American Board of Internal Medicine (ABIM) Certification Practice Exam

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For patients undergoing solid organ transplantation, what vaccination needs to be completed before the procedure?

  1. TDap

  2. Haemophilus influenzae type B

  3. Inactivated polio

  4. MMR

The correct answer is: Inactivated polio

For patients undergoing solid organ transplantation, it is crucial to complete the inactivated polio vaccination before the procedure. This is primarily due to the immunosuppressive therapies these patients will receive post-transplant. Transplant recipients are at an increased risk of infections and may not be able to mount an adequate immune response to live attenuated vaccines after transplantation. Inactivated polio vaccine is particularly important because it is safe to administer to immunocompromised patients, and maintaining their immunization against polio protects both the individual and the wider community. Vaccine-preventable diseases, such as polio, can have serious consequences for transplant recipients who will have compromised immunity; therefore, ensuring proper vaccination before surgery is key to their safety and long-term health. Other vaccines, such as the MMR vaccine, generally contain live attenuated viruses and are not advisable right before the procedure due to the risk of infection in an immunocompromised host. Similar concerns apply to the Tdap and Haemophilus influenzae type B vaccines, which, while important, do not specifically relate to the unique risks associated with polio in this patient population. Thus, ensuring that the inactivated polio vaccination is completed prior to organ transplantation is a critical component of pre-operative