Immunization Training: Modules 11-20
The combination hepatitis A and hepatitis B vaccine (Twinrix) is administered at which of the following monthly intervals? • 0, 1 • 0, 6 • 0, 1, 6 • 0, 2, 12
0, 1, 6
When counseling the parent of a one-year-old receiving the MMR vaccine, they should be told that their child may get a measles like rash after how long from vaccination? • Immediately • 48 hours • 6 weeks • 1 week
1 week
ACIP recommends the hepatitis A vaccine be administered to all children starting at which age? • 5 years • 11 years • 12 months • six months
12 months
Although the primary series for Hib varies between 2-3 doses, all vaccines are recommended to have a booster dose at age: • A booster is not recommended • 4-6 years • 2 years • 12-15 months
12-15 months
A child received the MMR vaccine when he was nine months of age before moving out of the country with his parents. He is now four years old and about to enter kindergarten. How many, if any, doses of MMR should the child receive now? • None • 2 • 1 • 3
2
Which of the following individuals are contra indicated from receiving the MMR vaccine? • 50-year-old with a low platelet count • 23-year-old and her 3rd trimester • 30 year old with asplenia • 75-year-old with COPD
23-year-old and her 3rd trimester
Refrigerated vaccine should be maintained at temperatures between: • 30- 40°F • 35-46° F • 34-42°F • 32-40°F
35-46° F
Which of the following patients should receive the varicella vaccination? • 10 month old at their well check • 65-year-old who had chickenpox over 60 years ago • 5-year-old who received one dose at 12 months of age • 12-year-old who received doses at 15 months and six years of age
5-year-old who received one dose at 12 months of age
Which of the following patients is eligible to receive their first dose of the rotavirus vaccine? • A newborn 3 days age before leaving the hospital • A 1-year-old with severe Gerd • An 8 month old • A 10 week old presenting to the pediatrician for their two month well check
A 10 week old presenting to the pediatrician for their two month well check
A contraindication to receiving a COVID-19 vaccination includes: • Any immediate allergic reaction to other vaccines or injectable therapies • Receipt of COVID-19 vaccine the same day the patient receives an influenza vaccination • A known (diagnosed) allergy to a component of a COVID-19 vaccine • ppl People with a contraindication to mRNA COVID-19 vaccines who request the Janssen COVID-19 vaccine
A known (diagnosed) allergy to a component of a COVID-19 vaccine
Which of the following best describes a standing order? • A directive from a third-party payer indicating that pharmacist can be reimbursed for administering vaccines • A preapproved document signed by collaborating physician who authorizes the pharmacist to administer a vaccine • The order of steps that must be followed when administering a vaccine • an order from the state board of pharmacy allowing pharmacist to administer vaccines
A preapproved document signed by collaborating physician who authorizes the pharmacist to administer a vaccine
When we constituting a vaccine for injection, pharmacist should: • Always withdraw the entire contents from the reconstituted vile • Always shake the dilute prior to reconstitution • always refer to the package insert for specific information • always shake the vaccine prior to reconstitution
Always refer to the package insert for specific information
In a patient experiencing anaphylaxis, pharmacist should administer epinephrine: • as a first line treatment • only in conjunction with diphenhydramine • intramuscularly in the deltoid • every two minutes until EMS arrives
As a first line treatment
What is the youngest age that hepatitis B vaccine is recommended in infants and children? • 6 months • At birth • 1 year • 4 weeks
At birth
Which of the following is a clinical feature of hepatitis B but not hepatitis A? • Fulminant hepatitis • Jaundice • Dark urine • Chronic infection
Chronic infection
Which of the following is considered a systemic symptoms of anaphylaxis? • myalgia • fever • headache • diarrhea and vomiting
Diarrhea and vomiting
What is the primary route that haemophilus influenzae is transmitted? • Fecal oral • Skin to skin contact • Droplet inhalation/respiratory tract secretions • Sexual transmission
Droplet inhalation/respiratory tract secretions
Why is it important to preserve the cold chain for vaccines? • exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency • vaccine stored at temperatures outside the recommended range are more likely to cause localized adverse event • maintaining the cold chain extends the shelf life for vaccines • vaccine stored it temperatures outside the recommended range are more likely to cause the stomach adverse reactions
Exposure to heat, cold, or light outside recommended ranges can reduce vaccine potency
T/F Polio always results in paralysis that can be short or long term?
