Quiz: An Immunization Mixed Bag

Question 1:

The correct answer is D. Two doses of the influenza vaccine, given 4 weeks apart.

According to current CDC recommendations, children aged 6 months through 8 years who have never received the flu vaccine, or for whom vaccination history is uncertain, should receive two doses of the influenza vaccine given four weeks apart.¹

Question 2.

The correct answer is B. An 18-year-old woman who is pregnant

According to current CDC recommendations, the HPV vaccine is not recommended during pregnancy. Pregnant women should delay initiation of the series until after giving birth. If a woman has already started the vaccination series, completion should be delayed until after pregnancy. Other contraindications and precautions to the HPV vaccine include anaphylactic allergy (for the bivalent HPV vaccine only), yeast allergy (for the 9-valent HPV vaccine), and moderate or severe acute illness. A minor illness, such as febrile or afebrile diarrhea or mild upper respiratory tract infection, is not a reason to defer vaccination.²

Question 3.

The correct answer is D. Either A or B

According to the package insert, the second dose of the Shingrix vaccine should be delivered anytime between 2 and 6 months after the first dose. Currently there is no data on the efficacy of receiving just one dose.³

Question 4.

The correct answer is C. $280

Shingrix is a herpes zoster vaccine that was approved by the FDA in October 2017. The cost for the required two doses is $280. In contrast, the current Zostavax vaccine requires one dose and costs $223. On October 25, 2017, the CDC’s Advisory Committee on Immunization Practices recommended that Shingrix should replace Zostavax as the preferred shingles vaccine in people age 50 years and older.^4,5

Question 5.

The correct answer is B. At age 67

According to CDC recommendations, all people aged 65 years and over should receive one dose of the Pneumovax vaccine. A patient who has received one or two doses before age 65 should receive one final dose at age 65 or older, provided 5 years have elapsed since the most recent dose. This patient received her previous dose at age 62, so her final dose should be at age 67.⁶

References:

1. Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2017–18 Influenza Season. MMWR Recomm Rep 2017;66(No. RR-2):1–20. DOI: 

2. Centers for Disease Control (CDC). HPV vaccine recommendations. Accessed November 27, 2017 at: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

3. Shingrix [package insert]. Research Triangle Park, NC: GlaxoSmithKline Biologicals; 2017.

4. Hamm N. GSK launches more effective shingles vaccine. Drug Topics. Posted October 23, 2017.  

5. GlaxoSmithKline. CDC’s Advisory Committee on Immunization Practices recommends Shingrix as the preferred vaccine for the prevention of shingles for adults aged 50 and up. October 25, 2017. Accessed October 27, 2017 at: https://www.gsk.com/en-gb/media/press-releases/cdc-s-advisory-committee-on-immunization-practices-recommends-shingrix-as-the-preferred-vaccine-for-the-prevention-of-shingles-for-adults-aged-50-and-up/

6. Centers for Disease Control and Prevention (CDC). Pneumococcal Vaccination. Accessed November 27, 2017 at: https://www.cdc.gov/pneumococcal/vaccination.html