APHA Immunization Exam with
complete solutions 2025
When .Mary .turned .64, .she .was .diagnosed .with .type .2 .diabetes. .At .that .time, .she .received
.PPSV23. .Which .of .the .following .represents .appropriate .pneumococcal .coverage .for .Mary. .-
.CORRECT .ANSWER✔✔Administer .PCV13 .at .age .65, .then .PPSV23 .at .age .69.
LO .3.4; .Module .3— .Pneumococcal .Disease, .Vaccine .Recommendations .Immunocompetent
.adults .aged .65 .years .or .older .should .receive .13-valent .pneumococcal .conjugate .vaccine
.(PCV13) .followed .by .23-valent .pneumococcal .polysaccharide .vaccine .(PPSV23) .at .least .1
.year .after .PCV13. .However, .if .an .individual .is .a .candidate .for .PPSV23 .prior .to .age .65 .due
.to .high-risk .conditions .(in .this .case .diabetes), .then .another .dose .of .PPSV23 .would .be
.recommended .after .the .individual .turns .65, .but .should .be .given .5 .years .after .the .1st
.dose. .Since .Mary .received .PPSV23 .prior .to .PCV13, .then .PCV13 .should .be .administered .at
.least .one .year .after .PPSV23.
According .to .ACIP .recommendations, .HZV .is .indicated .for .the .prevention .of .herpes .zoster
.in .adults .aged: .- .CORRECT .ANSWER✔✔60
LO .3.2; .Module .3—
Herpes .Zoster, .Target .Groups .for .VaccinationEven .though .the .herpes .zoster .vaccine
.(Zostavax) .is .FDA .approved .for .individuals .aged .50 .and .older, .the .ACIP .recommends .this
.vaccine .for .individuals .aged .60 .and .older. .There .are .concerns .about .waning .immunity .with
.this .vaccine. .If .given .too .soon .(before .age .60), .it .may .not .afford .protection .in .older
.individuals .who .are .at .higher .risk .of .herpes .zoster.
,In .which .publication .does .the .CDC .initially .publish .new .or .updated .vaccine
.recommendations? .- .CORRECT .ANSWER✔✔Morbidity .and .Mortality .Weekly .Report
.(MMWR)
LO .1.6; .Module .1—Vaccine .Recommendation .SourcesThe .Advisory .Committee .on
.Immunization .Practices .(ACIP) .develops .vaccine .recommendations .and .guidelines. .These
.are .reviewed .and .approved .by .the .CDC .Director .and .the .U.S. .Department .of .Health .and
.Human .Services. .Once .approved, .they .are .published .in .the .CDC's .Morbidity .and .Mortality
.Weekly .Report .(MMWR). .The .Epidemiology .and .Prevention .of .Vaccine-Preventable
.Diseases .(commonly .referred .to .as .the .Pink .Book) .provides .comprehensive .information
.about .vaccines .and .the .diseases .they .prevent. .Content .published .in .the .MMWR .regarding
.vaccines .is .often .incorporated .into .this .resource. .Needle .Tips .is .a .newsletter .published
.multiple .times .throughout .the .year .by .the .Immunization .Action .Coalition. .It .provides
.timely .updates .and .answers .to .frequently .asked .questions. .Vaccine .is .a .journal .affiliated
.with .the .Edward .Jenner .Society .and .The .Japanese .Society .for .Vaccinology. .It .is .a .forum .for
.the .publication .of .research, .reviews, .and .commentaries .related .to .vaccines.
Which .of .the .following .best .describes .how .to .administer .MMR .vaccine .to .an .adult .patient
.weighing .210 .lb? .- .CORRECT .ANSWER✔✔Inject .subcutaneously .at .a .45° .angle .in .the .outer
.aspect .of .the .upper .arm.
LO .4.10; .Module .4— .General .Injection .Principles .The .MMR .vaccine .is .administered
.subcutaneously .at .a .45 .degree .angle .into .the .outer .aspect .of .the .upper .arm. .Vaccines .that
.are .given .intramuscularly .are .administered .into .the .deltoid .muscle .at .a .90 .degree .angle.
.The .weight .of .the .patient .does .not .matter .with .regard .to .route .of .administration.
