# MCCQE Part I Immunisation Questions: 10 Free Practice MCQs

> 10 free MCCQE Part I immunisation questions with answers and explanations, from a bank of 29 immunisation questions. Try them now, no sign up.

Canonical: https://medhub.one/practice/mccqe-part-1/immunisation
Last updated: 2026-10-31

Immunisation questions test the schedule, the exception and the conversation. The MCC objectives expect the Canadian Immunization Guide schedule, catch-up rules for a child new to Canada, and the small number of true contraindications. They also expect you to answer a hesitant parent with evidence, to know which vaccines are funded for adults and pregnancy, and to report an adverse event.

## Where candidates lose marks

* Treating a mild illness or a previous local reaction as a contraindication.
* Missing the catch-up schedule for a child or adult who is under immunised.
* Forgetting the vaccines recommended in pregnancy and in older adults.
* Failing to report an adverse event following immunisation.

**Guideline to follow:** The MCCQE Part I follows the Canadian Immunization Guide and the National Advisory Committee on Immunization statements, with provincial funding schedules.

Ten MCCQE Part I-style immunisation questions with the answer and the reasoning behind it. They come from the CA.med bank, which has 29 immunisation questions and many more across every topic.

[Free timed mock exam](https://medhub.one/practice/mccqe-part-1/mock)

1. 1 / 10  
A 31-year-old woman is 30 weeks pregnant in October and asks about protecting her newborn from respiratory syncytial virus. She has no contraindications to vaccination and has not received any RSV product in this pregnancy. Local programs offer both a maternal vaccine and infant monoclonal antibody products.  
According to the National Advisory Committee on Immunization, what is the recommended timing for the RSVpreF vaccine in pregnancy?  
Show answer

**Answer: D.** From 28 to 36 weeks of gestation

**Why:** The RSVpreF vaccine is given during pregnancy so that protective maternal antibody crosses the placenta and protects the infant in the early postnatal period. The National Advisory Committee on Immunization recommends administration from 28 to 36 weeks of gestation, an off-label recommendation relative to the Canadian authorisation at 32 to 36 weeks that is supported by safety and efficacy data, broader access and alignment with international guidance. Infants born to mothers who did not receive the vaccine are offered monoclonal antibody instead.

  * **A.** Vaccination in the first trimester is not the recommended timing for this product, whose purpose is to generate maternal antibody that is transferred later in pregnancy.
  * **B.** The recommended window sits later in pregnancy so that antibodies are transferred to the baby before birth.
  * **C.** The maternal vaccine is specifically designed to protect the infant before birth, and infant monoclonal antibody products are used when the mother did not receive it.  
Sources: Public Health Agency of Canada / National Advisory Committee on Immunization. Updated guidance to protect infants and children from respiratory syncytial virus (RSV) disease (2026)
2. 2 / 10  
A 33-year-old woman is 22 weeks pregnant during influenza season. She has not yet received an influenza vaccine this year and is otherwise healthy. She is unsure whether the vaccine is safe in pregnancy and asks whether she should wait until after delivery.  
What is the most appropriate recommendation?  
Show answer

**Answer: A.** Give a non-live influenza vaccine now, since it is recommended at any stage of pregnancy

**Why:** Pregnancy is associated with an increased risk of influenza-related morbidity and hospitalisation as well as adverse neonatal outcomes, and vaccination protects the pregnant person and the infant during the first few months of life. A non-live influenza vaccine is recommended at any stage of pregnancy. When influenza vaccine was not received during pregnancy it should be given as early as possible postpartum, preferably before discharge from hospital.

  * **B.** Live attenuated influenza vaccine is not the recommended product in pregnancy, and deferring until after delivery would miss the opportunity to protect mother and infant.
  * **C.** Influenza vaccination in pregnancy is not restricted to those with chronic conditions, and pregnancy itself is associated with increased influenza-related morbidity.
  * **D.** Vaccination is recommended at any stage of pregnancy, and there is a robust body of evidence demonstrating the safety of most non-live influenza vaccines.  
Sources: Public Health Agency of Canada. Immunization in pregnancy and breastfeeding: Canadian Immunization Guide (2026)
3. 3 / 10  
An 8-year-old girl with a primary immunodeficiency is due for routine immunizations. Her immunodeficiency is mild and her T cell function is intact, but her immunologist notes that she may have some residual ability to mount a response. The family asks whether a live attenuated vaccine can be given.  
What is the most appropriate approach before administering a live attenuated replicating vaccine?  
Show answer

**Answer: D.** Consult a physician with expertise in immunodeficiency before giving the vaccine

**Why:** Immunocompromised people are more susceptible to vaccine-preventable infections, but live attenuated replicating vaccines can cause serious adverse events through uncontrolled replication of the vaccine strain. Severely immunocompromised people or those whose immune status is uncertain should not receive such vaccines. In less severely immunocompromised people the benefits may outweigh the risks, and the Canadian Immunization Guide advises that a physician with expertise in immunodeficiency should be consulted before administration. Non-live vaccines may generally be given, although the response may be reduced.

