LT is a 28-year-old pregnant woman that enters your community pharmacy one afternoon in the middle of October. She is interested in receiving the recommended vaccines to help protect her and her baby. She has not received any vaccines since she became pregnant. After speaking with LT, you receive her full medical history.

Allergies: No known drug or food allergies

PMH:

Third trimester of pregnancy (29 weeks pregnant)

General Anxiety Disorder

GERD

Medications:

Zoloft 50 mg QD

Pepcid 20 mg QD

According to current recommendations, which of the following statements would be correct to tell LT?

A. Recommend to LT that she is eligible to receive the Influenza, Respiratory Syncytial Virus (RSV), and Diphtheria, tetanus, and acellular pertussis booster (Tdap) vaccines 

B. Recommend to LT that she is eligible to receive the Tdap and influenza vaccines but not the RSV vaccine

C. Recommend to LT that she is eligible to receive the influenza and RSV vaccines but not the Tdap vaccine

D. Recommend to LT that it is too late in her pregnancy to administer any vaccines 

Rationale:

Getting the recommended vaccines for pregnant patients helps prevent the mother and baby from getting sick from potentially serious diseases. The CDC sets the vaccine schedule based off of the recommendations of the Advisory Committee on Immunization Practices (ACIP). RSV, influenza, and whooping cough are diseases that can be dangerous for the mom and baby, and this is why these vaccinations are strongly recommended during pregnancy. The Flu vaccine is recommended throughout all trimesters of pregnancy. The RSV vaccine is recommended for patients that are 32-36 weeks pregnant in the months of September - January. The Tdap vaccine is to prevent the whooping cough, and it is recommended in pregnant patients in weeks 27-36.

Answer A is incorrect: While LT is in the right time frame to receive the influenza and Tdap vaccines, it is too early for her to receive the RSV vaccine.

Answer B is correct: The patient is in the right time frame of her pregnancy to receive the influenza and Tdap vaccines. It is too early for her to receive the RSV vaccine. In current recommendations, the RSV vaccine should be given between weeks 32-36 of pregnancy. While there are two RSV vaccines FDA-approved (Abrysvo and Arexvy), only Abrysvo is currently approved for use in pregnant women. 

Answer C is incorrect: LT can receive the influenza vaccine. She is not recommended to receive the RSV vaccine yet, but she can receive the Tdap vaccine. 

Answer D is incorrect: It is not too late in her pregnancy to receive any vaccinations. It is currently recommended for her to receive the influenza and Tdap vaccines. In weeks 32-36 she will be able to receive the RSV vaccine (Abrysvo) as well.

Brand/Generics covered: Sertraline (Zoloft), Famotidine (Pepcid)

NAPLEX Competencies covered:

Area 1 – Obtain, Interpret, or Assess Data, Medical, or Patient Information

1.2 - From patients: treatment adherence, or medication-taking behavior; chief complaint, medication history, medical history, family history, social history, lifestyle habits, socioeconomic background

1.6 - Risk factors or maintenance of health and fitness

Area 2 – Identify Drug Characteristics

2.4 - Pregnancy or lactation

Area 3 – Develop or Manage Treatment Plans 

3.2 - Therapeutic goals or outcomes and clinical endpoints

Area 6 - Develop or Manage Practice or Medication- Use systems to Ensure Safety and Quality

6.3 - Disease prevention or screening programs; or stewardship