False
T/F Varicella is NOT transmitted by contact with the lesions.
False
An adverse event that is considered a systemic reaction to a vaccine is: • Tenderness • Fever • Wheezing • Angioedema
Fever
What is another name for rubella? • Rubeola • Epidemic measles • German measles • Scarlet fever
German measles
A simple way to communicate information about risks and benefits of vaccines to all patients is to: • offer town hall style events for your community to ask questions about vaccine • schedule a 10 minute counseling session prior to each vaccine • give them vaccine information statements • recommend patients do their own research online prior to the vaccine appointment
Give them vaccine information statements
Post vaccination testing for hepatitis B immunity is recommended for which of the following? • Healthcare workers • IV drug users • Men who have sex with men • Adolescents
Healthcare workers
Which of the following vaccines contains a synthetic adjunct? • Engerix • Recombivax • Havrix • Heplisav
Heplisav
A patient presents to the pediatric clinic for their 5-year-old well check before entering kindergarten. They received rotavirus at 2 and 4 months and pentacel (DTap/IPV/Hib) at 2, 4, 6, and 15 months what vaccine should they need to receive today? • IPV • Hib • Another dose of pentacel • Rotavirus
IPV
Which of the following organizations provide standing order templates? • infectious disease society of America • National Institute of health • public health Institute • immunization action coalition
Immunization action coalition
Which of the following is true regarding transmission of SARS-CoV-2? • Is not transmitted through contaminated surfaces or objects • Infected individuals who may be pre-symptomatic, asymptomatic, or symptomatic can transmit the virus • Incubation period is 14 days (range 7-14 days) • It is only spread through respiratory droplets
Infected individuals who may be pre-symptomatic, asymptomatic, or symptomatic can transmit the virus
Post vaccination counseling for patients should include: • Warnings to self isolate for 48 hours so that the vaccine does not spread disease to others • A discussion of the risks and benefits of the vaccine • Information about adverse reactions that require contact with the healthcare system • A review of all steps in the shared decision-making process
Information about adverse reactions that require contact with the healthcare system
Which of the following is true regarding the recombinant herpes zoster vaccination? • It cannot be given to someone who is had the varicella vaccine • It is indicated for prevention of herpes zoster and it has complications in patients > 50 years of age • It should not be given to someone who has previously received the exhaustor vaccine live. • It is approved as a treatment of herpes asked her if administered within 48 hours of onset of symptoms.
It is indicated for prevention of herpes zoster and it has complications in patients > 50 years of age
A standing order or protocol should include information about • managing medical emergencies that made her after administration of a vaccine • details regarding any liability that the signing practitioner assumes as a result of the standing order or protocol • The pharmacy workflow and staffing needed to support the vaccination service • A statement of indemnification for liability
Managing medical emergencies that made her after administration of a vaccine
Which COVID-19 vaccination has two doses administered 28 days apart? • Jansen • Pfizer BioNTech • Moderna • Pfizer BioNTech (Comirnaty)
Moderna
A young adult with swelling of the parotid glands most likely has which of the following diseases? • Measles • Mumps • Rubella • Congenital rubella
Mumps
The cold chain for vaccines: • applies to vaccines but not to diluents • Requires that all vaccines be kept refrigerated until they are ready to be prepared for administration • begins when the provider seems responsibility when accepting delivery of the vaccine • Must be maintained from manufacture until the vaccine is administered to the patient
Must be maintained from manufacture until the vaccine is administered to the patient
Which of the following over-the-counter medication's may be recommended to treat systemic reactions after vaccination? • Dextromethorphan and cetirizine • loperamide and bismuth subsalicylate • diphenhydramine and guaifenesin • NSAIDS and acetaminophen
NSAIDs and acetomenophin
Which of the following is true regarding risk for COVID-19? • Coronary atherosclerosis and other heart disease patients have the highest risk of death • There has not been in association between number of comorbid conditions and increase in death • In the workforce, only healthcare professionals are flagged as at high risk for exposure • Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications
Older adults and people with underlying medical conditions are some of the patients at highest risk for severe disease and complications
