APHA IMMUNIZATION TRAINING FINAL
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
●● According to ACIP recommendations, HZV is indicated for the
prevention of herpes zoster in adults aged:. Answer: 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.
●● In which publication does the CDC initially publish new or updated
vaccine recommendations?. Answer: 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.
●● Which of the following best describes how to administer MMR
vaccine to an adult patient weighing 210 lb?. Answer: Inject
subcutaneously at a 45° angle in the outer aspect of the upper arm.
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.
●● The presence of fever, diffuse maculopapular rash, and Koplik spots
are characteristic of which of the following diseases?. Answer: 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.
●● Which entity determines the specific vaccines that a pharmacist may
administer?. Answer: 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.
●● 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?.
Answer: 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
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.
●● Which of the following documents must be given to every patient or
patient's caregiver before administration of a vaccine covered under the
National Childhood Vaccine Injury Act (NCVIA)?. Answer: 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).
PAPER 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
●● According to ACIP recommendations, HZV is indicated for the
prevention of herpes zoster in adults aged:. Answer: 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.
●● In which publication does the CDC initially publish new or updated
vaccine recommendations?. Answer: 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.
●● Which of the following best describes how to administer MMR
vaccine to an adult patient weighing 210 lb?. Answer: Inject
subcutaneously at a 45° angle in the outer aspect of the upper arm.
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.
●● The presence of fever, diffuse maculopapular rash, and Koplik spots
are characteristic of which of the following diseases?. Answer: 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.
●● Which entity determines the specific vaccines that a pharmacist may
administer?. Answer: 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.
●● 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?.
Answer: 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
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.
●● Which of the following documents must be given to every patient or
patient's caregiver before administration of a vaccine covered under the
National Childhood Vaccine Injury Act (NCVIA)?. Answer: 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).
