APhA Immunization Exam Questions & Answers | Latest Already Graded A+ |Questions with Correct Answers 2026 latest update!!

What is the minimum needle length recommended for administering HepB vaccine to an adult patient weighing 130 lb?

Fixed 1-inch needles are acceptable for patients weighing 60 kg (132 lb) or less.

HZV, MMR, rabies, typhoid, varicella, or yellow fever vaccine should not be administered to a patient with a history of anaphylaxis to:

Gelatin

Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan?

1) Tdap

2) Td 4 weeks later

3) Td 6-12 months later

Td booster every 10 years after 3rd dose

Candidate for PPSV23?

All adults 65+ years

Immunocompromised (alcoholism, chronic liver; heart; lung disease, diabetics, cochlear implants, CSF leak) patients ages 19-64

Children with asthma only if theyre treated with high dose corticosteriods

Name the vaccine-preventable disease that may be contracted by unimmunized children from adults serving as reservoirs for the disease, which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death.

Pertussis

Which of the following vaccines may be administered to males and females aged 9 through 26 years to reduce the likelihood of acquiring genital warts?

9vHPV

Which of the following key questions is important to ask a patient before administering IIV?

Are you sick today?

*Mild illness is okay, but moderate to severe acute illness need to be resolved before getting vaccine.

Live attenuated vaccines..

produced by weakening the virus or bacteria to reduce the likelihood that it can cause disease

end to produce more persistent, longer-lasting immunity than inactivated vaccines

must replicate in order for the body to produce an immune response

could cause disease in immunocompromised patients

Circulating antibodies may interfere with a live attenuated vaccine's ability to replicate.

Inactivated vaccines...

are produced by killing the virus/bacteria

includes polysaccharide vaccines (conjugated [protein altered] or unconjugated), toxoids, or cellular vaccines

Which type of vaccine involves stimulation of B cells without the assistance of T helper cells?

A pure polysaccharide

*not recommended for children <2 because of their immature immune system

Conjugated vaccines..

provide longer lasting protection

the immune response that changes to a T cell mediated response allows children <2 to form an immune response

T/F

Both live attenuated vaccines and recombinant vaccines mimic natural infection and involve T cells in the immune response.

True

The incubation period for influenza can range from:

1-4 days

What is the time interval for which the development of Guillain-Barré syndrome following influenza vaccination would result in a precaution for future influenza vaccines?

6 weeks

The monitoring system that health care providers should use to report serious adverse events after vaccination is:

VAERS

Which of the following patients are appropriate candidates for the 2-dose schedule of HPV9?

11 or 12 year olds

*if series has not been started by age 15, then a 3 dose series is needed

*3 dose series recommended for immunocompromised patients

*1st/2nd dose- given at 0 and 6-12 months

*if 2nd dose is given sooner than 5 months after the first dose then a 3rd dose is needed

Why should refrigerated vaccines be stored in the middle of the refrigerator?

because the temperature in the middle does not fluctuate as much.

A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines?

Hep A, IPV, MMR, Rabies, smallpox, varicella, zoster, influenza

When looking at the schedule for vaccines that might be indicated for children and adolescents aged 18 years or younger based on medical indications, what does the orange bar represent?

Orange-indicates theres a precaution for the vaccine

*

Yellow-vaccine recommended according to routine schedule

Purple-recommended for people with an additional risk factor for which the vaccine would be indicated

Yellow/black- vaccine recommended, additional doses may be necessary based on medical condition

White-no recommendation

Red-vaccine is contraindicated

A health care provider who has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B-positive patient. In addition to hepatitis B vaccine, the health care provider also should receive hepatitis B Immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides:

Immediate protection

*its passive immunity so its short-lived, but provides protection right away

Contraindication of HZV

HZV is a live vaccine so its contraindicated in immunocompromised patients, pregnant women, and those who have experienced a severe allergic reaction to the vaccine components (neomycin, gelatin)

Viruses associated with the development of cancer:

HPV and Hep B

There should be a flat hard surface in the area where vaccines will be administered to ensure:

there is space to perform CPR

If pharmacists are called upon to assist with vaccination efforts following a natural disaster, which vaccine is likely to be needed by many of the victims?

Td or Tdap

According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient?

5/8 in needle at 45 degrees in the outer upper arm (SC)

How often are the Healthy People targets for vaccination rates updated?

every 10 years

Which of the following patients is a candidate for both MenACWY and MenB vaccines?

A 10 year old who just had his spleen removed

*MenA can be administered at 2months, MenB not recommended until 10 yrs

HIV infection and being in the military are risk factors for MenA

What must be documented for VIS?

-patient name

-date vaccine was administered

-vaccine manufacturer, lot number

-name, address, title of the administer

-date printed on VIS

-date VIS was given to patient or guardian

*signatures of patient/guardian not required by federal law, but some employers/companys may require signatures

Who should receive MMR vaccine?

2 dose series at 12-15 months and 4-6 years

*no additional doses needed

MMR is a live vaccine, not recommended until 12 months old

Adults w/o immunity evidence (being born before 1957, documentation of MMR vaccine, lab evidence of disease) should receive one dose

Healthcare professionals should receive 2 doses

If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted?

