Transcript Module 4 - CD-JEV administration in routine immunization pptx, 1.07Mb

CD-JEV Japanese Encephalitis Vaccine Introduction
Training Modules for Health Care Workers
Module 4
CD-JEV administration in routine
immunization
Learning objectives
 At the end of the module, the participant will be
able to:
– Identify necessary steps to ensure good vaccine
quality.
– Describe how to administer CD-JEV.
– Describe how to talk to parents about side effects.
 Duration:
– 30 minutes
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Key issues
1 How do I check the quality of the
vaccine?
2
How do I prepare for vaccination?
3 How do I administer the vaccine?
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How to check the quality of CD-JEV
JE vaccine
 Before administering the vaccine, make sure
you check the expiry date and the vaccine vial
monitor (VVM). Discard the vial if the:
– Expiry date has passed.
– Label has fallen off.
– VVM has reached the discard point.
 Make sure you have and use the correct,
manufacturer-supplied diluent.
 Discard the diluent if the:
– Expiry date has passed.
– Label has fallen off.
– Vial is damaged.
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How to prepare for vaccination
 CD-JEV is a lyophilized vaccine
that needs to be reconstituted
before use.
 There are two separate vials: one
contains a diluent made of sterile
phosphate-buffered saline and
the other contains the vaccine.
 CD-JEV is packaged in both 1-dose and 5-dose vials; steps for
reconstituting are basically the same and only vary by the amount of
diluent and the size of the mixing syringe.
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Vaccine reconstitution (1/4)
● Remember to wash your hands.
● Flick or tap the vaccine vial with your finger to make sure that all of the
vaccine powder is at the bottom of the vial. Visually inspect the vials to
ensure there is no damage to the vials.
● Prepare to reconstitute the vaccine:
̶ For 1-dose vials: Reconstitute only with the manufacturer-supplied
0.5 mL of diluent.
̶ For 5-dose vials: Reconstitute only with the manufacturer-supplied
2.5 mL of diluent.
● Flip the plastic cap of the diluent vial off
with your thumb. Do NOT remove the
rubber stopper.
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Vaccine reconstitution (2/4)
 Draw and add diluent:
̶
For 1-dose vials: Using a sterile 2.0
mL syringe with mixing needle, draw
up the diluent, making sure to
remove ALL diluent from the vial.
Insert needle into lyophilized JE
vaccine vial and empty the diluent.
̶
For 5-dose vials: Using a sterile 5.0
mL syringe with mixing needle, draw
up the diluent, making sure to
remove ALL diluent from the vial.
Insert needle into lyophilized JE
vaccine vial and empty the diluent.
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Vaccine reconstitution (3/4)
 To mix the diluent and
vaccine, draw them up slowly
into the syringe and inject
them slowly back into the vial.
Repeat several times.
 Ensure syringe is empty and
discard the mixing needle and
syringe into the safety box
and the used diluent vial into
the garbage bin.
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Vaccine reconstitution (4/4)
 Shake the vial thoroughly, but gently.
 For 1-dose vials: After JE vaccine has been
reconstituted, opened vials can be used for up
to 30 minutes as long as they are kept within
2⁰C – 8⁰C. Any remaining vaccine should be
discarded after 30 minutes or at the end of the
immunization session, whichever comes first.
 For 5-dose vials: After JE vaccine has been reconstituted, opened
vials can be used for up to 6 hours as long as they are kept within
2⁰C – 8⁰C. Any remaining vaccine should be discarded after 6 hours
or at the end of the immunization session, whichever comes first.
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How to talk to parents about side effects
 Explain to parents and caregivers that some children may experience
common side effects after vaccination, such as tenderness or swelling
at the injection site, or a rash or mild fever. The side effects are not
serious and will not last more than a few days. This will help ease
parents’ minds about mild symptoms.
 Explain that if a child becomes severely ill or appears to have an
allergic reaction, such as fever higher than 38.5⁰C, swelling, or hives,
in the days following the immunization, then the parent should bring
the child to a hospital or clinic as soon as possible. Reassure parents
that serious side effects are rare.
 CD-JEV does not cause Japanese encephalitis.
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Administration of vaccine (1/3)
 CD-JEV is given with a sterile 0.5 mL syringe and
needle (auto-disable [AD]), the same type of syringe
and needle as are routinely used for pentavalent
injections.
 Withdraw 0.5 mL of the reconstituted vaccine with a
new, sterile needle and syringe; the plunger will
automatically stop when the necessary dose of the
vaccine has been drawn (0.5 mL).
 One sterile syringe and needle must be used for each
injection. The syringe and needle used for
reconstitution should not be used for giving the
injection.
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Administration of vaccine (2/3)
 Position the caregiver with the child sideways on
her/his lap and ask the caregiver to hold the child’s
legs. If the child is older, he/she should be seated for
the injection.
 Clean appropriate injection site, if necessary, with a
wet swab.
 To give a subcutaneous injection: Reach your fingers
around the child’s arm and pinch up the skin.* Insert
the needle into the fatty layer between the skin and the
muscle on the child’s upper, outer arm, avoiding the
BCG scar. The needle should point toward the
shoulder.
 To avoid contamination, do not touch the needle.
* Note that while the package insert says to administer the
vaccine in the upper arm, national guidelines may specify a
different injection site.
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Administration of vaccine (3/3)
 Press the top of the plunger with your thumb to inject the JE vaccine
(0.5 mL).
NOTE: Needles should not be recapped due to the
danger of needle-stick injury and cross infection.
 Dispose of the needle and syringe immediately in a safety box.
 Countries using hub-cutters should cut the hub of the syringe
immediately after use with a hub-cutter.
 IMPORTANT: Do not pre-prepare syringes with vaccine for injection.
̶
For 1-dose vials: Discard any reconstituted JE vaccine after 30 minutes
or at the end of the immunization session, whichever comes first.
̶
For 5-dose vials: Discard any reconstituted JE vaccine after 6 hours or
at the end of the immunization session, whichever comes first.
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Waste disposal
 After use, discard empty vaccine vials in the garbage and used
needles/syringes in appropriate safety boxes.
 To avoid contamination, do not touch the stopper at any time.
 Make sure the safety box is not too full (less than 3/4 full)
to avoid needle-stick injuries.
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Key messages (1/2)
 Before administering the vaccine, check the expiry date, the vaccine vial
monitor (VVM), and the diluent for quality.
 CD-JEV is packaged in both 1-dose and 5-dose vials; steps for
reconstituting only vary by the amount of diluent and the size of the
mixing syringe. After reconstituting:
̶
For 1-dose vials: Discard any JE vaccine after 30 minutes or at the
end of the immunization session, whichever comes first.
̶
For 5-dose vials: Discard any JE vaccine after 6 hours or at the end
of the immunization session, whichever comes first.
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Key messages (2/2)
 Although CD-JEV is very safe, some children may experience mild side
effects after vaccination, such as tenderness or swelling at the injection
site, rash, or mild fever. If a child becomes severely ill or appears to
have an allergic reaction in the days following the immunization, the
parent should bring the child to a hospital or clinic as soon as possible.
 A sterile syringe and needle must be used for each injection; the syringe
and needle used for reconstitution should not be used for giving the
injection.
 The dose of CD-JEV is 0.5 mL, given by subcutaneous injection
normally in the outer upper arm.
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End of module
Thank you
for your attention!
 Next is Module 5:
Recording and monitoring
uptake of CD-JEV
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