APHA Immunization
Study online at https://quizlet.com/_hjde9s
1. When Mary turned 64, she was diagnosed with type 2 diabetes. At that time,
she received PPSV23. Which of the following represents appropriate pneumo-
coccal coverage for Mary.: 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.
2. According to ACIP recommendations, HZV is indicated for the prevention of
herpes zoster in adults aged:: 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.
3. In which publication does the CDC initially publish new or updated vaccine
recommendations?: 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.
4. Which of the following best describes how to administer MMR vaccine to an
adult patient weighing 210 lb?: Inject subcutaneously at a 45° angle in the outer aspect of the upper
arm.
, APHA Immunization
Study online at https://quizlet.com/_hjde9s
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.
5. The presence of fever, diffuse maculopapular rash, and Koplik spots are
characteristic of which of the following diseases?: 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.
6. Which entity determines the specific vaccines that a pharmacist may admin-
ister?: 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.
7. 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-con-
taining vaccines would be appropriate for him?: 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
, APHA Immunization
Study online at https://quizlet.com/_hjde9s
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.
8. Which of the following documents must be given to every patient or patient's
caregiver before administration of a vaccine covered under the National Child-
hood Vaccine Injury Act (NCVIA)?: 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).
9. Which vaccine does ACIP recommend for all college freshmen, aged 21 years
or younger, living in dormitories, who have not been previously vaccinated?: -
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.
10. 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?: 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 years of age to avoid injection site reactions in adolescents and adults. Following
the one-time dose of Tdap, a Td booster should be given every 10 years. DT, which has a higher amount of diphtheria
toxin is only reserved for children who have a contraindication to the pertussis component in DTaP.
Study online at https://quizlet.com/_hjde9s
1. When Mary turned 64, she was diagnosed with type 2 diabetes. At that time,
she received PPSV23. Which of the following represents appropriate pneumo-
coccal coverage for Mary.: 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.
2. According to ACIP recommendations, HZV is indicated for the prevention of
herpes zoster in adults aged:: 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.
3. In which publication does the CDC initially publish new or updated vaccine
recommendations?: 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.
4. Which of the following best describes how to administer MMR vaccine to an
adult patient weighing 210 lb?: Inject subcutaneously at a 45° angle in the outer aspect of the upper
arm.
, APHA Immunization
Study online at https://quizlet.com/_hjde9s
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.
5. The presence of fever, diffuse maculopapular rash, and Koplik spots are
characteristic of which of the following diseases?: 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.
6. Which entity determines the specific vaccines that a pharmacist may admin-
ister?: 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.
7. 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-con-
taining vaccines would be appropriate for him?: 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
, APHA Immunization
Study online at https://quizlet.com/_hjde9s
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.
8. Which of the following documents must be given to every patient or patient's
caregiver before administration of a vaccine covered under the National Child-
hood Vaccine Injury Act (NCVIA)?: 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).
9. Which vaccine does ACIP recommend for all college freshmen, aged 21 years
or younger, living in dormitories, who have not been previously vaccinated?: -
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.
10. 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?: 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 years of age to avoid injection site reactions in adolescents and adults. Following
the one-time dose of Tdap, a Td booster should be given every 10 years. DT, which has a higher amount of diphtheria
toxin is only reserved for children who have a contraindication to the pertussis component in DTaP.
