B Susceptible military personnel being deployed anywhere outside of the continental United States should be vaccinated. Option C Susceptible people traveling to South American and African countries near the equator should be vaccinated. Option D Susceptible military personnel being stationed anywhere outside of continental North America or Europe should be vaccinated.
c
You are administering DTaP to a 4 month old today. What is the recommended dose, route, and site? Option A 0.5 mL intramuscularly into the deltoid muscle. Option B 1 mL subcutaneously into the fatty area of the thigh. Option C 0.5 mL intramuscularly into the vastus lateralis muscle. Option D 1 mL subcutanesously into the upper arm.
c
A family moves from a state where there is a low rate of hepatitis A to a state where the average incidence of hepatitis A is more than twice the national average. The mother and father work as emergency medical technicians for a local fire department. The parents have not received hepatitis A vaccine. They have three children: a 6 month old, a 12 year old, and a 17 year old. For which family members is routine vaccination for hepatitis A recommended? Option A The parents and all three children. Option B Only the parents, the 6 month old, and the 12 year old. Option C Only the children. Option D Only the 12 year old and the 17 year old.
d
A man needs MMR, varicella vaccine, and poliovirus vaccine. He would like to receive all three today. Which statement is accurate? Option A Each vaccine must be separated by at least two weeks. Option B MMR vaccine and varicella vaccine must be separated by at least four weeks. Option C Only MMR and polio, or MMR and varicella can be given today. Option D All three vaccines can be given today at different injection sites.
d
A person receives Ty21a vaccine because he is traveling to a country in which typhoid fever is endemic. If he plans to continue this type of travel in the future, when is it recommended that he be revaccinated against typhoid fever? Option A In one year. Option B In two years. Option C In three years. Option D In five years.
d
An adult just received a dose of PPSV23 and you realize he also has an indication for PCV13. How soon can a dose of PCV13 be given? Option A Two weeks. Option B Eight weeks. Option C Six months. Option D One year.
d
What is recommended route for giving Hib vaccine to an infant? Option A Subcutaneously into the thigh. Option B Subcutaneously in the upper arm. Option C Intramuscularly into the deltoid muscle. Option D Intramuscularly into the vastus lateralis muscle.
d
What percent of healthy people develop protective antibodies against rabies when rabies vaccine is administered correctly? Option A 90%. Option B 95%. Option C 99%. Option D 100%.
d
Which person most likely will fail to develop active immunity following vaccination? The person who was given Option A yellow fever vaccine 3 days ago and packed red blood cells today. Option B MMR vaccine 28 days ago and varicella vaccine today. Option C hepatitis B vaccine 21 days ago and smallpox vaccine today. Option D hepatitis B immune globulin 2 months ago and MMR vaccine given today.
d
Which statement about Tdap is accurate? Option A Tdap has replaced Td and is given as a booster doses every 10 years. Option B Tdap is indicated for people 7 years of age and older. Option C Tdap is not indicated for use in postexposure tetanus prophylaxis. Option D Tdap should be given as a single-booster dose to people 10 - 64 years of age.
d
Which statement is correct about smallpox postvaccination guidelines for healthcare workers? A recently vaccinated healthcare worker Option A should be assigned to duties that do not involve direct patient care until his or her scabs fall off. Option B can provide patient care if he or she covers the vaccination site with a gauze bandage and short sleeves. Option C can work, as long as he or she does not care for patients in emergency departments or intensive care units. Option D should have a semi-permeable barrier over his or her vaccination site dressing, plus long sleeves, when providing patient care.
d
You are screening people before administering DTaP vaccine. Which person has a valid contraindication to DTaP vaccine? Option A A 2 month old who has a runny nose and occassional cough. Option B A 10 month old who had a red, sore area at the site of his last DTaP injection. Option C A 4 year old who had a temperature of 102ºF after her last dose of DTaP. Option D A 7 year old who has never received any prior doses of DTaP.
d
Assume that the person is susceptible to Japanese encephalitis and that he or she will be traveling to an area in which Japanese encephalitis virus is endemic during mosquito season. Click on Yes if the person should receive Japanese encephalitis vaccine today, on No if Japanese encephalitis vaccine is contraindicated, or on It Depends if it depends on the situation. A woman who is 5 months pregnant.
depends
A school nurse working in a public school in North Carolina.
no
Click on Yes if the person should be tested for immunity 1 to 2 months after he or she receives hepatitis B vaccine, or on No if postvaccination serologic testing is not needed. People who receive hepatitis B vaccine in the deltoid muscle.
no
Not everyone traveling overseas, or even traveling to areas in which Japanese encephalitis virus (JEV) is endemic, needs Japanese encephalitis vaccine. In the case below, assume that the person is susceptible to JEV. Click on Yes if Japanese encephalitis vaccine most likely would be recommended for the person, or on No if the vaccine most likely would not be recommended. A man who is traveling from his home in the United States to stay with family in Tokyo for the winter holidays.
no
Rotavirus vaccine for a 3-month old who has a high fever and severe diarrhea.
no
Here are two statements about rubella vaccine. One is true and the other is false. Click on the true statement. The 0.5 mL dose of rubella vaccine should be administered intramuscularly. The 0.5 mL dose of rubella vaccine should be administered subcutaneously.
subcutaneously
A toddler who was found playing with a dead bat, and who has a temperature of 103°F from an ear infection.
yes
Click on Yes if mumps vaccine is recommended for the person described, or on No if mumps vaccine should not be given to the person. Assume in all cases that MMR vaccine will be used. Also assume in all cases that the person is not currently immune to mumps and that there are no medical contraindications to mumps vaccination, unless otherwise indicated. An 18-year-old Coast Guard recruit.
yes
For each person described, click on Yes if polio vaccine is recommended, or on No if the vaccine is not recommended for the person. A laboratory worker who handles specimens that may contain polioviruses.
yes
Human papillomavirus vaccine for an adolescent who received MMR vaccine two weeks ago.
yes
Zoster vaccine for a man who uses a corticosteroid inhaler for asthma.
yes
Remembering what you have learned about the principles and rules to vaccine administration, let's screen some people who are scheduled to receive vaccines today. If necessary, you may refer to the resource buttons provided. Click on Yes if you think the person can receive the vaccine today, or on No if you think the vaccine is unnecessary, contraindicated, or should be delayed. Hepatitis B vaccine for an adolescent who received varicella immune globulin two weeks ago.
yes Hepatitis B vaccine can be given today because it is an inactivated vaccine and not affected by circulating antibodies.
