1. A 13-month-old child is due their routine immunisations. The parent says the child has a mild runny nose and cough but is feeding normally, has no fever and is otherwise well.
Which ONE of the following is the most appropriate advice?
A. Delay all vaccines for 4 weeks after any respiratory symptom.
B. Give only non-live vaccines and delay live vaccines.
C. Vaccination can usually proceed if the child has only a mild illness and is otherwise well.
D. Restart the entire childhood immunisation schedule.
E. Give antibiotics before vaccination.
2. A 42-year-old woman is taking high-dose prednisolone and mycophenolate for autoimmune disease. She asks about receiving a live attenuated travel vaccine next week.
Which ONE of the following is the most appropriate pharmacist advice?
A. Live vaccines are preferred in immunosuppressed patients because they give stronger protection.
B. Give the live vaccine at half dose.
C. Give the live vaccine if she feels well on the day.
D. Stop immunosuppressants for 24 hours and vaccinate.
E. Seek specialist advice because live vaccines may be contraindicated during significant immunosuppression.
3. A 28-year-old woman is 21 weeks pregnant and asks which vaccines are recommended during pregnancy. She is worried that all vaccines are unsafe.
Which ONE of the following is the most appropriate advice?
A. Inactivated flu, whooping cough and RSV vaccines are recommended at appropriate stages of pregnancy; live vaccines are usually avoided.
B. All vaccines should be avoided until after delivery.
C. MMR should be given routinely during pregnancy.
D. Yellow fever vaccine is routinely recommended for all pregnant women.
E. Vaccination in pregnancy protects only the mother and never the baby.
4. A 67-year-old man is due his seasonal influenza vaccine. He reports that after a previous influenza vaccine he developed immediate wheeze, facial swelling and collapse requiring emergency treatment.
Which ONE of the following is the most appropriate action?
A. Give the vaccine as normal because previous reactions do not matter.
B. Give the vaccine with an oral antihistamine only.
C. Give two smaller doses 30 minutes apart.
D. Do not vaccinate without specialist advice because the history suggests anaphylaxis to a previous dose.
E. Give the vaccine intranasally instead.
5. A 9-year-old child develops mild fever and soreness at the injection site the day after vaccination. The child is alert, drinking well and has no rash, breathing difficulty or swelling.
Which ONE of the following is the most appropriate advice?
A. Treat as anaphylaxis.
B. Reassure that mild fever and local soreness can occur after vaccination; provide self-care advice and safety-netting.
C. Report as definite vaccine failure.
D. Start oral antibiotics.
E. Avoid all future vaccines permanently.
6. A 5-year-old child has recently moved to the UK and has an incomplete vaccination history. The parent is unsure which childhood vaccines have been given.
Which ONE of the following is the most appropriate approach?
A. Avoid further vaccination because extra doses are always dangerous.
B. Restart only vaccines that are live.
C. Wait until adulthood to vaccinate.
D. Give antibiotics instead of vaccines.
E. Review records where possible and arrange catch-up immunisation according to UK guidance.
7. A 54-year-old man has had a splenectomy after trauma. He asks why his GP has arranged extra vaccinations and given advice about urgent antibiotics if febrile.
Which ONE of the following is the best explanation?
A. Asplenia increases risk from encapsulated organisms, so vaccination and urgent infection action plans are important.
B. Splenectomy reduces infection risk, so vaccines are optional.
C. Only live vaccines are needed after splenectomy.
D. Vaccination replaces the need to seek help for fever.
E. Antibiotics prevent all future infections permanently.
8. A 71-year-old woman asks whether she is eligible for shingles vaccination. She has not previously received a shingles vaccine and is generally well.
Which ONE of the following is the most appropriate advice?
A. Shingles vaccine is only available after a person has had shingles twice.
B. Shingles vaccine is only for people under 50.
C. Shingles vaccine is contraindicated in everyone over 70.
D. She should contact her GP surgery because people aged 70 to 79 are eligible under the NHS programme.
E. Shingles vaccine is the same as the childhood chickenpox vaccine.
9. A 62-year-old man has COPD and asks whether he needs vaccines because he already uses inhalers regularly.
Which ONE of the following is the most appropriate advice?
