Presentation on theme: "Instructions for users"— Presentation transcript:
1Instructions for users This slide presentation provides an overview of immunizing with the SA JE vaccine.This slide set should be used together with the manual “Immunizing Children Against Japanese Encephalitis using SA Japanese Encephalitis Vaccine: A Training Module for Vaccinators”.Below some of the slides, there are notes to explain the information in the slide.You should adapt the presentation for your own use.
2Immunizing Children Against Japanese Encephalitis with SA 14-14-2 JE Vaccine
3Learning Objectives Participants will: Be familiar with key facts on SA JE vaccine.Demonstrate correct vaccine administration techniques.Describe appropriate JE vaccine storage.Describe safe disposal of used needles and syringes.Communicate more effectively with parents of children being vaccinated.
4Facts about SA 14-14-2 JE vaccine SA is a live, attenuated vaccine.Licensed in the People’s Republic of China in 1988.Currently about 60 million doses are used annually in China.Also licensed and used in South Korea, India, Sri Lanka, Thailand and Nepal.Produced in primary hamster kidney cell cultures.
5Administering Japanese encephalitis vaccine Who should be given JE vaccine?Photo credit: Lisa Lundgren
6The following two slides need to be adapted according to the strategy and immunization schedule in your areaAn example is given
7For areas where JE vaccine is newly introduced A one-time preventive or “catch-up”campaign will be conducted.This will include children 1 to 15 years of age.Adapt this slide so it explains the strategy in your area
8For routine immunization Standard immunization scheduleAgeVaccines GivenBirthBCG HepB16 WeeksOPV1 DTP110 WeeksOPV2 DTP2 HepB214 WeeksOPV3 DTP3 HepB39 MonthsMeasles JE15 yearsMeaslesAll children who are 9 months of age should receive a dose of JE vaccine.Replace the example here with the schedule and recommendations in your country, including JE vaccine
9What if a dose is missed?If a child misses the date for vaccination, the child should make up the dose as soon as possible.There is no need to re-start the vaccination schedule.Photo credit: Lisa Lundgren
10The SA vaccine (1)SA is a lyophilized vaccine that needs to be reconstituted (mixed with diluent) before use.Prior to reconstitution it is a milky-white caked powder.After mixing with diluent it becomes a transparent pink liquid.
11After mixing with diluent, the vaccine is a transparent pink liquid. Photo credit: Chengdu Institute of Biological ProductsAfter mixing with diluent, the vaccine is a transparent pink liquid.
12The SA 14-14-2 vaccine (2) Provided in single-dose or 5-dose vials. Comes with two separate vialsLyophilized (freeze-dried) JE vaccineDiluent
13The diluent and vaccine (5-dose vial) Photo credit: Chengdu Institute of Biological ProductsThe diluent and vaccine (5-dose vial)
14Dosage and administration Dosage is 0.5 mL (all ages).Subcutaneous injection.Normally given in outer upper arm.
15What are the steps to follow when immunizing a child against JE disease? Initial assessment with parents and child.Prepare the vaccine.Give the injection.These 3 points summarize the steps to follow when immunizing a child against JE disease. The following slides provide more details.
16Before preparing the vaccine (1) Greet the parents.Evaluate the child’s immunization card and check what vaccine(s) are needed.Explain the vaccine to the parents, including possible side effects and how to manage them.Ask if the parent has any questions.Check to make sure the correct vaccine is available.Discuss with parents when to return for the next vaccination.
17Before preparing the vaccine (2) Prepare your supplies.Photo credit: Lisa Lundgren
18Prepare the vaccine (1) Read the expiry date on the vaccine vial. If the expiry date has passed, discard the vial.If the label has fallen off, discard the vial.If the VVM is at stage III or IV, discard the vial and inform your supervisor.Photo credit: Lisa Lundgren
19Prepare the vaccine (2)Make sure you have the correct, manufacturer-supplied diluent. Check the vial is in tact and read the expiry date.If the correct diluent is not available, do not reconstitute the vaccine with anything else.Discard the vial ifthe expiry date has passed.the label has fallen off.the vial is cracked.
20Prepare the vaccine (3)Remove the plastic flip-off cap from the diluent vial and the vaccine vial.Do not remove the rubber stopper.Photo credit: Lisa Lundgren
21Prepare the vaccine (4)Reconstitute only with the manufacturer-supplied diluent.Using a sterile syringe with mixing needle, draw up the diluent.Photo credit: Lisa Lundgren
22Prepare the vaccine (5)Insert the needle into the lyophilized JE vaccine vial.Photo credit: Lisa Lundgren
23Prepare the vaccine (6)Inject the diluent into the lyophilized vaccine vial.Photo credit: Lisa Lundgren
24Prepare the vaccine (7) Discard the mixing needle and syringe. Photo credit: Lisa Lundgren
25Prepare the vaccine (8)Shake the vial with the diluent and lyophilized vaccine gently, but thoroughly.The vaccine should be uniformly pink when completely mixed.After reconstitution the vaccine should be stored between 2°C and 8°C. Do not freeze reconstituted JE vaccine.Used reconstituted vaccine within x hours (adapt slide according to country regulations for this vaccine). Discard any vaccine remaining after this time.