Do not have to start series over (oral typhoid is the exception)

*Increasing the interval between doses of a multi-dose vaccine series does not diminish the ultimate effectiveness of the vaccine, but it does delay protection for the patient.

Which of the following best describes how to administer MMR vaccine to an adult patient weighing 210 lb?

SC at 45 degree angle

*weight of patient does not matter in regards to route of administration

HPV vaccine is recommended for..

Both males and females ages 9-26 years

*routinely recommended for 11 or 12 years of age

Tom is a 9-year old boy who has never had an influenza vaccine. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. What dose and schedule of IIV should be administered to Tom?

One dose during flu season

*influenza vaccine can be given beginning at 6 months

6 months-8 years who have not previously been vaccinated need 2 doses, 4 weeks apart

9 years-one dose during flu season

6 months-2 years 0.25mL dose

3+ years- 0.5mL dose

Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today?

Tdap

MCV4

HPV

Hep B

influenza vaccine if flu season

True regarding varicella-containing vaccines:

HZV (Zostavax) contains 14 times more antigen than varicella vaccine

the greater potency is necessary for an adequate immune response in older patients who have immunity to varicella because they had chicken pox

Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis?

Rabies

*it affects the CNS

If a patient with an egg allergy experiences hives following influenza vaccination, what is ACIP's recommendation for vaccinating this patient against influenza?

Hives only-can receive vaccine

If patient experienced anaphylaxis or required an epi pen -CAN still receive vaccine but it must be in a medical setting where they can be supervised by medical professionals to assist with any complications

The childhood/adolescent and adult immunization schedules are updated and published annually during which months?

once a year at the end of January or early February

How is the live, cholera vaccine administered?

single oral dose at least 10 days prior to potential exposure

*should not eat/drink for 1 hour before or after vaccine

RotaTeq (RV5) should be administered as a:

3-dose series at 2,4,6 months

Rotarix (RV1) should be administered as a:

2 dose oral series at 2 and 4 months

Diagnosis-based screening to identify people at risk for vaccine-preventable diseases:

identifies patients in need of vaccines based on the presence of a particular diagnosis.

ex: diabetes

Procedure based screening to identify people at risk for vaccine-preventable diseases:

involves assessing vaccine needs based on a patient's receipt of a surgical, medical, or pharmacy-based procedure.

ex: splenectomy

Occurrence based screening to identify people at risk for vaccine-preventable diseases:

takes advantage of an event, such as a hospital admission, clinic visit, or emergency department visit to identify people who need to be vaccinated

ex: discharge counseling

live attenuated vaccines (11)

1. Cholera

2. HZV

3. LAIV

4. MMR

5. MMRV

6. Rotavirus

7. TB (BCG)

8. Typhoid (Ty21a)

9. Vaccinia (smallpox)

10. Varicella

11. Yellow Fever

*all others are inactivated

For a patient who needs to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines?

No minimum interval between doses

*IIV is inactivated

HZV is live

inactivated do not interfere with live

Interval between 2 live vaccines NOT given simultaneously:

4 weeks

Why was the live attenuated influenza vaccine (LAIV) removed from the ACIP's influenza vaccine recommendations?

Lower than expected efficacy in 2013-2016

Epi doses:

1:1000 w/v

1mg/mL

based on weight: 0.01mg/kg/dose

max dose: 0.5mg/dose

dose 5-15min for up to 3 doses

The majority of vasovagal syncope cases occur withinin:

15min of vaccination

Which of the following diseases has been successfully eradicated worldwide through vaccination efforts?

smallpox

In 2014, which vaccination rate was lowest among adolescents 13 through 17 years of age?

HPV

How do vaccines evoke an immune response?

The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.

*Pure polysaccharide vaccines do not activate B cells.

What to do in case of anaphylaxis:

Do not offer water (do not want anything in the throat)

check BP and pulse to see if it is decreasing (decreasing means less blood flow and more likely to faint)

Administer epi pen when patient is wheezing and difficulty in breathing, give second dose if wheezing continues

IM is more prompt than SC

True allergic reaction:

immediate hypersensitivity with itching, hives, redness, or symptoms of anaphylaxis

False allergic reaction:

fever, GI upset, red eyes, neurological events

Can a women receive the flu vaccine if she is pregnant?

Yes, but it has to be the inactivated flu vaccine only during flu season

What vaccine should women get every pregnancy?

Tdap, after 20 weeks of pregnancy

What individuals are at an increased risk of adverse effects from live vaccines

Immunocompromised

Minimum interval when a PPD skin test is followed by a live vaccine

Administer vaccine after PPD skin test has been read

Minimum interval when a live vaccine is followed by a PPD skin test

28 days

Minimum interval when blood product is given before live vaccine

minimum varies (have to look up)

Minimum interval for live vaccines followed by blood products

2 weeks

Minimum interval for inactivated vaccines and antibodies

no minimum

Minimum interval for two live vaccines, if not simultaneous

28 days

Purpose of adjuvants

it strengthens the response to the antigen and the immune response is much greater because the adjuvant results in an inflammatory response

*adjuvants are added to recombinant vaccines

The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases?