  * **A.** Non-live vaccines may generally be given, but live attenuated replicating vaccines require a different assessment because inappropriate use can cause serious adverse events from uncontrolled replication.
  * **B.** Safety concerns with live attenuated replicating vaccines arise from vaccine strain replication, so monitoring after administration is not a substitute for prior specialist advice.
  * **C.** Withholding all immunizations would leave the child unprotected, and every effort should be made to ensure adequate protection while avoiding inappropriate live vaccines.  
Sources: Public Health Agency of Canada. Immunization of immunocompromised persons: Canadian Immunization Guide (2026)
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5. 4 / 10  
A 4-year-old boy is receiving immunosuppressive treatment for a chronic condition. He attends daycare and has no contraindication to vaccination. His parents ask whether he should receive the influenza vaccine each year given his treatment.  
What is the most appropriate recommendation?  
Show answer

**Answer: D.** He should receive an influenza vaccine every year, as all immunocompromised people 6 months of age and older are particularly recommended to do so

**Why:** Influenza can cause increased morbidity and mortality in immunocompromised people, so the Canadian Immunization Guide particularly recommends annual influenza vaccination for everyone 6 months of age and older who is immunocompromised. The vaccine can induce protective antibody levels in a substantial proportion of adults and children with immune compromising conditions, although effectiveness may be lower than in healthy individuals. Vaccinating family members, close contacts and health care workers is also part of the immunization environment for these patients.

  * **A.** People who are immunocompromised have an increased risk of morbidity and mortality from influenza, and vaccination is specifically recommended rather than avoided.
  * **B.** Immunity from influenza vaccine is short-lived and circulating strains change, so annual vaccination is recommended rather than a single dose.
  * **C.** Annual vaccination is recommended for the immunocompromised child regardless of exposure in the household, and household contacts are also vaccinated to reduce transmission.  
Sources: Public Health Agency of Canada. Immunization of immunocompromised persons: Canadian Immunization Guide (2026)
6. 5 / 10  
A 24-year-old male undergoes an emergent splenectomy following a grade V splenic laceration from a motor vehicle accident. He is recovering well on postoperative day 3.  
According to Canadian public health guidelines, when should post-splenectomy immunizations against encapsulated organisms be administered?  
Show answer

**Answer: A.** Approximately 14 days after surgery

**Why:** For patients undergoing urgent or emergent splenectomy, vaccinations against encapsulated organisms (Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b) should be administered 14 days postoperatively. This timing optimizes the immune response compared to immediate vaccination.

  * **B.** Immediate vaccination leads to sub-optimal antibody titers due to the acute post-traumatic inflammatory state and immunosuppression.
  * **C.** Day 5 is too early; waiting until day 14 is preferred to maximize immunogenicity and antibody response.
  * **D.** Delaying vaccination for 6 weeks leaves the patient vulnerable to overwhelming post-splenectomy infection (OPSI) in the early postoperative period.  
Sources: Canadian Immunization Guide, Public Health Agency of Canada
7. 6 / 10  
A 27-year-old woman is planning a pregnancy and asks about immunization. She is not immune to rubella and has no history of measles, mumps and rubella vaccination. She also has no history of varicella infection. She wants to know whether these vaccines can be given once she is pregnant.  
What is the most appropriate advice?  
Show answer

**Answer: B.** Give measles, mumps and rubella and varicella vaccines before conception, with advice to avoid pregnancy for at least 28 days after immunization

**Why:** When considering vaccination in pregnancy it is important to distinguish live from non-live vaccines. Live vaccines should generally not be given during pregnancy because of the theoretical risk of harm to the baby if transmission of the vaccine strain occurs, although they may be considered when benefits outweigh that theoretical risk, such as during a rubella outbreak. Non-live vaccines are considered safe in pregnancy. Live vaccines such as measles, mumps and rubella and varicella are best given before conception, with advice to avoid pregnancy for at least 28 days afterwards.

  * **A.** Live vaccines should generally not be given during pregnancy because of the theoretical risk of harm to the baby if the vaccine strain is transmitted.
  * **C.** Measles, mumps and rubella vaccine is a live attenuated vaccine, and in general live attenuated viral or bacterial vaccines are contraindicated in pregnancy.
  * **D.** Varicella vaccine is a live attenuated vaccine and is not the recommended approach at delivery; protection should be addressed before conception.  
Sources: Public Health Agency of Canada. Immunization in pregnancy and breastfeeding: Canadian Immunization Guide (2026)
8. 7 / 10  
A 12-year-old boy attends for a routine visit. He is healthy, takes no medications, and has no immunocompromising condition. His parents ask about the human papillomavirus vaccine that is offered through the school program and whether it is needed at his age.  
According to the Canadian Immunization Guide, how many doses of human papillomavirus vaccine should he receive?  
Show answer

**Answer: C.** One dose of nonavalent human papillomavirus vaccine

**Why:** In Canada the routine human papillomavirus schedule for individuals 9 to 17 years of age who are not immunocompromised is a single dose of nonavalent vaccine. A two-dose schedule at least 24 weeks apart, given at months 0 and 6, may be considered on an individual basis following discussion with a health care provider. Individuals who are immunocompromised follow a different schedule, so immune status is relevant to the recommendation.