The .presence .of .fever, .diffuse .maculopapular .rash, .and .Koplik .spots .are .characteristic .of
.which .of .the .following .diseases? .- .CORRECT .ANSWER✔✔Measles
Module .3—Measles, .Mumps, .Rubella. .MeaslesThe .classic .symptoms .of .measles .include
.fever, .cough, .coryza .(runny .nose), .conjunctivitis, .Koplik .spots .(a .bluish-white .rash .on
.mucous .membranes, .especially .the .mouth), .followed .by .the .development .of .a
.maculopapular .rash .approximately .14 .days .after .exposure. .Individuals .infected .with
.mumps .may .not .have .symptoms. .Others .may .have .nonspecific .symptoms, .such .as
,.headache, .fever, .myalgia, .and .malaise. .About .30% .to .40% .of .individuals .may .experience
.inflammation .of .the .parotid .glands. .Rubella .symptoms .tend .to .be .relatively .mild .and .may
.present .as .a .maculopapular .rash .that .occurs .approximately .14 .days .after .exposure. .Others
.may .experience .arthritis .and .arthralgia. .Varicella .presents .as .a .generalized .vesicular .rash.
Which .entity .determines .the .specific .vaccines .that .a .pharmacist .may .administer? .-
.CORRECT .ANSWER✔✔State .and .yada
Module .1—Expanding .Vaccination .Offerings
A .pharmacist's .scope .of .practice .and .immunization .authority .are .determined .by .the
.pharmacist's .state .practice .act. .As .such .the .laws .and .regulations .for .pharmacists .as
.immunizers .vary .by .state. .The .U.S. .Food .and .Drug .Administration .provides .the .regulatory
.oversight .for .the .approval .of .vaccines. .The .Advisory .Committee .on .Immunization .Practices
.is .the .leading .authority .in .the .U.S. .that .provides .comprehensive .vaccination
.recommendations .and .guidelines. .These .recommendations .are .reviewed .and .approved .by
.the .CDC. .The .local .health .departments .do .not .have .any .oversight .regarding .a .pharmacist's
.immunization .practices. .However, .pharmacists .often .work .with .their .local .health
.departments .to .provide .vaccines .and .public .health .services.
Kyle .is .a .5-year-old .boy .who .is .up .to .date .with .his .vaccinations. .He .has .never .experienced
.any .adverse .effects .from .vaccinations. .At .his .next .well-child .check-up, .Kyle .will .be
.receiving .the .following .vaccines: .IPV, .MMR, .varicella .vaccine, .and .a .tetanus-containing
.vaccine. .Which .of .the .following .tetanus-containing .vaccines .would .be .appropriate .for .him?
.- .CORRECT .ANSWER✔✔DTaP
LO .3.4; .Module .3—Target .Groups .for .Vaccination. .DTaP .VaccineDTaP .is .a .five-dose .series
.given .at .ages .2, .4, .6, .15 .through .18 .months, .and .4 .through .6 .years. .Kyle .is .due .for .his .5th
.and .final .dose .of .DTaP. .DTaP .is .appropriate .for .children .less .than .7 .years .of .age. .DT .is
.only .reserved .for .children .who .have .a .contraindication .to .the .pertussis .component .in
.DTaP. .Children, .adolescents, .and .adults .7 .years .of .age .and .older .who .require .protection
.against .tetanus, .diphtheria, .and .pertussis .would .receive .Tdap. .Following .the .one-time
.dose .of .Tdap, .a .Td .booster .should .be .given .every .10 .years.
, Which .of .the .following .documents .must .be .given .to .every .patient .or .patient's .caregiver
.before .administration .of .a .vaccine .covered .under .the .National .Childhood .Vaccine .Injury
.Act .(NCVIA)? .- .CORRECT .ANSWER✔✔VIS
Module .4— .Providing .Vaccine .Information .StatementsVaccine .information .statemetns
.(VISs) .are .standardized .forms .that .provide .an .overview .of .the .risks .and .benefits .of
.vaccines. .Health .care .providers .who .administer .vaccines .are .required .by .law .to .provide
.patients .with .the .most .up-to-date .version .of .the .VIS .for .any .vaccine .covered .under .the
.National .Childhood .Vaccine .Injury .Act .(NCVIA). .The .CMS-1500 .and .CMS-855B .are .forms
.required .by .the .Centers .for .Medicare .and .Medicaid .Services .(CMS) .for .billing .and .enrolling
.as .a .Medicare .provider, .respectively. .The .PHS-731 .is .now .the .CDC .731 .form .and .is .the
.International .Certificate .of .Vaccination .or .Prophylaxis .as .Approved .by .the .World .Health
.Organization .(the .Yellow .Card).
