Bumedinst 6230.15

Front 1

The DOD policy concerning immunizations follows the recommendations of________

Back 1

The CDC and the Advisory Committee on Immunization Practices (ACIP)

Front 2

Immunizing agents will not be used beyond the manufacturer’s potency expiration date unless

Back 2

the appropriate surgeon general or CG–11, USCG authorizes extension in exceptional circumstances

Front 3

Not more than ___ vaccine injections will be given on the same
day.

Back 3

5. The 5–injection
threshold should only be exceeded in cases where the vaccine recipient is deploying beyond the reach of deployable
medical resources, where exceptional personal exposure to infectious diseases exists, or when authorized by the
physician responsible for the immunization service.

Front 4

Individuals with reported hypersensitivity are deferred from immunization or chemoprophylaxis. True or False

Back 4

True

Front 5

A pregnancy screening test for women of childbearing potential is not routinely required before administering vaccines,
including live–virus vaccines. True or False

Back 5

True

Front 6

If the answer is “yes” to pregnancy,
defer her from immunization until her pregnancy ends, unless benefits of immunization outweigh risks in pregnancy, but what if the answer is uncertain?

Back 6

defer immunization until after a negative pregnancy evaluation

Front 7

For women whose last menstrual period was more than 28 days ago, a pregnancy test is recommended for what type of vaccination?

Back 7

Small Pox

Front 8

Breastfeeding women may be immunized in accordance with the current ACIP guidelines. True or Flase

Back 8

True

Front 9

What are the 2 types of exemptions from immunization?

Back 9

Medical - validated by a health care professional and Administrative - controlled by the individual’s unit commander

Front 10

Cases warranting permanent medical exemption
due to a vaccine–related adverse event will be reported to?

Back 10

Vaccine Adverse Events Reporting System (VAERS).

Front 11

For Non–electronic immunization and chemoprophylaxis records, transfer information regarding immunizations and chemoprophylaxis including date, product given, dose, and initials of person administering to what deployable health record

Back 11

DD 2766

Front 12

What form contains valid certificates of immunization for international travel and quarantine purposes in accordance with WHO
international health regulations

Back 12

PHS Form 731

Front 13

A new generation of needle–free disposable–cartridge jet injectors (DCJIs) is better than the multi–use nozzle jet injectors (MUNJIs) because

Back 13

It avoid the safety concerns for MUNJIs
by their use of a new, disposable, sterile fluid pathway for each patient

Front 14

The ACIP general recommendations suggest that persons be observed for ___to ___ minutes after being immunized

Back 14

15 to 20

Front 15

Aviation personnel typically will be grounded for __ hours after immunization, or as specified by their flight surgeon

Back 15

12 hours

Front 16

The NVIC program requires health care providers to report adverse events involving vaccines to VAERS. True or False

Back 16

True

Front 17

The DOD and USCG require health care providers to report adverse events involving other medications (for example, immune globulins, chemoprophylaxis agents) to ________

Back 17

Medwatch

Front 18

Health care personnel must report adverse events resulting in hospitalization, a life–threatening event (for example, anaphylaxis), time lost from duty more than 24 hours (that is, more than 1 duty shift), an event related to suspected contamination of a vaccine vial, and an event warranting permanent medical exemption (that is, a contraindicating
event). True or False

Back 18

True

Front 19

Reports of mild expected reactions are required

Back 19

False, they are NOT required

Front 20

Attach pertinent information from the recipient’s health record to the VAERS or MedWatch report. Submit copies of the report within ___ days of adverse event recognition

Back 20

7 days

Front 21

Military treatment facilities and commands storing health records will review immunization
and chemoprophylaxis practices at least ______ to ensure compliance with current standards of care and documentation
and as a measure of medical readiness and health promotion

Back 21

Annually

Front 22

Live–virus immunizations follow at least _______ after earlier live–virus
immunizations.

