Vaccine Schedules Quick Reference
Pharmacy technicians in many states can assist with or administer vaccines under pharmacist supervision. This cheat sheet covers vaccines commonly encountered in pharmacy practice, their general schedules, storage needs, and key facts for the CPHT exam.
Common Adult Vaccines
| Vaccine | Brand Name(s) | Route | Schedule (General Adult) | Key Notes |
|---|
| Influenza (inactivated) | Fluzone, Fluarix, others | IM | 1 dose annually | Given every fall/winter season. High-dose formulation available for adults 65+. |
| Influenza (live attenuated) | FluMist | Intranasal | 1 dose annually | Not for immunocompromised patients or pregnant women. |
| COVID-19 (mRNA) | Varies by manufacturer | IM | Per current CDC recommendations | Schedules and booster recommendations are updated regularly by the CDC. |
| Pneumococcal (PCV) | Prevnar 20 | IM | Consult current CDC schedule for age and risk-based recommendations | Recommended for adults 65+ and younger adults with certain risk factors. |
| Pneumococcal (PPSV) | Pneumovax 23 | IM or SubQ | Consult current CDC schedule | May be used in sequence with PCV per CDC guidance. |
| Shingles (recombinant) | Shingrix | IM | 2 doses, 2-6 months apart | Recommended for adults 50+. Preferred over the older live vaccine. |
| Tdap / Td | Boostrix, Adacel / Tenivac | IM | Tdap once, then Td booster every 10 years | Tdap given during each pregnancy (usually weeks 27-36). Td for wound management. |
| Hepatitis B | Engerix-B, Heplisav-B | IM | 2 or 3 dose series depending on product | Recommended for all adults through age 59; age 60+ based on risk. |
| Hepatitis A | Havrix, Vaqta | IM | 2 doses, 6-12 months apart | Recommended for travelers and those at risk. |
| HPV | Gardasil 9 | IM | 2 or 3 doses depending on age at initiation | Routinely given ages 11-12; catch-up through age 26. |
| MMR | M-M-R II | SubQ | 1 or 2 doses if no evidence of immunity | Live vaccine. Contraindicated in pregnancy and severe immunodeficiency. |
| Varicella | Varivax | SubQ | 2 doses, 4-8 weeks apart | Live vaccine. For adults without evidence of immunity. |
| RSV (adult) | Arexvy, Abrysvo | IM | Consult current CDC recommendations | For adults 60+ per shared clinical decision-making with provider. |
Key Pediatric Vaccines (Overview)
| Vaccine | Abbreviation | General Timing |
|---|
| Hepatitis B | HepB | Birth, 1-2 months, 6-18 months |
| Rotavirus | RV | 2, 4, (6) months depending on product |
| DTaP | DTaP | 2, 4, 6, 15-18 months, 4-6 years |
| Haemophilus influenzae type b | Hib | 2, 4, (6), 12-15 months |
| Pneumococcal conjugate | PCV | 2, 4, 6, 12-15 months |
| Inactivated poliovirus | IPV | 2, 4, 6-18 months, 4-6 years |
| Influenza | IIV or LAIV | Annually starting at 6 months |
| MMR | MMR | 12-15 months, 4-6 years |
| Varicella | VAR | 12-15 months, 4-6 years |
| Hepatitis A | HepA | 12-23 months (2 doses) |
Vaccine Storage
| Storage Type | Temperature Range | Examples |
|---|
| Refrigerated | 2-8 degrees C (36-46 degrees F) | Most inactivated vaccines, Shingrix, Hep B |
| Frozen | -50 to -15 degrees C (-58 to 5 degrees F) | Varicella (Varivax), some COVID-19 formulations |
| Ultra-cold | -90 to -60 degrees C (-130 to -76 degrees F) | Certain mRNA COVID-19 vaccines (initial storage) |
Vaccine Administration Key Points
- IM injection sites: Deltoid (adults and older children) or vastus lateralis (infants and young children).
- SubQ injection sites: Fatty tissue of the upper arm or thigh.
- Needle gauge and length: IM typically uses 22-25 gauge, 1 to 1.5 inch needle for adults. SubQ uses 23-25 gauge, 5/8 inch needle.
- Observation period: Patients should be monitored for at least 15 minutes after vaccination for signs of an allergic reaction.
- Epinephrine must be readily available at all vaccination sites for treatment of anaphylaxis.
- VIS (Vaccine Information Statement): Must be provided to the patient (or parent/guardian) before each vaccination, as required by federal law.
- Documentation: Record the vaccine name, manufacturer, lot number, expiration date, dose, route, site, date administered, and name/title of the person administering.
Cold Chain Management
- Use calibrated thermometers to monitor storage temperatures continuously.
- Record temperatures at least twice daily (beginning and end of workday).
- Do not store vaccines in the door of a refrigerator or freezer.
- Keep vaccines in their original packaging until use.
- Have a written emergency plan for temperature excursions (power outages, equipment failures).
- Report temperature excursions to the immunization coordinator and follow manufacturer guidance on viability.
Exam Tips
- Know the general route for each vaccine (IM vs. SubQ vs. intranasal).
- Shingrix (shingles vaccine) is a 2-dose series and is NOT a live vaccine - this is commonly tested.
- Live vaccines include MMR, varicella, LAIV (FluMist), and the oral rotavirus vaccine.
- The VIS must be provided before every vaccination - this is a federal requirement.
- Cold chain management and proper storage temperatures are frequently tested topics.