Immunization

Question 1

T or F: you should not delay immunizations for a child with mild URTI symptoms

Answer 1

True

Question 2

Name 4 moderate to severe acute illness that warrant postponing schedule vaccines

Answer 2

• Gastroenteritis (for oral typhoid and rotavirus)
• Measles (delay varicella)
• Wheezing (live attenuated influenza vaccine)
• active TB (delay live vaccines)

Question 3

Which vaccine should not be administered 48h after oseltamivir is used?

Answer 3

Live influenza vaccines

Question 4

T of F: if a patient does not follow the adequate interval time for a series of vaccines, they should be restarted.

Answer 4

False (but maximum protection may not be attained until the complete vaccine series has been administered)

Question 5

As of which age is the Shingles vaccine recommended?

Answer 5

50 y/o

Question 6

What is the recommended interval between shingles vaccine doses?

Answer 6

2 to 6 months between doses (for the recombinant zoster vaccine, Shingrix)

Question 7

What are the recommended age groups for HPV vaccination in Canada? (3)

Answer 7

Routine vaccination:
→ Ages 9–14 years (school-based programs; 2-dose schedule)

Catch-up vaccination:
→ Up to age 26 years

Adults 27 years and older:
→ May be offered based on individual risk assessment (shared decision-making)

Question 8

How many doses of HPV should be administered? (2)

Answer 8

2 doses (0 and 6–12 months) if started before age 15

3 doses if started ≥15 years or immunocompromised

Question 9

Who should receive the Pneumococcal 23-valent polysaccharide vaccine (Pneumovax 23) in Canada, and how many doses are given? (2)

Answer 9

1️⃣ All adults ≥ 65 years

2️⃣ Adults < 65 years with high-risk conditions

Question 10

Name 5 conditions that warrant the administration of the pneumo-23V

Answer 10

• Chronic heart, lung (including asthma/COPD), liver or kidney disease
• Diabetes mellitus
• Immunocompromised states (HIV, malignancy, transplant, immunosuppressive therapy)
• Asplenia or sickle cell disease
• Cochlear implant or CSF leak
• Residents of long-term care facilities

Question 11

How many pneumo-23 doses should a 65 year old adult w/o comorbidities receive?

Answer 11

1 dose (no booster)

Question 12

Who should get a booster of pneumo-23 vaccine and when?

Answer 12

High-risk / immunocompromised patients;
5 years later (if first dose given before age 65 or if high-risk)

Question 13

Name 5 vaccines recommended for travellers

Answer 13

Hepatitis A

Hepatitis B

Typhoid

Yellow fever

Rabies

Question 14

What is the recommended polio immunization for unvaccinated adults?

Answer 14

3-dose primary series of IPV (inactivated polio vaccine):

Dose 1: Day 0

Dose 2: 1–2 months after dose 1

Dose 3: 6–12 months after dose 2

Question 15

Name the vaccines recommended in pregnancy and when to give them (3)

Answer 15

Tdap
Every pregnancy
Give at 27–32 weeks gestation (optimal antibody transfer)

Influenza (inactivated)
Any trimester

COVID-19
Any trimester

(Additional: Hep A, B and rabies, if necessary)

Question 16

Name the vaccines that are contraindicated in pregnancy (3)

Answer 16

MMR

Varicella

Live attenuated influenza (intranasal)

Question 17

What is one consideration when vaccinating premature infants?

Answer 17

Vaccinate according to chronological age, NOT corrected gestational age

Question 18

What is one vaccine that should be delayed if infant is < 2 kg?

Answer 18

Hep B birth dose

Question 19

How long before a traveller leaves should a travel health clinic be consulted for specific immunizations?

Answer 19

4 - 6 weeks

Question 20

What is ONE true contraindication to vaccination?

Answer 20

Anaphylaxis to a previous dose or vaccine component

Question 21

What documentation is required after immunization? (3)

Answer 21

Vaccine name, lot number, site, date

Question 22

What must be done in the case of a serious adverse event following immunization?

Answer 22

Report to Public Health

Question 23

Name TWO populations where live vaccines are contraindicated.

Answer 23

Pregnant patients

Severely immunocompromised patients