JKO Seasonal Influenza Vaccine Cold Chain Management for Logistical Personnel

Which organization provides information on DOD-specific influenza activity?

Armed Forces Health Surveillance Center (AFHSC)

How many milliliters (mL) are there in one dose of intramuscular inactivated influenza vaccine for people 3 years of age or older?

0.5 mL

Common side effects after Influenza vaccination include which of the following?

All influenza vaccines - Low-grade fever, muscle aches
Intradermal vaccine - Erythema, induration, swelling, pain, and pruritus at the site of injection
Injectable vaccine - Soreness, redness, or swelling at the site of injection

To maintain potency, seasonal influenza vaccine must be stored properly. Which of the following statements is true concerning influenza vaccine storage and handling?

Syringes filled with vaccine by clinic staff must be used by the end of the duty day or thrown away and may not be administered on subsequent days

How many types are there of the Influenza Viruses?

A, B, C

What is the first step that you should take if you find your vaccine out of the required temperature range or you believe the vaccine is compromised?

Immediately place the vaccine in a functioning refrigerator and mark "DO NOT USE."

Which of the following steps must take place for proper administration of the influenza vaccine?

Select appropriate product; verify proper storage/expiration date; visually inspect vials/syringes; and shake syringes/single dose vial before administration

On which websites can you find information on influenza activity and trends in the United States?

Armed Forces Health Surveillance Center (AFHSC)
World Health Organization (WHO)
Centers for Disease Control and Prevention (CDC)

Which of the following statements is true regarding influenza B viruses?

Influenza B primarily affects children

You are conducting an off-site influenza clinic. How often should you check and record the temperature of the storage container?

Check and record temperature hourly

Immunizations must be recorded accurately and at the time of immunization in an approved immunization tracking system according to Service-specific policy. Each immunization entry must include which of the following?

Date immunized, name of vaccine, manufacturer, lot number, dosage, vaccinator's name/initials, and most current VIS date

When you are ordering temperature sensitive medical products (TSMP), like vaccines, you need to take into consideration which of the following?

Units who may not be staffed on a normal Monday through Friday schedule
Security requirements for your particular location
The address is assigned to your DoDAAC/UIC or best Exception Address

To maintain proper temperature in the refrigerator air circulation is essential, therefore, which of the following statements is true concerning where in the refrigerator the vaccine should be stored?

The vaccine should be stored in the middle of the refrigerator compartment at least 3" from the walls

Where in the refrigerator should you place the calibrated thermometer in order to receive the most accurate temperature reading

Placed in the center of the refrigerator near vaccine

True or False, the seasonal influenza vaccination program is a commander's force health protection responsibility?

True

Why is it important to provide a current Vaccine Information Statement (VIS) prior to influenza vaccination?

It explains the benefits and risks of the vaccine
The influenza VIS does not change annually
It is a requirement of the National Childhood Vaccine Injury Act

A Service member arrives to receive his seasonal influenza vaccine. He expresses that he is ill. Which of the following symptoms/disease characteristics lead you to think he may have an influenza infection?

Fever, myalgia, extreme fatigue
Sore throat, headache
Nonproductive cough

As stated in Health Affairs policy 08-013, dated 29 Sep 2008, which of the following is NOT included in the Department of Defense guidance on Thimerosal containing vaccines?

If thimerosal-free vaccine is not available, withhold influenza immunization

Your patient is an 18 month old who has never before received an influenza vaccination. Which of the following is the correct type of vaccine for this influenza season?

Injectable inactivated vaccine (IIV)

The influenza virus causes a higher incidence of complications, hospitalization and death in which of the following groups?

Adults age 65 or older

The Advisory Committee on Immunization Practices (ACIP) recommends routine annual immunization with injectable influenza vaccine for which of the following individuals?

Morbidly obese
Immunosuppressed
Pregnant

Flublok is a trivalent influenza vaccine that has been FDA approved for use in adults 18 years and older. How does this vaccine differ from the other approved flu vaccines?

It does not use the influenza virus or chicken eggs in its manufacturing process.
It has a shorter shelf life than most influenza vaccines

The use of the influenza vaccine and measures to prevent the spread of disease are important tools in keeping our uniformed Service members healthy. Which of the following statements best captures the modes of transmission for influenza?

The influenza virus is transmitted person to person via large droplets (i.e., cough or sneeze)
The influenza virus is transmitted by direct or indirect contact with secretions

The influenza vaccine has several mild adverse events that can occur within a few hours after administration. Which of the following is NOT considered a mild adverse event?

Voice change, wheezing, hives

Since the late 19th century which 4 major influenza pandemics have occurred?

1918 Spanish flu, the 1957 Asian flu, the 1968 Hong Kong flu, and the 2009 H1N1 flu

True or False, the seasonal influenza vaccination program traditionally ends at the beginning of March?

False

The proper abbreviation for the trivalent cell-cultured inactivated influenza vaccine is which of the following?

ccIIV3

The system used to keep and distribute vaccines in good condition is called Efficient Management Procedures

False

Which of the following are included in the eight standards of military immunizations?

Vaccine storage and handling; indications and contraindications
Immunization recordkeeping; adverse events after immunization; and vaccine advocacy to protect the military family
Immunization availability; vaccine information and vaccinee education; immunization personnel training

Your patient is a U.S. resident experiencing flu-like symptoms (e.g. fever, headache, muscle aches). You deduce if the patient has seasonal influenza or Ebola based on symptoms alone?