A. Inhalers replace the need for vaccination.
B. Influenza and pneumococcal vaccination should be encouraged if eligible because COPD increases infection complication risk.
C. Only travel vaccines are relevant to COPD.
D. Vaccines are useful only after a COPD exacerbation starts.
E. Pneumococcal vaccine is given weekly during winter.
10. A parent asks why their 12-year-old child has been offered the HPV vaccine at school, even though they are not sexually active.
Which ONE of the following is the most appropriate explanation?
A. HPV vaccine treats existing cervical cancer.
B. HPV vaccine is only useful after sexual debut.
C. Vaccination before exposure gives protection against HPV types linked to cancers and genital warts.
D. HPV vaccine replaces cervical screening in adulthood.
E. HPV vaccine is only for girls.
11. A newborn baby is being considered for BCG vaccination because the family has a high risk of tuberculosis exposure. The parent asks why BCG is not given to every baby routinely.
Which ONE of the following is the most appropriate explanation?
A. BCG is not a vaccine.
B. BCG is used only to treat active tuberculosis.
C. BCG is only given after a positive pregnancy test.
D. BCG is targeted to babies and individuals at higher risk of tuberculosis exposure.
E. BCG prevents all respiratory infections.
12. A 3-month-old baby is due rotavirus vaccine. The parent mentions the baby has previously been diagnosed with severe combined immunodeficiency.
Which ONE of the following is the most appropriate pharmacist action?
A. Query urgently because rotavirus vaccine is live and is contraindicated in severe combined immunodeficiency.
B. Give rotavirus vaccine as normal because it is inactivated.
C. Give a double dose to improve protection.
D. Delay until adulthood.
E. Replace rotavirus vaccine with antibiotics.
13. A 24-year-old woman has no documented MMR vaccination and is planning pregnancy. She is not currently pregnant.
Which ONE of the following is the most appropriate advice?
A. MMR should be given during pregnancy for best protection.
B. MMR is unnecessary if she had measles as a child.
C. MMR is safe to give at any time without checking pregnancy status.
D. MMR protects against influenza in pregnancy.
E. Discuss MMR vaccination before pregnancy and advise avoiding pregnancy for the recommended period after vaccination.
14. A 49-year-old gardener cuts his hand on soil-contaminated metal. His tetanus vaccination status is uncertain and the wound is deep and contaminated.
Which ONE of the following is the most appropriate action?
A. Reassure because tetanus only occurs after animal bites.
B. Give oral antibiotics only and ignore immunisation status.
C. Arrange assessment for tetanus-prone wound management, including vaccine and immunoglobulin consideration depending on history.
D. Wait until symptoms of tetanus appear.
E. Use a flu vaccine to cover tetanus risk.
15. A community pharmacy fridge alarm shows vaccines were stored above the recommended temperature range overnight. Staff are unsure how long the excursion lasted.
Which ONE of the following is the most appropriate action?
A. Use the vaccines first to avoid wastage.
B. Quarantine the affected stock, label clearly, maintain cold chain where possible and seek advice before use.
C. Freeze the vaccines to reverse the temperature excursion.
D. Discard all vaccines immediately without recording anything.
E. Mix affected stock with unaffected stock.
16. A 37-year-old man has just completed a course of intensive chemotherapy. He asks whether he can immediately restart all routine and travel vaccinations, including live vaccines.
Which ONE of the following is the most appropriate advice?
A. All vaccines are safe immediately after chemotherapy.
B. Live vaccines are preferred because immunity is reduced.
C. Vaccination timing is unrelated to chemotherapy.
D. Specialist advice is needed because vaccine timing and live vaccine safety depend on immune recovery.
E. Vaccines should never be given after cancer treatment.
17. A 74-year-old man taking apixaban is due an intramuscular influenza vaccine. He asks whether anticoagulation means he cannot be vaccinated.
Which ONE of the following is the most appropriate advice?
A. Intramuscular vaccination can often proceed with precautions such as using a fine needle and firm pressure afterwards, depending on bleeding risk.
