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Essential Training Package for HPV Vaccine Introduction. Module 4 HPV vaccine administration Cervarix TM. Learning Objectives. At the end of this module , you will have learned to: Describe activities carried out before, during and after an immunization session.
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Essential Training Package for HPV Vaccine Introduction Module 4 HPV vaccine administration CervarixTM
Learning Objectives • At the end of this module, you will have learned to: • Describe activities carried out before, during and after an immunization session. • Describe how to ensure that vaccine is of good quality • Describe the technique to administer the vaccine • Describe considerations for conducting immunization session in school setting • Duration • 45 ’
Key issues 1 How to ensure that the vaccine is of good quality? 2 How to prepare for vaccination? 3 4 How to handle 2-dose vial of CervarixTM vaccine? How to administer the vaccine? 5 What to do after completing the immunization session?
Immunization sessions: phases & critical activities Phase 1Before girls come for immunization • Phase 2When girls come for immunization • Phase 3After all girls leave immunization AREA
Phase 1: Before girls come for immunization 1. Take vaccines and vials out of the refrigerator 2. Check expiry date and VVM status for each vial 3. Collect & arrange supplies and monitoring tools for immunization session 4. Prepare an AEFI Kit
How to ensure that vaccine is of good quality? • Check the temperature inside the refrigerator, if vaccine freezing is suspected perform the Shake test to confirm • Check VVM status • Check the expiry date on the vials
How to check VVM status? • Before administering the vaccine, you need to check the Vaccine Vial Monitor (VVM) on the vaccine vial
What should you do in this scenario? The vaccine vial monitor shows that the inner square is lighter than the outer circle? What should you do?
Checklist of supplies and monitoring toolsneeded for HPV vaccination Monitoring tools • Vaccination register • Tally sheets • Vaccination cards • Calendar Supplies • Vaccine and syringes • IEC materials (e.g. flyers, pamphlets, posters) • Chair and table • Water and soap for cleaning hands • Trays • Safety box • Containers for used vials • Drugs to manage allergic reactions- 'AEFI kit' • Chairs to rest after vaccination (15 mins) • Pen, pencil
Phase 2: When girls come for immunization 1. Check eligibility of girls 2. Prepare injection using aseptic techniques 3. Administer vaccine according to the recommended techniques and injection site 4. Dispose used syringes immediately into the safety box after each injection 5. Complete immunization card and tally sheet 6. Give key messages to girl/caregiver/parent: inform about vaccines given, side effects, and date of return
What to do when girls come for immunization ? 3.Prepare for vaccine 4.Inject in the upper arm 2.Verify, register, explain HPV vaccine benefits 1.Greet the girl • 5.Determine date for next vaccine dose 6.Return the updated card 7.Observe the girl for 15’
How to prepare for vaccination ? (1/3) • Shake the vial well • Open AD syringe package and remove the syringe and needle from plastic wrapping • Ensure that you do not touch any part of the needle
How to prepare for vaccination ? (2/3) • Take off the needle cap when you are ready to give the vaccine • Insert the needle into the vaccine vial • Draw vaccine from the vial into the 0.5mL syringe
Route and site of administration • Injection route: Intramuscular • Injection site: the upper arm, check national policy on which arm (left or right) • The injection angle- 90 degree angle
Proper handling of 2-dose vial of CervarixTM? • After opening, handle the vaccine in the same manner as: • A reconstituted BCG vaccine vial • Or measles vaccine vial • Discard any opened vial with unused doses: • At the end of immunization session • Or6 hours after opening • During the session: • Put open vials in the vaccine carrier • DO NOT return them in the refrigerator
Phase 3: After all girls leave immunization site 1. Complete Immunization tally sheet by counting the number of doses given 2. Return unopened vaccine vials to the refrigerator 3. Put safety box in a safe location 4. Inform community of the next session and activities planned to reach unvaccinated girls
Key messages • HPV vaccine session requires planning of activities before girls come, when girls arrive and after all girls leave • The quality of vaccine should be checked before giving the vaccine • The HPV vaccine is given as an intramuscular injection in the deltoid muscle of the upper arm • Discard any opened vials with unused doses at the end of the immunization session or 6 hours after opening
End of module Thank you for your attention!
References • Comprehensive Cervical Cancer Control. A guide to essential practice (C4 GEP). WHO 2013 • HPV vaccine introduction into national immunization programmes: Information for programme managers and health workers. WHO 2013 • Global update on HPV vaccine introduction