NAPLEX Question of the Week: Immunizations

A common vaccination is the subject of our question of the week!

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A patient presents to your pharmacy inquiring regarding vaccinations. He is 67 years old and wishes to receive any vaccinations that he is eligible for. His only vaccines in the last 20 years are an influenza vaccine that he gets yearly (last dose one year previously). His PMH is significant for diabetes, hypertension, hyperlipidemia, GERD, and hypothyroidism. He currently takes Janumet 50-1000mg BID, Lotrel 10-40mg QD, atorvastatin 40mg daily, omeprazole 40mg daily, and levothyroxine 100mcg daily. His past surgical history is significant for splenectomy and appendectomy. Which of the following vaccines would our patient be eligible to receive? Select all that apply.

A. Influenza vaccine

B. Live attenuated influenza vaccine

C. Pneumococcal conjugate vaccine

D. Shingrix

E. Tdap

Answer with rationale:

The correct answers are A, C, D, and E.

Vaccines are a daily component of pharmacy practice, especially in the community setting. The CDC on an annual basis publishes recommendations for both childen and adults. For our patient, he is over 65, has diabetes, and asplenia which are the key components of his medical and surgical history pertinent to vaccines. Answer B (live attenuated influenza vaccine) is inappropriate due to his asplenia. Each of the other vaccines would be appropriate including Tdap considering he has not had any vaccines in the last 20 years outside of influenza. Answer C is appropriate considering he is over 65, has diabetes, and has asplenia.

A current schedule for adults can be found here: https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

***Note***NABP has announced that the exam has decreased from 250 questions to 225 questions with 25 of these not counting toward your score. Each candidate still has 6 hours to take the entire exam.

See you next week!

Dr. B

Christopher M. Bland

Clinical Associate Professor, University of Georgia College of Pharmacy

Dr. Christopher M. Bland is a Clinical Associate Professor at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has over 20 years of academic and clinical experience in a number of clinical areas. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy. He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with over 80 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as Editor-In-Chief for the Question of the Week. He has provided live, interactive reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.