B. Vaccination is absolutely contraindicated with all anticoagulants.
C. He should stop apixaban permanently.
D. Vaccines must be given intravenously instead.
E. Anticoagulation prevents vaccines from working.
18. A breastfeeding woman asks whether she can receive routine inactivated vaccines, such as influenza vaccine.
Which ONE of the following is the most appropriate advice?
A. Breastfeeding is a contraindication to all vaccines.
B. Only live vaccines are allowed during breastfeeding.
C. Vaccines should be delayed until breastfeeding stops.
D. The baby must stop breastfeeding for 48 hours after maternal vaccination.
E. Inactivated vaccines can usually be given during breastfeeding when indicated.
19. A patient is due influenza and pneumococcal vaccines at the same appointment. They ask whether receiving two vaccines together will overload the immune system.
Which ONE of the following is the most appropriate response?
A. Vaccines must always be separated by 12 months.
B. Only live vaccines can be given together.
C. Multiple vaccines can often be given at the same visit at different sites, following guidance.
D. Co-administration makes both vaccines ineffective.
E. Pneumococcal vaccine should be delayed if influenza vaccine is given.
20. A parent is worried that vaccines cause autism and asks whether delaying MMR would be safer.
Which ONE of the following is the most appropriate pharmacist response?
A. Agree that delaying vaccines is always safer.
B. Acknowledge concerns, explain that evidence does not support a link between MMR and autism, and discuss the risks of remaining unvaccinated.
C. Dismiss the parent’s concerns and end the consultation.
D. Recommend single measles vaccine instead of MMR.
E. Advise antibiotics as an alternative to vaccination.
21. A patient develops faintness immediately after vaccination while standing. They are pale and sweaty but have no wheeze, swelling, rash or breathing difficulty.
Which ONE of the following is the most appropriate interpretation?
A. This is definitely vaccine anaphylaxis.
B. This proves vaccine allergy.
C. The vaccine should be repeated immediately.
D. This is always a sign of sepsis.
E. Vasovagal faint should be considered, while continuing to assess for anaphylaxis features.
22. A 6-year-old child is due live attenuated intranasal influenza vaccine. The parent says the child has severe immunosuppression due to treatment for leukaemia.
Which ONE of the following is the most appropriate action?
A. Give the intranasal vaccine because it is easier than injection.
B. Give two doses of the intranasal vaccine.
C. Do not give live intranasal vaccine without specialist advice; consider appropriate alternative protection.
D. Delay all future flu vaccination until adulthood.
E. Give the vaccine to treat current influenza symptoms.
23. A 44-year-old healthcare worker has no documented hepatitis B vaccination and is starting work in a haemodialysis unit.
Which ONE of the following is the most appropriate occupational health consideration?
A. Hepatitis B vaccination and post-vaccination serology should be considered according to occupational risk guidance.
B. Hepatitis B vaccine is only for children.
C. Vaccination is unnecessary if gloves are worn.
D. Hepatitis B vaccine treats established chronic hepatitis B.
E. One dose gives lifelong confirmed protection in all people.
24. A 72-year-old man asks about the RSV vaccine. He has heard it is only for babies and is unsure whether older adults can receive it.
Which ONE of the following is the most appropriate advice?
A. RSV vaccination is only ever used in pregnancy.
B. RSV vaccine treats active RSV infection.
C. RSV vaccine is the same as influenza vaccine.
D. Older adults may be eligible for RSV vaccination under the NHS programme and should check with their GP surgery.
E. RSV vaccine is contraindicated in all adults.
25. A patient asks whether they still need vaccination after having had shingles last year. They are now eligible for the NHS shingles vaccination programme.
Which ONE of the following is the most appropriate advice?
A. Previous shingles gives complete lifelong immunity.
B. Shingles vaccination is still recommended when eligible because shingles can occur more than once.
C. Vaccination should be replaced by long-term aciclovir.
D. The vaccine treats current shingles pain.
E. Only people who have never had chickenpox can receive shingles vaccine.
Vaccines Questions
Answers and Rationale
1. C
Mild illness without fever or systemic upset is not usually a reason to postpone vaccination. Delaying routine immunisation unnecessarily can leave the child unprotected.