Back 22

28 Days

Front 23

______immunization is required for all Marine Corps personnel and for all Navy personnel assigned to Marine Operating Forces

Back 23

Yellow Fever

Front 24

yellow fever immunization is required for Navy personnel
assigned to Navy units subject to deployment within _______ of notification into land areas where yellow fever is
endemic

Back 24

10 Days

Front 25

Family members receive immunizations according to current ________ recommendations

Back 25

ACIP

Front 26

Anthrax

Back 26

Administer anthrax vaccine to military personnel and applicable civilians according to DOD or USCG policy for the Anthrax Vaccine Immunization Program and Service–specific implementation plans. Anthrax immunization will be conducted for personnel in geographical areas or in occupational roles designated
by the Services, chairman of the Joint Chiefs, or the Office of the Secretary of Defense as being at higher threat for release of anthrax as a weapon

Front 27

Cholera

Back 27

Cholera immunization is no longer
required by any nation to meet international travel requirements.

Front 28

Haemophilus influenzae type b (Hib)

Back 28

Administer 1 dose of Hib vaccine to people who do not have spleens

Front 29

Hepatitis A

Back 29

Administer hepatitis A vaccine to all military personnel. Whenever possible, administer the first
dose during initial entry training

Front 30

Hepatitis B

Back 30

Unless already immune, administer hepatitis B vaccine to susceptible military personnel with the second cluster of immunizations during initial entry training, as well as military personnel susceptible based on occupation or behavior, or deploying for more than 30 days to areas of high hepatitis B endemicity (for example, portions of Asia). For personnel on permanent change of station orders or assigned to the Korean peninsula, complete the primary series of hepatitis B immunizations. Administer at least 2 doses according to the licensed
schedule before arriving in Korea, whenever possible.

Front 31

Influenza A and B

Back 31

Administer influenza vaccine annually to all active duty and Selected Reserve military personnel.

Front 32

Japanese encephalitis - a mosquitoborne viral disease, during deployments and travel to endemic areas in Eastern Asia and certain western Pacific Islands. Japanese encephalitis virus can cause an
acute infection of the brain, spinal cord, and meninges with high rates of complications, chronic disability, and death.

Back 32

The main groups needing JEV are designated
special operation units, Navy mobile construction battalions, Marine expeditionary units operating in the Western
Pacific, and troops assigned or deploying to Okinawa with extended field exposure. Administer JEV to military personnel, civilian personnel, contracted workers, and
other beneficiaries who are or will be stationed at least 30 days in rural areas of Asia where there is substantial risk of exposure to the virus, especially during prolonged field operations at night. Administer booster doses according to the manufacturer’s recommendations if risk of exposure is still present.

Front 33

Japanese encephalitis

Back 33

Administer JEV to alert personnel who would deploy within 10 days of notification to rural areas of Asia in which the disease is endemic. Administer booster doses every 3 years if still eligible to deploy to rural areas of Asia. Aviation personnel will be grounded for 12 hours after immunization (the standard procedure after any immunization) or according to the instructions of their flight surgeon. Personnel who previously experienced urticaria or hypersensitivity phenomena of any type after JEV will be exempt
from flying duties for at least 3 days after first dose, 5 days after second dose, and 3 days after third dose.

Front 34

Measles, mumps, and rubella

Back 34

Administer MMR vaccine to susceptible basic trainees and accessions within the first 2 weeks of training. Ensure military personnel born after 1957 have received 2 lifetime doses of MMR vaccine or have positive serologic
test results.

Front 35

Meningococcal disease

Back 35

Administer meningococcal vaccine to basic trainees and cadets at Service academies within the first 2 weeks of training. Administer meningococcal vaccine to military personnel traveling for more than
15 days to regions subject to meningococcal outbreaks, if not administered within an appropriate booster interval. Administer meningococcal vaccine to personnel traveling to sub–Saharan Africa during the dry season (December to June), and other countries as recommended by the CDC, if not administered within an appropriate booster interval.

