Pharmacy-Based Immunization Delivery

Certificate Training Program

Active Learning Exercises

© 2018 American Pharmacists Association. All rights reserved. July Edition.

 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Instructions

Work in groups of 2 or 3 participants to evaluate this case. For each family member, review the
information provided about the person’s history, and determine his or her current vaccination needs.

History
You are working as a pharmacist in a medical home in October. One of your responsibilities is to assess
the medication needs, including vaccination needs, of all new patients who come to the practice.

Today you are meeting with a family and an individual that has just joined the practice. Family members,
who all live together, include:

A. Family

1. Rachel, 8-year-old daughter.

2. Luke, 14-year-old son.

3. Isabella, 39-year-old mother.

4. Jeff, 43-year-old father.

5. Ginny, 68-year old grandmother.

B. Individual

6. Steve, 43 year old pharmacist.

Known information about each patient’s vaccination history and current medications is provided on the
following pages. Use this information to record vaccination needs for these patients in the tables, which
are based on the relevant schedule. If the patient should receive the vaccine, state how many doses are
required, the appropriate schedule, and the specific vaccine if relevant (e.g., IIV or LAIV). If the patient
should not receive the vaccine, explain why (e.g., not indicated, vaccine already completed,
contraindicated).

Page | 1
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 1.
Rachel, 8-year-old daughter. Presents today with a runny nose, post-nasal drip, and a cough. No fever.
No chronic conditions. Her vaccination history is as follows:

Hepatitis B: 0, 2, and 6 months

Rotavirus: 2, 4, and 6 months
DTaP: 2, 4, 6, and 18 months
Hib: 2, 4, 6, and 15 months
PCV7: 2, 4, 6, and 15 months
IPV: 2, 4, 6 months
Influenza: No history of influenza vaccine in the past
MMR: 15 months
Varicella: 15 months
Hepatitis A: 15 months and 24 months

Current medications: None

Vaccine Yes, list doses, schedule, No, explain why

vaccine
Hepatitis B
Rotavirus
DTaP
Tdap
Hib
PCV13
PPSV23
IPV
Influenza
MMR
Varicella
Hepatitis A
HPV
Meningococcal
ACWY

Page | 2
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 2.
Luke, 14-year-old son. He is a healthy patient who presents to your pharmacy requesting cold
medications. His vaccination history is as follows:

Hepatitis B: 0, 2, and 6 months

DTaP: 2, 4, 6, 18 months, 5 years
Hib: 2, 4, 6, and 15 months
PCV7: 2, 4, 6, and 15 months
IPV: 2, 4, 6 months, 5 years
Influenza: IIV received previous year
MMR: 15 months, 5 years
Varicella: 15 months, 5 years
Hepatitis A: 15 months, 5 years

Current medications: None

Vaccine Yes, list doses, schedule, vaccine No, explain why

Hepatitis B
Rotavirus
DTaP
Tdap
Hib
PCV13
PPSV23
IPV
Influenza
MMR
Varicella
Hepatitis A
HPV9
Meningococcal ACWY

Page | 3
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 3.
Isabella, 39-year-old mother. She is 32-weeks pregnant and has gestational diabetes. Her vaccination
history is as follows:

DTaP: 2, 4, 6, and 18 months, 5 years

OPV: 2, 4, and 6 months, 5 years
Influenza: LAIV received last year
MMR: 15 months, 4 years
Td: 30 years of age

Current medications: insulin, prenatal vitamins.

Vaccine Yes, list doses, schedule, No, explain why

vaccine
Influenza
Td/Tdap
Varicella
HPV
Zoster
MMR
PCV13
PPSV23
Meningococcal
Hepatitis A
Hepatitis B
Hib

Page | 4
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 4.
Jeff, 43-year-old father. He weighs 178 lbs (81 kg) and was recently diagnosed with psoriatic arthritis.
His vaccination history is as follows:

DTaP: 2, 4, 6, and 18 months, 5 years

OPV: 2, 4, and 6 months, 5 years
Influenza: IIV received last year
Td: 40 years of age

 He is taking adalimumab 40mg every other week.

