APHA APHA Legal, Ethical & Professional Standards in Immunization 1 — Questions and Answers
Question 1: What document must a patient receive before administration of vaccines covered by the National Childhood Vaccine Injury Act (NCVIA)?
- A signed physician order
- A Vaccine Information Statement (VIS) (Correct answer)
- A CDC Pink Book excerpt
- An insurance pre-authorization form
Correct answer: A Vaccine Information Statement (VIS)
Federal law requires that patients or their legal representatives receive the current Vaccine Information Statement (VIS) before each dose of vaccines covered under the NCVIA.
Question 2: Under the National Vaccine Injury Compensation Program (VICP), claims for vaccine injuries must typically be filed within how long after the first symptom of injury?
- 6 months
- 1 year
- 3 years (Correct answer)
- 5 years
Correct answer: 3 years
Under the VICP, petitioners must generally file within 3 years of the first symptom of a vaccine injury, or 2 years of a vaccine-related death.
Question 3: Standing orders for vaccination allow nurses and pharmacists to administer vaccines without a patient-specific physician order. What is a key requirement for a valid standing order program?
- A licensed physician must be physically present during each vaccination
- Standing orders must be approved by a physician, pharmacist, or other authorized provider and reviewed regularly (Correct answer)
- Standing orders are only valid in hospital inpatient settings
- Each patient must sign a standing order authorization form before every visit
Correct answer: Standing orders must be approved by a physician, pharmacist, or other authorized provider and reviewed regularly
Valid standing order programs require authorization from a licensed prescriber (physician, pharmacist, NP, or PA) and must be reviewed and updated regularly to reflect current ACIP recommendations.
Question 4: The principle of informed consent in immunization practice requires that patients are told which information before vaccination?
- Only the name and manufacturer of the vaccine being given
- Benefits, risks, alternatives, and the right to refuse vaccination (Correct answer)
- Only that the vaccine is required by law or employer policy
- The cost of the vaccine and insurance billing codes
Correct answer: Benefits, risks, alternatives, and the right to refuse vaccination
Informed consent requires disclosure of the vaccine's benefits, risks, potential adverse effects, alternatives, and the patient's right to refuse before proceeding with vaccination.
Question 5: Which federal program provides a vaccine injury table that creates a presumption of causation for certain adverse events following specific vaccines?
- VAERS (Vaccine Adverse Event Reporting System)
- VICP (Vaccine Injury Compensation Program) (Correct answer)
- VSD (Vaccine Safety Datalink)
- CDC Immunization Safety Office
Correct answer: VICP (Vaccine Injury Compensation Program)
The VICP maintains a Vaccine Injury Table that presumes causation for specific conditions following designated vaccines, shifting the burden of proof to help petitioners receive compensation.
Question 6: A parent refuses vaccination for their child citing personal beliefs. What is the recommended approach for the immunization provider?
- Immediately report the refusal to child protective services
- Document the refusal, provide education about risks, and request a signed refusal form (Correct answer)
- Refuse to provide any further medical care to the family
- Administer the vaccine anyway citing public health authority
Correct answer: Document the refusal, provide education about risks, and request a signed refusal form
The recommended approach is to respectfully provide education about vaccine-preventable disease risks, document the discussion, and ask the parent to sign a vaccine refusal form for the medical record.
APHA APHA Legal, Ethical & Professional Standards in Immunization 1
What document must a patient receive before administration of vaccines covered by the National Childhood Vaccine Injury Act (NCVIA)?