Pharmacy Immunizations and Vaccines 2 — Questions and Answers
Question 1: The HPV vaccine (Gardasil 9) is recommended starting at age 11–12. If the series is started at age 15 or older, how many doses are required?
- 1 dose
- 2 doses
- 3 doses (Correct answer)
- 4 doses
Correct answer: 3 doses
If HPV vaccination is started at age 15 or older, or if dose 1 was given before 15 but dose 2 is delayed beyond schedule, 3 doses are required (0, 1–2, and 6 months).
Question 2: Which component of the COVID-19 mRNA vaccine does the mRNA instruct cells to produce?
- The entire SARS-CoV-2 virus
- The spike (S) protein of SARS-CoV-2 (Correct answer)
- ACE2 receptors
- Neutralizing antibodies directly
Correct answer: The spike (S) protein of SARS-CoV-2
mRNA COVID-19 vaccines (Moderna, Pfizer-BioNTech) deliver instructions for cells to produce the SARS-CoV-2 spike protein, triggering an immune response without introducing live virus.
Question 3: Vaccine Information Statements (VIS) must be provided to patients before administering which vaccines?
- Only vaccines given in hospitals
- Only live vaccines
- All vaccines covered by the National Childhood Vaccine Injury Act (NCVIA) (Correct answer)
- Only vaccines that are on the childhood immunization schedule
Correct answer: All vaccines covered by the National Childhood Vaccine Injury Act (NCVIA)
Federal law (NCVIA) requires healthcare providers to give the appropriate VIS before administering any vaccine covered by the Act — including many adult vaccines like influenza, Td/Tdap, and hepatitis B.
Question 4: Tdap vaccine is recommended during each pregnancy to protect the newborn. The optimal time for administration is:
- First trimester (weeks 1–12)
- Between 27 and 36 weeks gestation (Correct answer)
- Immediately postpartum
- Only for mothers who have never received Tdap before
Correct answer: Between 27 and 36 weeks gestation
ACIP recommends Tdap during each pregnancy between 27 and 36 weeks gestation (ideally 27–32 weeks) to maximize maternal antibody transfer to the fetus, protecting newborns before they can receive their own vaccines.
Question 5: A patient receives a live vaccine today and asks when they can receive another live vaccine. Per CDC guidelines:
- Any time — there is no minimum interval between live vaccines
- At least 28 days later if they are given on different days (Correct answer)
- At least 6 months later
- Immediately — all live vaccines can be given simultaneously
Correct answer: At least 28 days later if they are given on different days
If two live vaccines are not given on the same day, they must be separated by at least 28 days (4 weeks) to prevent immune interference from one vaccine reducing response to the other.
Question 6: Which vaccine is recommended for all adults 65+ who have never received any pneumococcal vaccine?
- PCV15 only
- PPSV23 only
- PCV15 or PCV20, followed by PPSV23 if PCV15 was used (Correct answer)
- No pneumococcal vaccine is recommended for immunocompetent adults 65+
Correct answer: PCV15 or PCV20, followed by PPSV23 if PCV15 was used
ACIP (2021) recommends adults 65+ receive PCV15 followed by PPSV23 (at least 1 year later), or PCV20 alone. PCV20 alone is an acceptable single-dose option for vaccine-naive adults.
Pharmacy Immunizations and Vaccines 2
The HPV vaccine (Gardasil 9) is recommended starting at age 11–12.
If the series is started at age 15 or older, how many doses are required?