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Smallpox Vaccinee Evaluation and Follow-Up

Smallpox Vaccinee Evaluation and Follow-Up. WVDHHR/BPH US Department of Health and Human Services Centers for Disease Control and Prevention December 2002 / January 2003. Smallpox Vaccinee Evaluation and Follow-Up. Learning Objectives:

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Smallpox Vaccinee Evaluation and Follow-Up

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  1. Smallpox Vaccinee Evaluation and Follow-Up WVDHHR/BPH US Department of Health and Human Services Centers for Disease Control and Prevention December 2002 / January 2003

  2. Smallpox Vaccinee Evaluation and Follow-Up • Learning Objectives: • Describe the “take” that can be expected after vaccination • Describe the care of the vaccination site • Describe the management of vaccinees after vaccination • Describe the system for vaccinee follow-up in West Virginia

  3. Normal Response to Vaccination – “Take” • First (primary) Vaccination • Vesicular or pustular lesion • Area of definite palpable induration surrounding a center crust or ulcer • Revaccination • Less pronounced and more rapid progression • Pustular lesion or induration surrounding a central crust or ulcer • Take MUST be documented

  4. Normal Variants • Local satellite lesions • Lymphangitis • Local edema • Viral cellulitis • Swelling and tenderness of axillary lymph nodes, usually during 2nd week • Fever and malaise common

  5. Satellite Lesion

  6. Lymphangitis

  7. Edema

  8. Viral Cellulitis

  9. Equivocal Reaction • All responses other than major reaction or ‘take’ • Caused by partial immunity, insufficiently potent vaccine, vaccination technique failure • Vaccination should be repeated ASAP, if possible

  10. Vaccination Site Care • Virus can be recovered at site from time of papule until scab separates • Site should be kept dry and covered • Normal bathing can occur if covered by a waterproof bandage • Healthcare workers should keep site covered • Use gauze or similar absorbent material

  11. Vaccination Site Care • Cover this with semi-permeable dressing • Hand hygiene immediately after handling dressing or contact with site CRITICAL to preventing spread • Other infection control precautions to prevent contact with site • Clothing over site

  12. Vaccination Site Care • Do NOT use semi-permeable dressing alone; could cause: • maceration of vaccination site • prolonged irritation and itching • increases touching/scratching, thereby contaminating hands • Designate staff to assess dressings daily

  13. Administrative Leave • Do not need to place healthcare workers on leave, unless: • physically unable to work due to systemic signs and symptoms • extensive skin lesions or vaccination site that cannot be covered • healthcare workers do not adhere to infection control precautions and recommendations

  14. Follow-up in West Virginia • Vaccinee take-home information: • List the number of the local vaccine safety monitor • Vaccine safety monitor • Monitor the vaccination site daily • Refer to Hospital Assigned Physicians for serious adverse events / questions • Support for HAPS / Vax Safety Monitor • IDEP: 800-423-1271 • CDC: contractor 800-###-#TBA

  15. Twenty-one Day Diary • Surveillance for mild adverse events • Record PVN for vaccinee on the form • Give to vaccinee at clinic • Educate them to record symptoms daily until day 21 • Collect when the scab falls off. • Send to: IDEP • ATTN: Neely Kaydos-Daniels, PhD

  16. Telephone Survey • Patient Medical History Form has check-off: • ‘Will you participate in a survey?’ • If checked ‘yes:’ notify Neely Kaydos-Daniels, PhD: • Photocopy all forms immediately after vaccination clinic, OR • List name, phone, PVN AND • Fax: 304-558-6335, OR • Mail: Room 125, 350 Capitol St / Charleston, WV 25301

  17. Severe Vaccine Adverse Events • If VIG / Cidofovir is needed • Contact IDEP to initiate request • IDEP / physician will contact CDC • IDEP will work with physician to assure reporting • Reporting • Urgent • IDEP will assist with filing the report

  18. Before you start, you must have: • Vaccine Safety Monitor • Site care education plan • Follow up plan • Hospital Assigned Physicians: • Infectious disease • Allergy/immunology • Neurology • Dermatology • Ophthalmology • Primary care

  19. For More Information • Coming soon: • CDC satellite training • MMWR • IDEP conference calls • IDEP: 800-423-1271 • CDC Smallpox website www.cdc.gov/smallpox • National Immunization Program website www.cdc.gov/nip

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