1. Module 3 IPV schedule, eligibility and contraindications Training for Inactivated Poliovirus Vaccine (IPV) introduction

2. IPV schedule, eligibility and contraindications, Module 3 | February 2015 2 |2 | Learning objectives At the end of the module, the participant will be able to: – Describe the recommended immunization schedule for inactivated poliovirus vaccine (IPV) – Determine when an infant can receive IPV – Describe the absolute contraindications for vaccination and understand the false-contraindications Duration – 25minutes

3. IPV schedule, eligibility and contraindications, Module 3 | February 2015 3 |3 | Key issues What is the recommended schedule for IPV? 1 1 What are the true and false contraindications to vaccination? 2 2 Can you administer IPV to immunodeficient or premature infants? 3 3

4. IPV schedule, eligibility and contraindications, Module 3 | February 2015 4 |4 | When should IPV be administered? Schedule BasicBooster 1st2nd3rd1st2nd First option IPV OPV Alternate option IPVOPV Vaccination Schedule recommended for the introduction of inactivated poliovirus vaccine (IPV) in combination with the oral poliovirus vaccine (OPV). The TAG recommends that countries use a sequential schedule, preferably: IPV + IPV + OPV + OPV + OPV The second option is one dose of IPV followed by two doses of OPV for the regular schedule and two OPV doses as boosters

5. IPV schedule, eligibility and contraindications, Module 3 | February 2015 5 |5 | Why introduce IPV as first (and second) doses in schedule? Very rarely, tOPV can cause vaccine-associated paralytic polio (VAPP) The incidence of VAPP in the Region is around 1 case per 7.68 million doses administered. 49% of VAPP cases in the Region are associated with the first dose of OPV, and 21% are associated with the second dose. Introducing IPV at the first immunization contact will be a reduction in VAPP incidence by around 50%.

6. IPV schedule, eligibility and contraindications, Module 3 | February 2015 6 |6 | A child comes in at 4 months of age and has had no vaccines. What should you do? What should you do in this scenario?

7. IPV schedule, eligibility and contraindications, Module 3 | February 2015 7 |7 | Answer: The child should receive the first dose of IPV and other vaccines according to national schedule. Explain to the caretaker the importance of coming for vaccination on time and completing the immunization schedule Prepare/update the immunization card

8. IPV schedule, eligibility and contraindications, Module 3 | February 2015 8 |8 | Absolute contraindications to IPV Do not vaccinate if recipient has: Known or documented allergy to vaccine components, including: -Streptomycin -Neomycin -Polymyxin B History of an allergic reaction following a previous IPV injection Thrombocytopenia (insufficient blood platelets, which play an important role in coagulation) Other bleeding disorder Wait! Postpone vaccination if recipient is: Taking temporary treatment that suppresses the immune response -Treatment could reduce immune response to the vaccine -Postpone vaccination until the end of the treatment to make sure the infant is well protected by the vaccine

9. IPV schedule, eligibility and contraindications, Module 3 | February 2015 9 |9 | Can IPV be administered on schedule to immunodeficient infants or infants born prematurely? Yes! Immunodeficiency is not a contraindication of IPV Vaccination of infants with immunodeficiency, such as HIV infection, is recommended Infants born prematurely should receive IPV on schedule

10. IPV schedule, eligibility and contraindications, Module 3 | February 2015 10 | Contraindication Checklist Do I still give IPV if recipient has….?YesNoPostpone …mild illness …malnutrition …HIV …prematurity …allergy to streptomycin, neomycin or polymyxin B …bleeding disorder …had a previous severe reaction to IPV …taking treatment that suppresses immune response

11. IPV schedule, eligibility and contraindications, Module 3 | February 2015 11 | Key messages TAG recommended schedule: IPV can be given at the same time as other injectable vaccines like pentavalent and pneumococcal vaccine IPV can be administered to children with immunodeficiency disorders and those born prematurely Schedule BasicBooster 1st2nd3rd1st2nd First option IPV OPV Alternate option IPVOPV

12. IPV schedule, eligibility and contraindications, Module 3 | February 2015 12 | End of module Thank you for your attention!