MMR

Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated?

1) perceived susceptibility to a disease

2) perceived seriousness of a disease

3) perceived vaccine benefits

4) perceived vaccine barriers (e.g., adverse effects, access)

5) social influence (e.g., recommendation from a health care provider)

In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to:

quiet activites and comfort them

*Can use acetaminophen/ibuprofen for discomfort

Aspirin is not recommended

During which step of the Pharmacists' Patient Care Process would a pharmacist analyze a patient's need for certain vaccines?

Assess

After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every:

every 10 years

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?

one dose of Tdap

Ava has arrived at the clinic for her well-child visit. She is 4 months old. Ava's immunization record reveals that she has received the following vaccines:

2 doses of HepB

1 dose of Hib

1 dose of rotavirus

1 dose of PCV13

1 dose of DTaP

1 dose of IPV

Which vaccines should Ava receive at today's visit?

2nd Hib

Rotavirus

DTaP

PCV13

IPV

*3rd Hep B at 6 months

too young for flu vaccine

MMR/varicella are live and recommend at 1 year

Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B?

3 dose series at 0, 1, and 6 months

At what point during pregnancy is it recommended to administer the influenza vaccine?

Any trimester

Which of the following statements about pharmacy-based vaccination programs is true?

Feedback

Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians.

Which of the following is the best example of a group with which individual pharmacists can collaborate to increase immunization rates in their communities?

Local Health Departments

A 69 year-old man received Td vaccination 4 years ago. He is preparing to travel to see his newborn granddaughter next month. Which of the following vaccines containing tetanus, diphtheria, and/or pertussis would be most appropriate for him?

Tdap if he has not received that

and a Td booster every 10 years

Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate's immunization record indicates that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines, and she received a dose of Tdap 2 years ago. For complete coverage, which of the following vaccines should she receive?

PPSV23

HPV

Influenza if flu season

*PCV13 is for immunocompromised not asthma

What is the type of immunity that occurs when a pregnant woman is vaccinated with Tdap to protect the infant from pertussis after birth?

Passive Immunity

*antibodies are provided from another source

Acquired immunity:

immunological memory

*can be active or passive

Active immunity:

an antigen from an invading pathogen triggers an immune response

Which of the following statements would be accurate when responding to a patient's concerns about the safety of vaccines?

Inactivated is killed so cannot cause influenza

intranasal is live but modified so cannot cause disease

No vaccine is 100% effective

If illness does occur its often less severe in those who were vaccinated

No evidence that Thimerosal has caused any short or long term harm

Several vaccines on the same day in immunocompetent people will not overload their immune system

people are exposed . to more antigens every day from food or bacteria than from vaccines

If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine?

1-3 doses with 5 years between

under age of 65 who are immunocompromised or asplenia-2 doses with 5 years apart

Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction?

Diphtheria

Which of the following best describes how to administer Tdap vaccine to an adult patient weighing 185 lb?

IM at 90 degrees

*weight of patient is irrelevant in regards to route of administration

Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He leaves in 3 weeks and will be gone a month. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine:

2nd dose given at least 6 months after the first dose

Adolescents should be routinely vaccinated with MCV4 on the following schedule:

1 dose at 11 or 12 years

booster at 16 years

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?

5th dose DTaP

*one time dose of Tdap at 7 years

Td booster every 10 years

Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient?

HZV-SC, 0.65mL dose

IIV-IM, 0.5mL

What is meant by the term "immunization neighborhood"?

Immunization stakeholders collaborate to meet community immunization needs.

Even though state laws may have specific mandates, how long should pharmacists maintain records of immunizations?

Immunizations should become part of the patient's permanent record and should be kept for the patient's lifetime.

All Medicare Part B enrollees are covered for which vaccines?

both pneumococcal vaccines

influenza vaccine

All Medicare Part D enrollees are covered for which vaccines?

Td/Tdap

HZV

Arthus reactions, which are exaggerated local reactions that can occur if a patient is vaccinated too frequently, are most commonly reported after which vaccine?

Td or Tdap

Aiden is a 6-month-old healthy boy with no known allergies. He has received vaccinations in the past with no reported adverse reactions. Aiden's father asks about having his son vaccinated against influenza. The most appropriate response would be to inform the father that Aiden:

If he has not had 2 doses of the flu vaccine then he needs 2 doses, 4 weeks apart

According to the ACIP, which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary?

Diagnosis of chickenpox/shingles by a health care provider.

Born in U.S. before 1980

2 doses of varicella at least 4 weeks apart

Vaccines as well as exposure to natural disease are both examples of which type of immunity?

Active immunity

How vaccines evoke an immune response:

The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.

*Pure polysaccharide vaccines do not activate B cells.

If a vial of influenza vaccine is left out of the refrigerator on the pharmacy counter overnight, what should be done with the vaccine?

Should be quarantined in fridge/freezer and marked "do not use" and contact manufacturer for further instructions

*RPh should document each step anytime theres a break in the cold chain