Which .vaccine .does .ACIP .recommend .for .all .college .freshmen, .aged .21 .years .or .younger,
.living .in .dormitories, .who .have .not .been .previously .vaccinated? .- .CORRECT
.ANSWER✔✔MCV4,
LO .3.4; .Module .3— .Meningococcal .Disease, .Target .Groups .for .Vaccination .Routine
.vaccination .with .the .quadrivalent .meningococcal .conjugate .vaccine .(MenACWY .or .MCV4)
.is .one .dose .at .ages .11 .to .12 .years .and .a .booster .dose .at .age .16 .years. .A .first-year .college
.student .aged .21 .years .or .younger .living .in .residential .housing .who .has .not .been
.previously .vaccinated .with .MCV4 .is .considered .high-risk .for .meningococcal .disease. .One
.dose .should .be .administered. .Living .in .dormitories .on .a .college .campus .is .not .considered
.a .risk .factor .for .pneumococcal .disease, .HPV, .or .varicella.
Which .of .the .following .tetanus .booster .vaccines .would .be .most .appropriate .for
.administration .to .a .12-year-old .boy .who .has .completed .a .primary .series .with .DTaP .and
.has .no .known .allergies? .- .CORRECT .ANSWER✔✔Tdap
LO .3.4; .Module .3— .Pertussis. .Target .Groups .for .Vaccination. .Tdap .Vaccine
One .dose .of .Tdap .is .routinely .recommended .for .all .adolescents .who .have .completed .the
.primary .series .of .DTaP. .This .should .be .given .at .11 .to .12 .years .of .age. .DTaP .contains .higher
.amounts .diphtheria .toxoid .and .pertussis .than .Tdap. .It .is .only .used .in .children .less .than .7
complete solutions 2025
When .Mary .turned .64, .she .was .diagnosed .with .type .2 .diabetes. .At .that .time, .she .received
.PPSV23. .Which .of .the .following .represents .appropriate .pneumococcal .coverage .for .Mary. .-
.CORRECT .ANSWER✔✔Administer .PCV13 .at .age .65, .then .PPSV23 .at .age .69.
LO .3.4; .Module .3— .Pneumococcal .Disease, .Vaccine .Recommendations .Immunocompetent
.adults .aged .65 .years .or .older .should .receive .13-valent .pneumococcal .conjugate .vaccine
.(PCV13) .followed .by .23-valent .pneumococcal .polysaccharide .vaccine .(PPSV23) .at .least .1
.year .after .PCV13. .However, .if .an .individual .is .a .candidate .for .PPSV23 .prior .to .age .65 .due
.to .high-risk .conditions .(in .this .case .diabetes), .then .another .dose .of .PPSV23 .would .be
.recommended .after .the .individual .turns .65, .but .should .be .given .5 .years .after .the .1st
.dose. .Since .Mary .received .PPSV23 .prior .to .PCV13, .then .PCV13 .should .be .administered .at
.least .one .year .after .PPSV23.
According .to .ACIP .recommendations, .HZV .is .indicated .for .the .prevention .of .herpes .zoster
.in .adults .aged: .- .CORRECT .ANSWER✔✔60
LO .3.2; .Module .3—
Herpes .Zoster, .Target .Groups .for .VaccinationEven .though .the .herpes .zoster .vaccine
.(Zostavax) .is .FDA .approved .for .individuals .aged .50 .and .older, .the .ACIP .recommends .this
.vaccine .for .individuals .aged .60 .and .older. .There .are .concerns .about .waning .immunity .with
.this .vaccine. .If .given .too .soon .(before .age .60), .it .may .not .afford .protection .in .older
.individuals .who .are .at .higher .risk .of .herpes .zoster.