26Giving the injection (1) Draw up the reconstituted vaccine, using a new sterile needle and syringe for each injection.The needle and syringe used for reconstitution should not be used for giving the injection.Photo credit: Lisa Lundgren
27Giving the injection (2) Give:0.5 ml of JE vaccine.As a subcutaneous injection.In the outer upper arm, avoiding the BCG scar.
28Giving the injection (3) To give a subcutaneous injection:Position child sideways on mother’s lap.Ask the parent to hold the child’s legs.Reach fingers around child’s arm and pinch up the skin.Push the needle into the fatty layer between the skin and the muscle on the child’s upper, outer arm.The direction of the needle is towards the shoulder.Do not push the needle too far in.Photo credit: WHO, Immunization in Practice
29Giving the injection (4) Dispose of the needle and syringe immediately in the safety box.Needles should not be recapped due to the danger of needle-stick injury.Photo credit: Lisa Lundgren
30Giving the injection (5) Record the date of vaccination on the child’s vaccination card.Remind parents about when to bring the child back for the next vaccination.
31What are the possible side effects of JE vaccine? (1) Some children may experience mild symptoms such as tenderness or swelling at the injection site, rash, mild fever, nausea, or dizziness.These side effects are not serious and will not last more than a few days.Neither acute encephalitis nor hypersensitivity reactions have been associated with the SA vaccine.
32What are the possible side effects of JE vaccine? (2) JE vaccine does not cause JE disease.If a child becomes unusually or severely ill in the days following the immunization, the parents should bring the child to a hospital or clinic as soon as possible.
33What are the contra-indications to SA 14-14-2 JE vaccine? A very severe adverse reaction (anaphylaxis) to a prior dose of SA JE vaccine.Known allergy to any vaccine component (gelatin, gentamicin, kanamycin).Immunosuppression (due to disease or medication) or having the signs and symptoms of AIDS.PregnancyNote: if a child has a fever higher than 38.5°C, vaccination should be postponed. An appointment should be made for vaccination as soon as possible after the fever settles.
34How do you store JE vaccine? Powdered, lyophilized JE vaccine should be stored below 8°C, protected from light.After reconstitution, the vaccine should be stored between 2°C and 8°C.Do not freeze reconstituted JE vaccine.The vaccine should be discarded after x hours* or at the end of the immunization session, whichever comes first.*Insert regulations for this vaccine for your country
35How can you safely dispose of used syringes and needles? (1) Keep a safety box within reach whenever you give injections.Photo credit: Lisa Lundgren
36How can you safely dispose of used syringes and needles? (2) Immediately after giving an injection, place the used needle and syringe in the safety box.Photo credit: Lisa Lundgren
37How can you safely dispose of used syringes and needles? If no official safety box is available, use a hard plastic container for disposing of used syringes and needles.Clearly mark the container “SHARPS” so others will know to dispose of it properly.When the box is ¾ full, seal the box and burn it in an incinerator.If there is no incinerator, burn the safety box in a metal drum or shallow pit.After burning, bury all remaining ashes and debris (including burned needles and melted plastic).
38Monitoring use of JE vaccine Record JE vaccine doses given on the child’s immunization card and clinic record.Record doses of JE vaccine used on the routine reporting form.Think about ways to reduce wastage.
39How can you help ensure that parents bring their children for all needed immunizations? (1) Be friendly and courteous in all interactions with parents.Listen respectfully to parents’ questions and concerns.Answer questions and explain things simply and clearly.Be patient with people who cannot read or who have not attended school.
40How can you help ensure that parents bring their children for all needed immunizations? (2) Speak the local language and use words the parents can understand.Find out when it is convenient for parents to bring their children for immunization and offer immunizations at those times.Maintain a regular immunization schedule so that parents know when to come.Clearly post the schedule where parents will see it.
41How can you help ensure that parents bring their children for all needed immunizations? (3) Explain to parents when and why the child should return for future vaccinations.Remind them to bring the child’s vaccination card.Assure them that the child should be vaccinated even if he or she has a slight fever or cold.Ensure a smooth patient flow so that children are seen in the order they arrive, and without unnecessary delay.Allow only one family at a time in the immunization area.
42How can you help ensure that parents bring their children for all needed immunizations? (4) Help parents understand possible common side effects and how they can treat the symptoms.Explain what to do in case of uncommon allergic reactions.Before the parent leaves the clinic, be sure he or she knows when the child’s next vaccine is due.Guide the parents and child to the exit after giving the immunization and thank them for coming.
43How can you help ensure that parents bring their children for all needed immunizations? (5) Ask community leaders, school teachers and community organizations to help educate parents about full immunization and motivate or assist them to bring their children on time.Photo credit: Lisa LundgrenPhoto credit: Lisa Lundgren
44AcknowledgementsPlease include the following acknowledgement if you use this slide set:This slide set was adapted from a slide set prepared by Lisa Lundgren, Northrop Grumman Contractor with the U.S. Centers for Disease Control and Prevention, and PATH’s Japanese Encephalitis Project.For information:Please include this acknowledgement if you are adapting and using this slide set.