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Learn to monitor & report HPV vaccine coverage & adverse events. Utilize tools at different levels to collect data effectively. Understand AEFI reporting procedure.
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Essential Training Package for HPV Vaccine Introduction Module 5 Recording and monitoring of HPV vaccine GardasilTM
Learning objectives • At the end of the module, youwill have learnedto: • Define process of monitoring HPV vaccine coverage data • Describe the 4 main monitoring tools at service delivery level • Describe the procedure to monitor AEFIs • Duration • 25’
Key issues 1 3 Whatis the process for AEFI monitoring and reporting? 2 What is the process for HPV vaccine coverage monitoring? How to use the monitoring tools?
Flowchart of HPV vaccine coverage monitoring process and tools Data collection & reporting tools 1 - Service delivery/site level (i.e. point of vaccine delivery) Record each vaccinated girl by year of age and by dose number (fill out one tally sheet/vaccination day) 1- Immunization cards 2- Immunization register Sum up tally sheets 3-Tally sheet Report numbers of doses given by year of age and by dose number to district 4- Monthly report 2 - District level 3 - Country level
HPV vaccine coverage data collection procedure Key steps Tools 1 Register each eligible girl Immunization register Complete the girl’s immunization card 2 Immunization card Tally the number of dose given, by dose number & by year of age (per vaccination) 3 Tally Sheet Calculate sub-totals of HPV doses given, by dose number & by year of age (at the end of each vaccination session) 4 5 Report the sub-totals to service delivery site Monthly record sheet
Monitoring tool 1: Immunization card HPV vaccination should always be recorded in the appropriate immunization card Girls and Health Workers need to understand the importance of the card and how to handle it
Whatshouldyou do in this scenario? The girldoes not bring her HPV immunization card How should you record the vaccination given?
Monitoring tool 2: Immunization register Use one register per service delivery site • Record the details of each girl in the register • When a girl returns for HPV2 use her card to locate her entry in the register • Use register to follow up with girls that did not return for 2nd dose of HPV vaccine
Monitoring tool 3: Tally sheetRecord the number (No.) of HPV doses given on a single vaccination day
Using data to improve HPV vaccine coverage • Compare doses given to the target population by year (e.g. no. of 9 year old girls that received HPV1 dose versus no. of 9 year old girls in the catchment area) and consider: • Are there groups of girls that are not reached? • Are girls in the right age group being vaccinated? • Compare number of HPV1 doses administered with number of HPV2 doses administered and consider • Are there problems with communication, vaccine availability, etc. causing drop-outs? • Identify and vaccinate defaulters
Considerations of AEFI related to HPV vaccine • HPV vaccine is a safe vaccine but mild adverse events can occur after administering the vaccine • Redness, pain or swellingat the injection site • Syncope (fainting) • In extremely rare instances it can cause anaphylaxis • One per 1.7 million doses • Girls should be observed carefully for 15 minutes after administration of vaccine • Manage and document any adverse reaction accordingly to the national reporting procedures
Procedure for AEFI reporting • Report AEFIs through existing AEFI reporting systems established by national immunization programs National Authoritieswillthendecide if futher investigation isrequired Suspectedsigns or symptoms Healthworkershouldimmediately report to a local public healthauthority 1 2 3
AEFI reporting form • AEFI report should contain • Details of Patient Reporter details • Details of Vaccine • Details of the event
Key messages (1/2) Monitoring vaccine coverage • Monitoring and reporting HPV vaccine coverage is crucial for evaluating the performance of the immunization programme and its impact on the vaccinated girls • HPV vaccine coverage should be monitored by year of age and by dose number • Vaccine coverage should be monitored with a set of tools including immunization card, register, tally sheet, and monthly report form. • The process for monitoring vaccine coverage data includes 5 steps 4. Calculate sub-totals of HPV dose given 2. Using immunization card 3. registering given dose per age 5. Report Sub-totals to service delivery site 1.Registering girls details
Key messages (2/2) Monitoring AEFI related to HPV vaccine • Monitoring and reporting AEFI related to HPV vaccine is essential for dispelling rumors and monitoring continued safety of HPV vaccines • AEFI should be reported using the existing system established by the national immunization program • Suspected AEFI related to HPV vaccines should be reported immediately to reporting authorities • The AEFI reporting form should contain details of patient, event, vaccine and reporter details
End of module Thank you for your attention!
References • Comprehensive Cervical Cancer Control. A guide to essential practice (C4 GEP). WHO 2014 • HPV vaccine introduction into national immunization programmes: Information for programme managers and health workers. WHO 2014 • Human Papillomavirus (HPV) Vaccine Coverage Monitoring Tool. WHO 2014