APHA APHA Special Populations & High-Risk Groups 1 — Questions and Answers
Question 1: Which live attenuated vaccines are generally contraindicated in severely immunocompromised patients?
- MMR and varicella (Correct answer)
- Hepatitis B and HPV
- Influenza inactivated and Tdap
- Pneumococcal and meningococcal
Correct answer: MMR and varicella
Live attenuated vaccines such as MMR and varicella are contraindicated in severely immunocompromised individuals because the weakened virus may replicate and cause disease.
Question 2: Pregnant women are recommended to receive which vaccine during every pregnancy, ideally between 27 and 36 weeks gestation?
- MMR
- Varicella
- Tdap (Correct answer)
- Hepatitis A
Correct answer: Tdap
Tdap is recommended during every pregnancy between 27–36 weeks gestation to protect newborns from pertussis through maternal antibody transfer.
Question 3: Adults aged 65 and older should receive which pneumococcal vaccine series according to ACIP recommendations?
- PCV15 only
- PPSV23 only
- PCV20 alone or PCV15 followed by PPSV23 (Correct answer)
- PCV13 followed by PPSV23
Correct answer: PCV20 alone or PCV15 followed by PPSV23
ACIP recommends adults 65+ receive either PCV20 alone or PCV15 followed by PPSV23 at least one year later for optimal pneumococcal disease protection.
Question 4: Which statement is TRUE regarding influenza vaccination in individuals with egg allergy?
- All individuals with egg allergy must avoid all influenza vaccines
- Persons with egg allergy of any severity can receive any age-appropriate influenza vaccine (Correct answer)
- Only egg-free influenza vaccines may be given to patients with egg allergy
- Epinephrine must be pre-administered before flu vaccine in egg-allergic patients
Correct answer: Persons with egg allergy of any severity can receive any age-appropriate influenza vaccine
ACIP states that persons with egg allergy of any severity can receive any licensed, recommended, age-appropriate influenza vaccine without special precautions beyond standard vaccine administration.
Question 5: For preterm infants, vaccines should generally be administered based on which age parameter?
- Corrected gestational age
- Chronological age from birth (Correct answer)
- Weight-based dosing schedule
- Delayed until 6 months after NICU discharge
Correct answer: Chronological age from birth
Preterm infants should be vaccinated according to their chronological age (age since birth), not corrected gestational age, following the same recommended immunization schedule.
Question 6: HIV-infected individuals who are NOT severely immunocompromised (CD4 count ≥200 cells/µL) may receive which vaccine?
- Oral typhoid vaccine
- MMR vaccine (Correct answer)
- BCG vaccine
- Yellow fever vaccine
Correct answer: MMR vaccine
MMR vaccine may be given to HIV-positive persons with CD4 counts ≥200 cells/µL who are not severely immunocompromised, as they can mount an adequate immune response.
APHA APHA Special Populations & High-Risk Groups 1
Which live attenuated vaccines are generally contraindicated in severely immunocompromised patients?