Front 36

Pertussis

Back 36

Using FDA–licensed pertussis vaccines for adolescents and adults to counter Bordetella pertussis, immunize according
to ACIP recommendations

Front 37

Pneumococcal disease

Back 37

If warranted, based on disease incidence, administer pneumococcal vaccine to high–risk trainees and accessions within the first 2 weeks of training based on preventive medicine guidance. Administer pneumococcal vaccine to military personnel and beneficiaries who are in a
high–risk category per ACIP recommendations. Administer a second dose to persons without spleens 5 years after the initial dose.

Front 38

Poliomyelitis - acquired by person–to–person transmission through the fecal–oral route.

Back 38

Administer a single booster dose of IPV to trainees and accessions. Because of the high level of childhood immunization against these diseases, do not screen
immunization records with regard to poliovirus immunity after completion of initial training except in an outbreak setting or for individual clinical purposes.

Front 39

Rabies

Back 39

Administer pre–exposure rabies vaccine series to special operations personnel. Give booster doses every 2 years or when antibody concentrations indicate.

Front 40

Smallpox - Screening. A specific screening form posted at http://www.smallpox.mil will be used to identify persons with
personal or household contraindications to smallpox vaccination. Screening will include assessing pregnancy status and
recency of testing for human immunodeficiency virus infection.

Back 40

Internal MTF and command clinical quality management programs will have mechanisms to confirm
that vaccinators demonstrate proper vaccination technique.

Front 41

Tetanus, diphtheria, and pertussis

Back 41

Basic trainees and other accessions. Individuals with previous history of Td immunization receive a booster dose of Td or Tdap upon accession. For those individuals lacking a reliable history of prior immunization, initiate a primary series of Td toxoid according to ACIP guidelines. Administer booster doses of Td or Tdap to all personnel every 10 years

Front 42

Typhoid fever - To prevent typhoid fever, a systemic bacterial disease acquired by consuming food or water
contaminated with Salmonella typhi, during deployment or travel to typhoid–endemic areas and other areas with poor
sanitation.

Back 42

Administer typhoid vaccine to military personnel before overseas deployment to typhoid–endemic areas.

Front 43

Varicella

Back 43

Administer varicella vaccine to susceptible trainees and other accessions
within the first 2 weeks of training. Serologic screening of trainees is the preferred means of determining those susceptible to varicella infection and in need of immunization. Adults and adolescents require 2 doses of varicella vaccine given 4 to 8 weeks apart

Front 44

Yellow fever

Back 44

Administer yellow fever vaccine to military personnel traveling to or transiting
through yellow–fever–endemic areas. For Marine Corps, all personnel. For Navy, administer to all personnel assigned to Marine Operating Forces and those assigned to Navy units subject to deployment within 10 days
of notification into land areas where yellow fever is endemic.

Front 45

Anthrax

Back 45

Chemoprophylaxis. Consider doxycycline or ciprofloxacin. For children, consider amoxicillin suspension.

Front 46

Group A streptococcal disease

Back 46

Chemoprophylaxis. Consider penicillin G benzathine (IM, also known as Bicillin LA) or penicillin VK (oral). Administration prophylactically to an entire group may be needed to terminate disease transmission.

Front 47

Influenza A and B

Back 47

Chemoprophylaxis. Consider amantadine, rimantidine, or oseltamivir.

Front 48

Leptospirosis

Back 48

Chemoprophylaxis. Consider doxycycline.

Front 49

Malaria

Back 49

Chemoprophylaxis. Anti–malarials are prescription
medications to be individually dispensed in labeled, child–resistant containers. Health care providers must document
malaria chemoprophylaxis prescriptions in the Service personnel’s health record whenever these medications are
prescribed.

Front 50

Meningococcal disease

Back 50

Chemoprophylaxis.For intimate or household contacts of meningococcal disease cases, consider rifampin,
ceftriaxone, ciprofloxacin, or sulfadiazine.

Front 51

Plague

Back 51

Chemoprophylaxis. Consider tetracycline, doxycycline, or chloramphenicol

Front 52

Scrub typhus

Back 52

Chemoprophylaxis. Consider doxycycline.

Front 53

Traveler’s diarrhea

Back 53

Chemoprophylaxis. Consider ciprofloxacin or other quinolones.