Essential Training Package for HPV Vaccine Introduction Module

Essential Training Package for HPV Vaccine Introduction Module 5 Recording and monitoring of HPV vaccine Gardasil. TM

Learning objectives l At the end of the module, you will have learned to: – Define process of monitoring HPV vaccine coverage data – Describe the 4 main monitoring tools at service delivery level – Describe the procedure to monitor AEFIs l Duration – 25’ 2 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Key issues 1 What is the process for HPV vaccine coverage monitoring? 2 How to use the monitoring tools? 3 What is the process for AEFI monitoring and reporting? 3 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Flowchart of HPV vaccine coverage monitoring process and tools 1 - Service delivery/site level (i. e. point of vaccine delivery) Record each vaccinated girl by year of age and by dose number 1 - Immunization cards (fill out one tally sheet/vaccination day) 2 - Immunization register Sum up tally sheets Report numbers of doses given by year of age and by dose number to district 2 - District level 3 - Country level 4 | Data collection & reporting tools Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020 3 -Tally sheet 4 - Monthly report

HPV vaccine coverage data collection procedure Key steps Tools 1 Register each eligible girl Immunization register 2 Complete the girl’s immunization card Immunization card 3 Tally the number of dose given, by dose number & by year of age (per vaccination) 4 Calculate sub-totals of HPV doses given, by dose number & by year of age (at the end of each vaccination session) 5 Report the sub-totals to service delivery site 5 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020 Tally Sheet Monthly record sheet

Monitoring tool 1: Immunization card l HPV vaccination should always be recorded in the appropriate immunization card l Girls and Health Workers need to understand the importance of the card and how to handle it 6 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

What should you do in this scenario? The girl does not bring her HPV immunization card How should you record the vaccination given? 7 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Monitoring tool 2: Immunization register Use one register per service delivery site l Record the details of each girl in the register l When a girl returns for HPV 2 or HPV 3 use her card to locate her entry in the register l Use register to follow up with girls that did not return for 2 nd or 3 rd dose of HPV vaccine 8 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Monitoring tool 3: Tally sheet Record the number (No. ) of HPV doses given on a single vaccination day Date of vaccination (DD/MM/YYYY): 01/01/2010 District: ___________________________________ Town/Village: _________________________________ Service delivery site: _____________________________ Age (years) 9 10 11 12 13 14 ≥ 15 Unknown No. of HPV 1 doses given 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 9 yr. HPV 1= 8 10 yr. HPV 1= 0 11 yr. HPV 1= 12 yr. HPV 1= 13 yr. HPV 1= 14 yr. HPV 1= 15 yr. HPV 1= Ukn. HPV 1= No. of HPV 2 doses given 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 9 yr. HPV 2= 10 10 yr. HPV 2= 15 11 yr. HPV 2= 12 yr. HPV 2= 13 yr. HPV 2= 14 yr. HPV 2= 15 yr. HPV 2= Ukn. HPV 2= = OPTIONAL CHECK TM I = | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil 9 ROW November 2020 (sum up columns) No. of HPV 3 doses given 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 00000 9 yr. HPV 3= 3 10 yr. HPV 3= 4 OPTIONAL CHECK COLUMN (sum up rows) = = 11 yr. HPV 3= = 12 yr. HPV 3= = 13 yr. HPV 3= = 14 yr. HPV 3= = 15 yr. HPV 3= = Ukn. HPV 3= = Grand total =