,In .which .publication .does .the .CDC .initially .publish .new .or .updated .vaccine
.recommendations? .- .CORRECT .ANSWER✔✔Morbidity .and .Mortality .Weekly .Report
.(MMWR)
LO .1.6; .Module .1—Vaccine .Recommendation .SourcesThe .Advisory .Committee .on
.Immunization .Practices .(ACIP) .develops .vaccine .recommendations .and .guidelines. .These
.are .reviewed .and .approved .by .the .CDC .Director .and .the .U.S. .Department .of .Health .and
.Human .Services. .Once .approved, .they .are .published .in .the .CDC's .Morbidity .and .Mortality
.Weekly .Report .(MMWR). .The .Epidemiology .and .Prevention .of .Vaccine-Preventable
.Diseases .(commonly .referred .to .as .the .Pink .Book) .provides .comprehensive .information
.about .vaccines .and .the .diseases .they .prevent. .Content .published .in .the .MMWR .regarding
.vaccines .is .often .incorporated .into .this .resource. .Needle .Tips .is .a .newsletter .published
.multiple .times .throughout .the .year .by .the .Immunization .Action .Coalition. .It .provides
.timely .updates .and .answers .to .frequently .asked .questions. .Vaccine .is .a .journal .affiliated
.with .the .Edward .Jenner .Society .and .The .Japanese .Society .for .Vaccinology. .It .is .a .forum .for
.the .publication .of .research, .reviews, .and .commentaries .related .to .vaccines.
Which .of .the .following .best .describes .how .to .administer .MMR .vaccine .to .an .adult .patient
.weighing .210 .lb? .- .CORRECT .ANSWER✔✔Inject .subcutaneously .at .a .45° .angle .in .the .outer
.aspect .of .the .upper .arm.
LO .4.10; .Module .4— .General .Injection .Principles .The .MMR .vaccine .is .administered
.subcutaneously .at .a .45 .degree .angle .into .the .outer .aspect .of .the .upper .arm. .Vaccines .that
.are .given .intramuscularly .are .administered .into .the .deltoid .muscle .at .a .90 .degree .angle.
.The .weight .of .the .patient .does .not .matter .with .regard .to .route .of .administration.
The .presence .of .fever, .diffuse .maculopapular .rash, .and .Koplik .spots .are .characteristic .of
.which .of .the .following .diseases? .- .CORRECT .ANSWER✔✔Measles
Module .3—Measles, .Mumps, .Rubella. .MeaslesThe .classic .symptoms .of .measles .include
.fever, .cough, .coryza .(runny .nose), .conjunctivitis, .Koplik .spots .(a .bluish-white .rash .on
.mucous .membranes, .especially .the .mouth), .followed .by .the .development .of .a
.maculopapular .rash .approximately .14 .days .after .exposure. .Individuals .infected .with
.mumps .may .not .have .symptoms. .Others .may .have .nonspecific .symptoms, .such .as
,.headache, .fever, .myalgia, .and .malaise. .About .30% .to .40% .of .individuals .may .experience
.inflammation .of .the .parotid .glands. .Rubella .symptoms .tend .to .be .relatively .mild .and .may
.present .as .a .maculopapular .rash .that .occurs .approximately .14 .days .after .exposure. .Others
.may .experience .arthritis .and .arthralgia. .Varicella .presents .as .a .generalized .vesicular .rash.
Which .entity .determines .the .specific .vaccines .that .a .pharmacist .may .administer? .-
.CORRECT .ANSWER✔✔State .and .yada
Module .1—Expanding .Vaccination .Offerings
A .pharmacist's .scope .of .practice .and .immunization .authority .are .determined .by .the
.pharmacist's .state .practice .act. .As .such .the .laws .and .regulations .for .pharmacists .as
.immunizers .vary .by .state. .The .U.S. .Food .and .Drug .Administration .provides .the .regulatory
.oversight .for .the .approval .of .vaccines. .The .Advisory .Committee .on .Immunization .Practices
.is .the .leading .authority .in .the .U.S. .that .provides .comprehensive .vaccination
.recommendations .and .guidelines. .These .recommendations .are .reviewed .and .approved .by
.the .CDC. .The .local .health .departments .do .not .have .any .oversight .regarding .a .pharmacist's
.immunization .practices. .However, .pharmacists .often .work .with .their .local .health
.departments .to .provide .vaccines .and .public .health .services.
