1. Training for rotavirus vaccine introduction
Module 7
Communicating about rotavirus vaccine with caretakers

2. Learning objectives
At the end of the module, the participant will be able to:
Describe how to communicate with caretakers
Advise caretakers on rotavirus disease and prevention methods
Alert caretakers of potential side effects and how to respond to them
Provide other messages to caretakers before they leave the session
Duration
20’

3. Key issues 1 2 3 4 How to communicate with caretakers?
How to advise on rotavirus disease and prevention methods? 2
How to advise on potential side effects? 3
What other messages to give caretakers before they leave the session? 4
To the facilitator:
Explain to the participants the key issues raised in this module.
We will provide you with answers to the following questions:
How to communicate with caretakers?
How to advise on rotavirus disease and prevention methods?
How to advise on potential side effects?
What other messages to give caretakers before they leave the session?

4. How to communicate with caretakers?
Be respectful
Use simple words and avoid technical terms
Listen to caretaker's concerns
Made sure the caretaker has understood your key messages
To the facilitator:
Explain to the participants how to communicate with parents.
To effectively communicate with caretakers, health workers must first understand the concerns of parents regarding immunization and understand factors that can lead to misinformation about the safety and effectiveness of vaccines. Healthcare workers should establish an open, friendly dialogue with vaccine-hesitant parents at an early stage and provide clear answers to their questions and provide accurate information about vaccination.
In a few words, the health worker should :
Be respectful: smile often, be friendly
Use simple words to make sure the caretaker understands your key messages: look directly at caretakers and try to judge by their body language if they have understood your messages. Reword and simplify if needed.
Listen to caretaker's concerns: do not get angry or irritated when caretakers ask questions or raise concerns.
Ongoing dialogue may successfully reassure vaccine-hesitant parents that immunization is the best and safest option for their child.

5. What is “triple A” communication
with parents?
Advice
on what is
given
Alert
on side effects and how to respond
Arrange
for when
to return
To the facilitator:
Describe to the participants what the concept of triple A communication with parents.
Triple A is a mnemonic system/memory trigger that allows health workers to remember the three ways of communicating with parents: A A A as Advice, Alert, and Arrange.
Advice: Health workers should advise parents on what is given: the name of the vaccine(s), the diseases prevented, etc.
Alert: Health workers should alert parents of the potential side effects after immunization and how to respond.
Arrange: Health workers should arrange with parents the next appointment for administering the subsequent doses to complete the schedule.

6. Advice: How to inform about the disease?
Rotavirus causes severe diarrhea, vomiting, and fever leading to rapid dehydration
Rotavirus is found everywhere
Almost every child in the world will suffer from at least one infection by the time he or she is three years old
Rotavirus is not the only cause of diarrhea, but it is one of the most serious
Rotavirus infection spreads very quickly
To the facilitator:
Explain to the participants how to inform about rotavirus disease.
Key messages for caretakers include:
Rotavirus is a virus that causes diarrhea, sometimes severe, mostly in babies and young children. It is often accompanied by vomiting and fever and can lead to dehydration.
Rotavirus is not the only cause of diarrhea, but it is one of the most serious. Before a vaccine was available, rotavirus was responsible for the death of as many as 600,000 children each year (worldwide). Almost every child in the world will suffer from at least one infection by the time he or she is three years old.
The primary mode of transmission of rotavirus is the passage of the virus in stool to the mouth of another child. This is known as a fecal-oral route of transmission. Children can transmit the virus also when they forget to wash their hands before eating or after using the toilet. Touching a surface that has been contaminated with rotavirus and then touching the mouth area can result in infection.

7. Advice: How to communicate about diarrhoea prevention methods?
To the facilitator:
Explain to the participants how to communicate about prevention methods.
The use of rotavirus vaccine needs to be part of a comprehensive strategy to control diarrhoeal diseases with the scaling up of both prevention (promotion of early and exclusive breastfeeding for six months, vitamin A supplementation, safe drinking water, hygiene, especially hand-washing with soap, and sanitation) and treatment packages (ORS, zinc, and continued feeding).Currently, vaccination is the only way to prevent severe episodes of rotavirus infection.