Which of the following is true regarding varicella zoster transmission? • Covering lesions will prevent chance of transmission to others • Period of contagiousness 1-2 days before the rash to 4-7 days later • The incidence of varicella disease has remained unchanged since vaccinations became available • It is not respiratory transmitted
Period of contagiousness 1-2 days before the rash to 4-7 days later
Which of the following is the reason for the most recent hepatitis A outbreak? • Person to person transmission • Imported food • Domestic food • International travelers
Person to person transmission
Which disease states can potentially lead to meningitis? • Polio and Haemophilus influenzae • Polio • Rotavirus and polio • Haemophilus influenzae
Polio and Haemophilus influenzae
Which of the following complications are correctly matched the associated condition? • Ramsey hunt syndrome - varicella zoster • zoster ophthalmicus - varicella zoster • pneumonia - herpes Austin • post herpetic neuralgia - herpes zoster
Post herpetic neuralgia - herpes zoster
Documentation requirements for COVID-19 vaccinations include: • Only cases of COVID-19 that result in hospitalization or death after the recipient has received COVID-19 vaccine should be reported to VAERS • Report administration data to your jurisdiction system (e.g. IIS) within 72 hours after administration • Emergency use authorization (EUA) fact sheets should be provided after the patient receives a vaccine • COVID-19 vaccination record cards can be redesigned by the pharmacy
Report administration data to your jurisdiction system (e.g. IIS) within 72 hours after administration
What is the primary transmission route of measles, mumps, and rubella? • Blood transfusions • Gastrointestinal • Respiratory • Skin to skin contact
Respiratory
Which vaccination is not part of a combined antigen vaccine? • Rotavirus • Haemophilus influenzae • DTaP • Polio
Rotavirus
Which of the disease is prevented by the MMR vaccine is most rare in the US? • Marburg • Measles • Mumps • Rubella
Rubella
The first step in AHR cues share approach to vaccines is to: • Ask if your patient has any questions about the vaccine • Assess your patients values and preferences • Seek your patients participation in a discussion • Ask if your patient is ready to make a decision about getting the vaccine
Seek your patients participation in a discussion
To prevent errors a vaccine administration, pharmacist should: • select the appropriate needle • use the same diluent for all vaccines prepared in one sitting • Prepare enough vaccine for the entire shift at the beginning of the • memorize vaccine schedules
Select the appropriate needle
If patients believe that influenza vaccines can cause influenza because they were ill after receiving the vaccine last year, pharmacist should educate them that: • Some people experience systemic reactions to influenza vaccine that include mild flu like symptoms • only immunocompromise individuals can become ill from inactivated vaccines • it takes 3 to 4 weeks for the immune system to respond to the vaccine, so it is possible to become ill within that window • influenza vaccine can cause mild influenza infections in some people
Some people experience systemic reactions to influenza vaccine that include mild flu like symptoms
Which of the following statements about standing orders and protocols is true? • protocols, by definition, apply to all patients within a state • A sending order similar to a protocol but is usually brought her, authorizing the administration of multiple vaccines • standing orders and protocols may be needed for non-prescription products • standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations
Standing orders and protocols must consider which vaccines may be administered by pharmacists according to state laws and regulations
Which of the following is true regarding third dose and booster doses for COVID-19? • Booster doses must always be from the same product as the primary series • The 3rd dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines • A homologous booster dose is a subsequent dose of the vaccine that is a different product than the primary series • Booster doses for all COVID-19 vaccinations are given 6 months after completing the primary series
The 3rd dose and booster dose recommendations for immunocompromised patients are only for mRNA vaccines
Vaccine hesitancy is defined as: • The perception that the risk of a disease is low and the vaccines are not necessary • The delay in acceptance or refusal of a vaccination despite the availability of vaccination services • A lack of trust in the safety and effectiveness of vaccines • A lack of confidence in the reliability and competence of the health system
The delay in acceptance or refusal of a vaccination despite the availability of vaccination services
Which of the following correctly describes current ACIP recommendations? • The varicella zoster vaccine should be given at birth • Patients > 13 years without prior evidence of immunity should only receive 1 dose of varicella zoster vaccine • The herpes has vaccine should be given to patients > 40 years • The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age
The varicella zoster vaccine should be given at 12-15 months and 4-6 years of age.