False

What is the correct temperature range for the storage of the seasonal influenza vaccine?

Store vaccine in refrigerator at 2-8 degrees Celsius (36-46 degrees Fahrenheit)

Treatment of anaphylaxis must begin when following the onset of symptoms?

Immediately

These symptoms: pale skin, lightheadedness, profuse sweating, and slowed heart rate should alert you that the patient is experiencing which of the following?

Syncope

Routine vaccination of certain people who serve as a source of influenza virus transmission might provide protection to people at risk for influenza complications. Which of the following groups should be targeted for a flu shot?

Adults 65 years and older
Healthcare personnel
Contacts of high risk persons

Immunization entries for Uniformed personnel must be documented in which of the following?

Service's Immunization Tracking System (ITS)

What is critical for the health and safety of our beneficiaries when screening for contraindications prior to vaccination with influenza?

Previous adverse events
Current health status
Known allergies to vaccine components

If a Service member has a rare or unexplained adverse event after receipt of the seasonal influenza vaccine, what are the proper measures to take?

Notify a healthcare provider and file a vaccine adverse event report (VAERS)

How frequently is the DOD influenza activity reported to the Armed Forces Health Surveillance Center?

Weekly

If there is a shortage of Influenza vaccine, priorities must be set. In general, those at greatest risk for complications and those at greatest risk for infecting those at risk for complications receive Influenza vaccine first. Which of the following are considered priorities?

Pregnant women
Adults aged 65 years of age or older
All children aged 6 to 23 months

Select True if the steps described reflect proper storage and handling of the vaccine prior to administration, or False if the vaccine has not been properly stored or handled. Multidose vials of inactivated influenza vaccine arrive at the administration site in an insulated container. The temperature in the shipping container has remained at 5 degrees Celsius during shipping. The vaccine is stored overnight in the refrigerator. The next morning, the vaccine is placed in an insulated container with chilled coolant packs for transport to a senior citizen center. Each vaccine vial is taken from the insulated container and shaken well before the vaccine is withdrawn. Withdrawn doses are immediately injected. The Multidose vials that are not used are transported back to the administration site in the insulated container, which contains chilled coolant packs. Open vials are dated and all vials are placed back into the refrigerator.

True

True or False, dormitory or bar-style refrigerator/freezers should not be used for ANY vaccine storage?

True

Which statement about vaccine inventory and storage is correct?

Place extra water bottles in the refrigerator door and coolant packs in the freezer to provide additional insulation.

Your patient is an 18 month old who has never before received an influenza vaccination. Which of the following is the correct dose schedule for this influenza season?

0.25 mL dose injected into the anterolateral thigh muscle; and a second dose administered 4 weeks later

A shipment of vaccine has been delivered to your vaccine administration site. What would be the correct initial action to take?

You should check the condition of the vaccine and make sure the cold chain has been maintained during shipping by looking at the TempTale's LCD screen prior to stopping the TempTale in order to determine if the shipment is in Alarm or not.

Each influenza vaccine shipping container will include ___________.

A Temperature Monitor

What are the most common causes of vaccine compromise?

All the above

Once you have a proper refrigerator and thermometer, the units should never be completely full of vaccine so that it allows for proper cooling and temperature maintenance.

True

Once the influenza vaccine arrives at your site, and it is cleared for use, it should be immediately placed in a working refrigerator in its original packaging at temperatures from ___________.

36 to 46 degrees Fahrenheit

DOD and Coast Guard activities should not dispose of either opened and compromised or expired vaccine.

False

Excess heat or cold will not reduce vaccine potency therefore vaccines can be stored almost anywhere.

False

What happens if an influenza vaccine shipment has been compromised and/or not stored at appropriate temperatures?

It may no longer be effective and cannot be administered

To verify proper temperature of the refrigerator the CDC guidelines state the units must be checked at a minimum ___________.

Twice a day

What happens if an influenza vaccine shipment has been compromised and/or not stored at appropriate temperatures?
-Nothing happens and it is still good to use
-It may no longer be effective and cannot be administered
-Only half of the vaccine shipment can be administered
-None of the above

It may no longer be effective and cannot be administered

Each influenza vaccine shipping container will include ___________.
-A Temperature Monitor
-Extra influenza vaccine
-Recycled syringes to be used
-All the above

A Temperature Monitor

What are the most common causes of vaccine compromise?
-Failure to immediately move the vaccine to the appropriate storage unit
-Alarm system
-Placement of vaccine in the wrong storage unit
-All the above

All the above

To verify proper temperature of the refrigerator the CDC guidelines state the units must be checked at a minimum ___________.
-Twice a day
-Three times a day
-Once a day
-Five times a day

Twice a day

Once you have a proper refrigerator and thermometer, the units should never be completely full of vaccine so that it allows for proper cooling and temperature maintenance.
-True
-False

True

Once the influenza vaccine arrives at your site, and it is cleared for use, it should be immediately placed in a working refrigerator in its original packaging at temperatures from ___________.
-45 to 56 degrees Fahrenheit
-36 to 46 degrees Fahrenheit
-5 to 16 degrees Fahrenheit
-10 to 21 degrees Fahrenheit

36 to 46 degrees Fahrenheit

Excess heat or cold will not reduce vaccine potency therefore vaccines can be stored almost anywhere.
-True
-False

False

DoD and Coast Guard activities should not dispose of either opened and compromised, or expired vaccine.
-True
-False

False