8. Advice: What is the new rotavirus vaccine?
Millions of children have received rotavirus vaccine in the last 8 years and the vaccine is considered very safe and effective
This vaccine will be given at the same time as pentavalent vaccine, therefore no extra visit is required for this vaccine
Your child can still get diarrhea due to other infections
To the facilitator:
Explain to the participants what the new rotavirus vaccine is.
This vaccine offers the best hope for protection against rotavirus!
A vaccine has been administered to many infants and is safe. This is an oral vaccine that is given along with pentavalent vaccine so no extra visit is required. Your child can still get diarrhea due to other means therefore methods to prevent diarrhea should always be applied.

9. Alert: How to respond to side effects?
Infants may be more irritable and could have loss of appetite. Some infants may also experience fever, fatigue, diarrhea, and vomiting
After immunization you can give paracetamol if your infant has fever (>39˚C)
If your infant shows any unusual symptoms take him/her directly to the hospital
To the facilitator:
Explain to the participants how to respond to side effects.
Current rotavirus vaccines are generally well tolerated.
Irritability and loss of appetite are very common side effects of rotavirus vaccine.
If the child has fever (>39˚C), paracetamol may be given
If the child shows any unusual symptoms, take him/her directly to the hospital or contact the health worker who administered the vaccine.
Parents have to understand that the risk of the side effects after rotavirus vaccination is much lower than the risk of severe
rotavirus disease in unvaccinated children.

10. Arrange: When to return?
Make an appointment for the next dose of rotavirus vaccine and other vaccines according to the immunization schedule
Wait at least 4 weeks before next appointment
Ensure that there is a session on the attributed date
i.e., no public holiday, weekend, or other event
Write the date of the next visit on the immunization card
Remind the caretaker to come on the specified date and to bring the card
To the facilitator:
Explain to the participants when to return for the second dose.
Make an appointment for the next dose of rotavirus vaccine and other vaccines according to the immunization schedule.
Make sure a minimum interval of 4 weeks is maintained.
Ensure that there is a session on the given date (no public holiday, weekend, etc.).
Write the date of the next visit on the immunization card and remind the caretaker to come on the specified date and to bring the card.

11. Key messages (1/4)
Triple A communication - Be respectful - Listen to caretaker's concerns
Use simple phrases and avoid technical terms to make sure the caretaker understands your key messages
Ongoing dialogue may successfully reassure vaccine- hesitant parents that immunization is the best and safest option for their child
To the facilitator:
Explain to the participants that this is the main information to keep in mind. 11

12. Key messages (2/4) Rotavirus infection is highly contagious
Vaccination is the only way to prevent the severe episodes of rotavirus infection
A child immunized with rotavirus vaccine can still get diarrhea from other agents
Follow all steps to prevent and control diarrhea
To the facilitator:
Explain to the participants that this is the main information to give to the caretakers.

13. Key messages (3/4) On-time vaccination is very important
Current rotavirus vaccines are generally well tolerated
Parents have to understand that the risk of side effects after rotavirus vaccination is much lower than the risk of severe rotavirus disease in unvaccinated children
Keep the immunization card safe and remember to bring it next time
To the facilitator:
Explain to the participants that this is the main information to give to the caretakers. 13

14. Key messages (4/4)
Synergistic interventions related to diarrhoea prevention and treatment should be practiced, such as:
Rotavirus and measles vaccination,
Promotion of exclusive breastfeeding and Vitamin A supplementation,
Promotion of hand washing with soap,
Improved water supply including treatment and safe storage of household water,
Community-wide sanitation promotion,
Fluid replacement (ORS) and
Zinc treatment
To the facilitator:
Explain to the participants that this is the main information to give to the caretakers. 14

15. End of module for your attention! Thank you To the facilitator:
This is the end of the training, thank you for your attention!
A Pocket Guide of the training is available. This Pocket Guide is intended to remind you of key information in routine practice.