T/F The incubation period for SARS cove two is typically 5 days.
True
Which of the following is the primary reason we have measles outbreaks in the US? • Low MMR vaccination rates nationally • Low effectiveness of the MMR vaccine • There is a shortage of MMR vaccine in the US • Unvaccinated people with measles coming to the US
Unvaccinated people with measles coming to the US
When administering an intramuscular injection pharmacist should: • Insert they need a little 45° angle • tell patients to flex the muscle into which the vaccine will be injected • use a 20 to 25 gauge needle • administer the vaccine in the deltoid or gluteus maximus
Use a 20 to 25 gauge needle
When storing vaccines in the refrigerator, pharmacist should: • keep vaccines and food on separate shells • use dorm style units • Store vaccines on the bottom of the refrigerator • use water bottles to help stabilize temperatures
Use water bottles to help stabilize temperatures
Which of the following are true regarding vaccine efficacy and safety for the live varicella vaccine and the recombinant zoster vaccine? • Vaccines have over 90% effectiveness in prevention of disease after two doses • Injection site pain for both vaccines less than 5% • Postherpetic neuralgia was not reduce impatience greater than 70 years of age receiving the recombinant zoster vaccine • Systemic grade 3 reactions (preventing normal activities) were lower after dose 2 for the recombinant zoster vaccine
Vaccines have over 90% effectiveness in prevention of disease after two doses
During a public health declared months outbreak a 21-year-old college student with a history of two MMR vaccine doses as a child wants to know if she needs a dose of MMR now. Which of the following is the best response? • Yes, since there is a declared mumps outbreak • Yes, since all college student should have three doses of MMR • No, as a third dose of MMR is only for measles outbreaks • No, as a third dose of MMR is only for rubella outbreaks
Yes, since there is a declared mumps outbreak
When preparing vaccines for administration, pharmacist should: • always use aseptic technique • reuse needles and syringes if multiple vaccines are administered to the same patient • prepare all vaccines in a multidose file at the same time • prepare enough vaccine for the entire shift at the beginning of the day
always use aseptic technique
Generalized your to Caria following a vaccine is considered: • A reactogenicity symptom • an allergic reaction • A localized reaction • unrelated to vaccine administration
an allergic reaction
An important benefit of standing orders and protocols is that they: • provide education to patient about The risks and benefits of vaccines • Ensure that all members of a patient's health care team are informed of vaccines • improve patient access to vaccines and efficacy of services • Allow for pharmacist a bill as providers for Medicare part
improve patient access to vaccines and efficacy of services
When administering a subcutaneous injection, pharmacist should: • pinch a fold of skin over the triceps muscle • use a 1 -1 1/2 inch needle • insert the needle at a 90° angle • tell the patient to flex the muscle under the injection site
pinch a fold of skin over the triceps muscle
Which of the following vaccines must be frozen? • Live attenuated influenza • TDaP • zostavax • inactivated influenza
zostavax
Which of the following are complications that result from diarrhea caused by rotavirus? • Electrolyte imbalance • Brain damage • Dehydration • Paralysis
• Electrolyte imbalance • Dehydration
ACIP offer shared decision making recommendations for which vaccines? • Hepatitis B vaccine • 9-valentHPV • Meningococcal B • Meningococcal ACWY • Measles • DTaP • Zoster
• Hepatitis B vaccine • 9-valentHPV • Meningococcal B
SATA which of the following statements are true regarding the recombinant zoster vaccine? • It requires adjuvant • It requires reconstitution • It is indicated starting at 60 years of age • It requires 2 doses
• It requires adjuvant • It requires reconstitution • It requires 2 doses
Which of the following groups are high risk for hepatitis A? • Infants • Adolescence • Persons experiencing homelessness • Illicit drug users • International travelers
• Persons experiencing homelessness • Illicit drug users • International travelers
Which of the following vaccines are mRNA vaccines? • Pfizer BioNTech • Moderna • Janssen • Pfizer BioNTech (Comirnaty)
• Pfizer BioNTech • Moderna • Pfizer BioNTech (Comirnaty)
