Essential Training Package for HPV Vaccine Introduction Module

Essential Training Package for HPV Vaccine Introduction Module 4 HPV vaccine administration Cervarix. TM

Learning Objectives l 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 l Duration – 45 ’ 2| HPV Vaccine administration, Module 4 | November 2020

Key issues 1 How to ensure that the vaccine is of good quality? 2 How to prepare for vaccination? 3 How to administer the vaccine? 4 How to handle 2 -dose vial of Cervarix. TM vaccine? 5 What to do after completing the immunization session? 3| HPV Vaccine administration, Module 4 | November 2020

Immunization sessions: phases & critical activities Phase 1 Phase 2 Phase 3 Before girls come for immunization When girls come for immunization After all girls leave immunization AREA 4| HPV Vaccine administration, Module 4 | November 2020

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 5| HPV Vaccine administration, Module 4 | November 2020

How to ensure that vaccine is of good quality? l Check the temperature inside the refrigerator, if vaccine freezing is suspected perform the Shake test to confirm l Check VVM status l Check the expiry date on the vials 6| HPV Vaccine administration, Module 4 | November 2020

How to check VVM status? l Before administering the vaccine, you need to check the Vaccine Vial Monitor (VVM) on the vaccine vial 7| HPV Vaccine administration, Module 4 | November 2020

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? 8| HPV Vaccine administration, Module 4 | November 2020

Checklist of supplies and monitoring tools needed for HPV vaccination Supplies Monitoring tools q Vaccine and syringes q q IEC materials (e. g. flyers, pamphlets, q posters) q q Chair and table q q Water and soap for cleaning hands q Trays q Safety box q Containers for used vials q Drugs to manage allergic reactions- 'AEFI kit' q Chairs to rest after vaccination (15 mins) q Pen, pencil 9| HPV Vaccine administration, Module 4 | November 2020 Vaccination register Tally sheets Vaccination cards Calendar

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 10 | HPV Vaccine administration, Module 4 | November 2020

What to do when girls come for immunization ? 3. Prepare for vaccine 1. Greet the girl 4. Inject in the upper arm 2. Verify, register, explain HPV vaccine benefits 5. Determine date for next vaccine dose 7. Observe the girl for 15’ 11 | 6. Return the updated card HPV Vaccine administration, Module 4 | November 2020

How to prepare for vaccination ? (1/3) l Shake the vial well l Open AD syringe package and remove the syringe and needle from plastic wrapping l Ensure that you do not touch any part of the needle 12 | HPV Vaccine administration, Module 4 | November 2020

How to prepare for vaccination ? (2/3) l Take off the needle cap when you are ready to give the vaccine l Insert the needle into the vaccine vial l Draw vaccine from the vial into the 0. 5 m. L syringe 13 | HPV Vaccine administration, Module 4 | November 2020

Route and site of administration l Injection route: Intramuscular l Injection site: the upper arm, check national policy on which arm (left or right) l The injection angle- 90 degree angle 14 | HPV Vaccine administration, Module 4 | November 2020

Proper handling of 2 -dose vial of Cervarix. TM? l After opening, handle the vaccine in the same manner as: – A reconstituted BCG vaccine vial – Or measles vaccine vial l Discard any opened vial with unused doses: – At the end of immunization session – Or 6 hours after opening l During the session: – Put open vials in the vaccine carrier – DO NOT return them in the refrigerator 15 | HPV Vaccine administration, Module 4 | November 2020

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 16 | HPV Vaccine administration, Module 4 | November 2020

Key messages l HPV vaccine session requires planning of activities before girls come, when girls arrive and after all girls leave l The quality of vaccine should be checked before giving the vaccine l The HPV vaccine is given as an intramuscular injection in the deltoid muscle of the upper arm l Discard any opened vials with unused doses at the end of the immunization session or 6 hours after opening 17 | HPV Vaccine administration, Module 4 | November 2020

End of module Thank you for your attention! 18 | HPV Vaccine administration, Module 4 | 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 Global update on HPV vaccine introduction 19 | HPV Vaccine administration, Module 4 | November 2020