 You take a vaccination history and discover he has not had any vaccinations since childhood, except
for influenza.

Vaccine Yes, list doses, schedule, No, explain why

vaccine
Influenza
Td/Tdap
Varicella
HPV
Zoster vaccine, live
MMR
PCV13
PPSV23
Meningococcal
Hepatitis A
Hepatitis B
Hib

Page | 5
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 5.
Ginny, 68-year old grandmother. Has hypertension, hypercholesterolemia, and COPD. Former smoker
(stopped 10 years ago). Her vaccination history is as follows:

Smallpox: Completed in childhood

OPV: Completed in childhood
Influenza: IIV received last year
Td: most recent—60 years
PPSV23: 60 years of age

Current medications: HCTZ 25 mg/day, atorvastatin 20 mg/day, combination bronchodilators and

inhaled corticosteroid.

Vaccine Yes, list doses, schedule, No, explain why

vaccine
Influenza
Td/Tdap
Varicella
HPV
Zoster
MMR
PCV13
PPSV23
Varicella
Meningococcal
Hepatitis A
Hepatitis B
Hib

Page | 6
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 1—Learner Worksheets
Determining Patient Vaccination Needs

Patient 6.
Steve, 43 year old pharmacist. He is healthy and will be offering a pharmacy-based immunization
program for the first time. His vaccination history is as follows:

Inactivated influenza – yearly

Tetanus-diphtheria – 2 years ago
Hepatitis A 2-dose series – 6 years ago
MMR 2-dose series – 10 years ago
Physician-documented case of chickenpox

Current medication: None

Vaccine Yes, list doses, schedule, No, explain why

vaccine
Influenza
Td/Tdap
Varicella
HPV
Zoster
MMR
PCV13
PPSV23
Meningococcal
Hepatitis A
Hepatitis B
Hib

Page | 7
©APhA 2018 – Updated 07/2018
 Active Learning Exercise 2 
Communication Role Play

Patient Instructions 

Imagine you are Tiffany or Kent, a parent in the case presented on the slide. You are surprised that the 
pharmacist is recommending the HPV vaccine for your daughter, Emily. 

Your concerns include: 

1) Why are some vaccines okay, but the pharmacist said she has to wait to receive others?

2) She seems awfully young (12 years old) to be getting a vaccine to prevent a sexually transmitted
disease.

You start by asking the pharmacist, “Why does Emily need this vaccine?” 

Page | 1 

©APhA 2017    
 Active Learning Exercise 2 
Communication Role Play

Pharmacist Instructions 

Imagine you are speaking with Tiffany and Kent, the parents in the case presented on the slide.  They are 
concerned about their daughter, Emily, receiving the HPV vaccine.  

Notes: 

 Ask open‐ended questions.
 Respond with empathy and concern.
 Ask permission before providing information.
 Provide accurate information and suggest authoritative websites if requested.
 Don’t forget to ask the parents what they think about the information you provided.

Page | 2 

©APhA 2017    
 Active Learning Exercise 2 
Communication Role Play

Observer Instructions 

Imagine you are watching the pharmacist speak with Tiffany and Kent, the parents in the case presented 
on the slide.  Tiffany and Kent are concerned about their daughter, Emily, receiving the HPV vaccine.  

Consider the following and take notes.  Write down specific examples of what did or didn’t work. 

1) Does the pharmacist ask open‐ended questions?

2) Does the pharmacist respond with empathy and concern?

3) Does the pharmacist ask permission before providing information?

4) Does the pharmacist provide accurate information and suggest authoritative websites if
requested?

5) If the parents do not agree to have their child vaccinated, does the pharmacist continue to treat
them with respect and leave the door open for further discussion?

6) Did the pharmacist say anything that alienated the patient?

Page | 3 

©APhA 2017