2. E
Live vaccines may be contraindicated in significant immunosuppression because the attenuated organism may replicate excessively. Specialist advice should be sought before administration.
3. A
Inactivated influenza, whooping cough and RSV vaccines are recommended during pregnancy at appropriate stages to protect the mother and baby. Live vaccines such as MMR are usually avoided during pregnancy.
4. D
A history of immediate wheeze, facial swelling and collapse after a previous vaccine suggests anaphylaxis. Further vaccination should not proceed without specialist advice.
5. B
Mild fever and local soreness are common post-vaccination effects and usually settle with self-care. Safety-netting is important for severe allergy symptoms, persistent high fever or clinical deterioration.
6. E
Children with incomplete or uncertain immunisation histories should have records reviewed where possible and be offered catch-up vaccination according to UK guidance. The schedule does not usually need to be restarted from the beginning.
7. A
Asplenia increases susceptibility to severe infection from encapsulated organisms such as pneumococcus, meningococcus and Hib. Vaccination and urgent action for fever are important risk-reduction measures.
8. D
People aged 70 to 79 are eligible for shingles vaccination under the NHS programme. Eligible patients who have not been contacted should speak to their GP surgery.
9. B
COPD increases the risk of complications from respiratory infections. Influenza and pneumococcal vaccination should be encouraged where the patient is eligible.
10. C
HPV vaccination is most effective before exposure to HPV. It helps protect against HPV types associated with cancers and genital warts but does not replace future screening where applicable.
11. D
BCG vaccination is targeted to infants and individuals at higher risk of tuberculosis exposure rather than being universally given to every baby in the UK.
12. A
Rotavirus vaccine is a live vaccine and is contraindicated in severe combined immunodeficiency. This history should be escalated before vaccination.
13. E
MMR is a live vaccine and should be given before pregnancy where indicated, not during pregnancy. Pregnancy should be avoided for the recommended interval after vaccination.
14. C
A deep soil-contaminated wound with uncertain tetanus status requires assessment for tetanus-prone wound management. This may include tetanus-containing vaccine and immunoglobulin depending on immunisation history and wound risk.
15. B
Vaccines exposed to a cold-chain breach should be quarantined, labelled and kept appropriately while advice is sought. They should not be used until their suitability has been confirmed.
16. D
Chemotherapy can significantly impair immune response and live vaccine safety. Timing of vaccination after chemotherapy depends on immune recovery and should be planned with specialist advice.
17. A
Anticoagulation is not an automatic contraindication to intramuscular vaccination. Precautions such as a fine needle and firm pressure can reduce bleeding or bruising risk.
18. E
Breastfeeding is not usually a contraindication to inactivated vaccines. Vaccination should be offered when indicated to protect the mother and, indirectly, the infant.
19. C
Many vaccines can be given at the same visit using different injection sites, following guidance. Co-administration can improve uptake and does not “overload” the immune system.
20. B
Concerns should be acknowledged respectfully. The evidence does not support a link between MMR and autism, and delaying vaccination increases the period of susceptibility to preventable infections.
21. E
Faintness, pallor and sweating immediately after vaccination may be vasovagal syncope, especially in adolescents or anxious patients. The vaccinator must still assess for anaphylaxis features such as airway, breathing or circulation compromise.
22. C
The intranasal flu vaccine is live attenuated and may be unsuitable in severe immunosuppression. Specialist advice and alternative vaccination strategies should be considered.
23. A
Healthcare workers with exposure-prone or blood/body fluid contact roles may require hepatitis B vaccination and post-vaccination serology. Gloves reduce risk but do not replace vaccination.
24. D
RSV vaccination is included in UK programmes for certain groups, including older adults according to eligibility criteria. Patients should check with their GP surgery or NHS service for eligibility.
25. B
Shingles can occur more than once. Eligible patients should still receive shingles vaccination even if they have had shingles previously, unless a specific contraindication applies.
Here are 25 multiple-choice questions designed to mimic the GPHC exam itself. At the bottom of the page you will find answers and rationale for each question.