Monitoring tool 4: Monthly Record Sheet Month/Year of report: 01/2010 District: ________________ Town/Village: ______________ Service delivery site: ___________ Age (years) 9 year old No. of HPV 1 doses given No. of HPV 2 doses given 9 yr. HPV 1: 9 yr. HPV 2: 1. 2. 8 1. 2. 0 1. 2. 3. 4. 5. Total 1. 2. 10 5. Total 1. 2. 15 3. 10 yr. HPV 1: 10 year old 3. 11 yr. HPV 1: 11 year old 12 year old 13 year old 3. 2. 1. 2. 4. 1. 2. 3. 5. Total 1. 2. 3. Total 1. 2. 5. Total 1. 2. 4. 5. Total 1. 2. 3. 13 yr. HPV 1: 3. 4. 4. 3 5. Total 1. 2. 4 5. Total 1. 2. 3. 4. 5. Total 3. 4. 5. Total 2. 3. 4. 5. Total 5. Total 1. 2. 3. 4. 5. Total 4. 5. Total 1. 2. 3. 4. 5. Total 5. Total 1. 2. 5. Total 13 yr. HPV 3: 1. 14 yr. HPV 3: 15 yr. HPV 2: Total 14 yr. HPV 2: Tot al 5. 12 yr. HPV 3: 15 yr. HPV 3: Ukn. HPV 3: Total 4. 5. Ukn. HPV 1: Ukn. HPV 2: TM 3. I 1. 2. 3. 4. 5. 1. 2. 4. 10 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil Unknown November 2020 3. 11 yr. HPV 3: 13 yr. HPV 2: 3. 4. 15 yr. HPV 1: ≥ 15 year olds 2. 12 yr. HPV 2: 3. 4. 14 yr. HPV 1: 14 year old 1. 10 yr. HPV 3: 4. 5. Total 11 yr. HPV 2: 12 yr. HPV 1: 3. 4. 1. 5. 10 yr. HPV 2: 4. No. of HPV 3 doses given 9 yr. HPV 3: 3. 4.

Using data to improve HPV vaccine coverage l Compare doses given to the target population by year (e. g. no. of 9 year old girls that received HPV 1 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? l Compare number of HPV 1 doses administered with number of HPV 2 and HPV 3 doses administered and consider – Are there problems with communication, vaccine availability, etc. causing drop-outs? – Identify and vaccinate defaulters 11 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Considerations of AEFI related to HPV vaccine l HPV vaccine is a safe vaccine but mild adverse events can occur after administering the vaccine – Redness, pain or swelling at the injection site – Syncope (fainting) l In extremely rare instances it can cause anaphylaxis – One per 1. 7 million doses l Girls should be observed carefully for 15 minutes after administration of vaccine l Manage and document any adverse reaction accordingly to the national reporting procedures 12 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Procedure for AEFI reporting l Report AEFIs through existing AEFI reporting systems established by national immunization programs Suspected signs or symptoms 1 13 | Health worker should immediately report to a local public health authority 2 Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020 National Authorities will then decide if futher investigation is required 3

AEFI reporting form l AEFI report should contain Details of Patient Reporter details Details of Vaccine Details of the event 14 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Key messages (1/2) Monitoring vaccine coverage l Monitoring and reporting HPV vaccine coverage is crucial for evaluating the performance of the immunization programme and its impact on the vaccinated girls l HPV vaccine coverage should be monitored by year of age and by dose number l Vaccine coverage should be monitored with a set of tools including immunization card, register, tally sheet, and monthly report form. l The process for monitoring vaccine coverage data includes 5 steps 3. registering 1. Registering 2. Using girls details immunization given dose card per age 15 | 4. Calculate sub-totals 5. Report Sub-totals of HPV dose given to service delivery site Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

Key messages (2/2) Monitoring AEFI related to HPV vaccine l Monitoring and reporting AEFI related to HPV vaccine is essential for dispelling rumors and monitoring continued safety of HPV vaccines l AEFI should be reported using the existing system established by the national immunization program l Suspected AEFI related to HPV vaccines should be reported immediately to reporting authorities l The AEFI reporting form should contain details of patient, event, vaccine and reporter details 16 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

End of module Thank you for your attention! 17 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020

References l Comprehensive Cervical Cancer Control. A guide to essential practice (C 4 GEP). WHO 2013 l HPV vaccine introduction into national immunization programmes: Information for programme managers and health workers. WHO 2013 l Draft Human Papillomavirus (HPV) Vaccine Coverage Monitoring Tool. WHO 2012 18 | Recording and Monitoring of HPV Vaccine, Module 5 Gardasil. TM I November 2020