  * **A.** The routine schedule recommends human papillomavirus vaccination for individuals 9 to 17 years of age, so waiting until 18 years would miss the recommended window.
  * **B.** A three-dose schedule is used for immunocompromised individuals, whereas this boy has no immunocompromising condition.
  * **D.** A two-dose schedule may be considered on an individual basis in discussion with a health care provider, but the routine recommendation for this age group is a single dose.  
Sources: Public Health Agency of Canada. Recommended immunization schedules: Canadian Immunization Guide (2026)
9. 8 / 10  
A 32-year-old woman with a documented egg allergy attends her family physician for seasonal influenza immunization. Her previous reaction was urticaria after eating eggs; she has no asthma and no history of anaphylaxis to any vaccine.  
What is the most appropriate advice regarding influenza vaccination?  
Show answer

**Answer: A.** She may receive any influenza vaccine authorized for use in Canada

**Why:** The Canadian Immunization Guide notes that studies have clearly demonstrated that egg-allergic persons can receive influenza vaccines, that all egg-allergic individuals may be vaccinated against influenza using any of the vaccines authorized for use in Canada, and that no prior skin test is needed irrespective of a past severe reaction to egg. The full recommended dose can be used and the vaccine may be given in any setting where vaccines are routinely administered. An egg allergy is therefore neither a contraindication nor a reason to require skin testing or intensive monitoring in this patient, who has no asthma and no vaccine anaphylaxis.

  * **B.** A known egg allergy is not a contraindication to influenza vaccine, and studies show egg-allergic people can be safely vaccinated.
  * **C.** A prior influenza vaccine skin test is not required, even after a past severe reaction to egg.
  * **D.** The vaccine may be given wherever vaccines are routinely administered, and prolonged observation is not routinely mandated.  
Sources: Public Health Agency of Canada. Canadian Immunization Guide, Part 2: Vaccine Safety, Contraindications and precautions (2026).
10. 9 / 10  
A 29-year-old woman is 28 weeks pregnant with her third child. She received tetanus, diphtheria and acellular pertussis vaccine in a previous pregnancy 3 years ago and has completed her routine tetanus boosters. She asks whether she needs the vaccine again in this pregnancy.  
What is the most appropriate recommendation?  
Show answer

**Answer: C.** Give tetanus, diphtheria and acellular pertussis vaccine during every pregnancy, ideally between 27 and 32 weeks of gestation

**Why:** Pertussis immunization in pregnancy protects the newborn during the first two months of life, when morbidity and mortality from pertussis are highest, because maternal antibody is transferred across the placenta. The Canadian Immunization Guide advises giving tetanus, diphtheria and acellular pertussis vaccine during every pregnancy irrespective of previous immunization history, ideally between 27 and 32 weeks of gestation. Immunization between 13 and 26 weeks may be considered when preterm delivery is likely, and if not given earlier it should be offered at any time until delivery.

  * **A.** The recommendation applies to every pregnancy irrespective of previous tetanus, diphtheria and acellular pertussis immunization history.
  * **B.** The timing rule is based on each pregnancy rather than on the interval since the last tetanus booster.
  * **D.** Postpartum administration would not provide the transplacental antibody that protects the newborn during the first two months of life.  
Sources: Public Health Agency of Canada. Immunization in pregnancy and breastfeeding: Canadian Immunization Guide (2026)
11. 10 / 10  
A 32-year-old mother brings her 15-month-old child for a routine visit. She says she delayed the measles, mumps and rubella vaccine because she read that it could cause the illness it prevents, and she is uncertain about proceeding today. She is not hostile and is willing to discuss the decision.  
Which communication approach best matches what the 2024 Chief Public Health Officer's report recommends for this conversation?  
Show answer

**Answer: B.** Use motivational interviewing by fostering a collaborative and empathetic atmosphere, understanding her views, offering information, and clarifying and accepting her decision.

**Why:** The 2024 Chief Public Health Officer's report describes motivational interviewing as a person-centred communication strategy designed to enhance an individual's internal motivation to change, and it presents a four-step framework for vaccine conversations: engage, understand the person's views, offer information, and clarify and accept the decision. The technique aims to educate patients about vaccination in a way that is tailored to their needs and level of understanding while respecting their beliefs and remaining empathetic. Correcting the parent, ending the discussion until she agrees to all vaccines, or handing over literature without a conversation all miss the collaborative and empathetic elements the report recommends.

  * **A.** The report recommends a strategy that respects the parent's beliefs and remains empathetic, rather than simply correcting the concern and proceeding.
  * **C.** Ending the conversation works against the report's emphasis on trusted relationships, tailored discussion and continued engagement.
  * **D.** Providing material without discussion does not match the report's focus on a tailored, person-centred conversation about vaccination.  
Sources: Public Health Agency of Canada - Chief Public Health Officer's Report 2024

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