American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommendation for administering the meningococcal vaccine for solid organ transplant recipients?

1. Per individual schedule regardless of immune status

2. As per recommendations for nontransplant patients

3. Registered nurse can decide level of care

4. Vaccination is not necessary

The correct answer is: As per recommendations for nontransplant patients

The recommendation for administering the meningococcal vaccine to solid organ transplant recipients is based on their immunocompromised status, which increases their susceptibility to infections. Solid organ transplant recipients often have impaired immune function due to the transplant itself and the immunosuppressive medications necessary to prevent transplant rejection. Therefore, it is crucial that these individuals receive vaccinations according to guidelines that are specifically tailored to their immune status. Although nontransplant patients may follow a standard vaccination schedule, transplant recipients require a modified approach to ensure adequate protection. It's important to note that robust immunization is key to preventing invasive disease caused by Neisseria meningitidis, especially in transplant recipients who may have a higher risk of severe outcomes from such infections. Recommendations usually involve vaccinating these patients with the meningococcal vaccine at specific intervals before and after transplant to establish adequate immunity. The other options do not appropriately consider the unique needs of this patient population. For example, following a general or nontransplant patient schedule would not address their compromised immune systems, and leaving the decision to a registered nurse without clear guidelines may lead to inconsistencies in care. Additionally, stating that vaccination is not necessary overlooks the increased risk of meningococcal infections in this vulnerable group.