Kyle .is .a .5-year-old .boy .who .is .up .to .date .with .his .vaccinations. .He .has .never .experienced
.any .adverse .effects .from .vaccinations. .At .his .next .well-child .check-up, .Kyle .will .be
.receiving .the .following .vaccines: .IPV, .MMR, .varicella .vaccine, .and .a .tetanus-containing
.vaccine. .Which .of .the .following .tetanus-containing .vaccines .would .be .appropriate .for .him?
.- .CORRECT .ANSWER✔✔DTaP
LO .3.4; .Module .3—Target .Groups .for .Vaccination. .DTaP .VaccineDTaP .is .a .five-dose .series
.given .at .ages .2, .4, .6, .15 .through .18 .months, .and .4 .through .6 .years. .Kyle .is .due .for .his .5th
.and .final .dose .of .DTaP. .DTaP .is .appropriate .for .children .less .than .7 .years .of .age. .DT .is
.only .reserved .for .children .who .have .a .contraindication .to .the .pertussis .component .in
.DTaP. .Children, .adolescents, .and .adults .7 .years .of .age .and .older .who .require .protection
.against .tetanus, .diphtheria, .and .pertussis .would .receive .Tdap. .Following .the .one-time
.dose .of .Tdap, .a .Td .booster .should .be .given .every .10 .years.
, Which .of .the .following .documents .must .be .given .to .every .patient .or .patient's .caregiver
.before .administration .of .a .vaccine .covered .under .the .National .Childhood .Vaccine .Injury
.Act .(NCVIA)? .- .CORRECT .ANSWER✔✔VIS
Module .4— .Providing .Vaccine .Information .StatementsVaccine .information .statemetns
.(VISs) .are .standardized .forms .that .provide .an .overview .of .the .risks .and .benefits .of
.vaccines. .Health .care .providers .who .administer .vaccines .are .required .by .law .to .provide
.patients .with .the .most .up-to-date .version .of .the .VIS .for .any .vaccine .covered .under .the
.National .Childhood .Vaccine .Injury .Act .(NCVIA). .The .CMS-1500 .and .CMS-855B .are .forms
.required .by .the .Centers .for .Medicare .and .Medicaid .Services .(CMS) .for .billing .and .enrolling
.as .a .Medicare .provider, .respectively. .The .PHS-731 .is .now .the .CDC .731 .form .and .is .the
.International .Certificate .of .Vaccination .or .Prophylaxis .as .Approved .by .the .World .Health
.Organization .(the .Yellow .Card).
Which .vaccine .does .ACIP .recommend .for .all .college .freshmen, .aged .21 .years .or .younger,
.living .in .dormitories, .who .have .not .been .previously .vaccinated? .- .CORRECT
.ANSWER✔✔MCV4,
LO .3.4; .Module .3— .Meningococcal .Disease, .Target .Groups .for .Vaccination .Routine
.vaccination .with .the .quadrivalent .meningococcal .conjugate .vaccine .(MenACWY .or .MCV4)
.is .one .dose .at .ages .11 .to .12 .years .and .a .booster .dose .at .age .16 .years. .A .first-year .college
.student .aged .21 .years .or .younger .living .in .residential .housing .who .has .not .been
.previously .vaccinated .with .MCV4 .is .considered .high-risk .for .meningococcal .disease. .One
.dose .should .be .administered. .Living .in .dormitories .on .a .college .campus .is .not .considered
.a .risk .factor .for .pneumococcal .disease, .HPV, .or .varicella.
Which .of .the .following .tetanus .booster .vaccines .would .be .most .appropriate .for
.administration .to .a .12-year-old .boy .who .has .completed .a .primary .series .with .DTaP .and
.has .no .known .allergies? .- .CORRECT .ANSWER✔✔Tdap
LO .3.4; .Module .3— .Pertussis. .Target .Groups .for .Vaccination. .Tdap .Vaccine
One .dose .of .Tdap .is .routinely .recommended .for .all .adolescents .who .have .completed .the
.primary .series .of .DTaP. .This .should .be .given .at .11 .to .12 .years .of .age. .DTaP .contains .higher
.amounts .diphtheria .toxoid .and .pertussis .than .Tdap. .It .is .only .used .in .children .less .than .7
