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Childhood immunization catch-up — MCCQE Part 1 MCQ

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EasyPreventive MedicineChildhood immunization catch-upMCCQE Part 1

A 27-year-old newly hired respiratory therapist has no vaccination records and cannot recall having chickenpox. Varicella-zoster IgG is negative. She is healthy, is not pregnant and has no contraindication to a live vaccine. Which immunization plan is most appropriate?

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Correct answer: C — Two doses of univalent varicella vaccine at least four weeks apart

This newly hired health-care worker has laboratory-confirmed susceptibility and no contraindication to live vaccination. The Canadian Immunization Guide recommends two doses of univalent varicella vaccine for susceptible adults younger than 50 years, with a minimum interval of four weeks. A general presumption of adult immunity does not override her negative serology in this occupational context. MMRV is not authorized for adults, recombinant zoster vaccine prevents herpes zoster rather than serving as primary varicella immunization, and immune globulin is reserved for selected susceptible people after significant exposure when vaccine is contraindicated. Pregnancy should be avoided for at least four weeks after each live-varicella dose.

Reference: Canadian Immunization Guide—Varicella vaccines: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-24-varicella-chickenpox-vaccine.html