Training for rotavirus vaccine introduction Module 4 Rotavirus

Training for rotavirus vaccine introduction Module 4 Rotavirus vaccine administration

Learning objectives l At the end of the module, the participant will be able to: – Identify the necessary steps to assure good vaccine quality – Describe the method to administer the vaccine – Describe special considerations for outreach l Duration – 45’ 2| Rotavirus vaccine administration, Module 4 | 17 October 2021

Key issues 1 How to check the quality of the vaccine? 2 How to prepare for vaccination? 3 How to administer the vaccine? 4 What to do if the infant spits part of the vaccine out? 3| Rotavirus vaccine administration, Module 4 | 17 October 2021

How to check the quality of the Rotarix. TM vaccine? (1/2) l Before administering Rotarix. TM vaccine, always check the Vaccine Vial Monitor (VVM) on the top connecting bar 4| Rotavirus vaccine administration, Module 4 | 17 October 2021

How to check the quality of the vaccine? (2/2) l Before administering the Rotarix. TM vaccine, always check the expiration date on the top connecting bar l If the VVM is not in good condition or the vaccine is expired, you must discard ALL THE TUBES attached to the connecting bar 5| Rotavirus vaccine administration, Module 4 | 17 October 2021

What should you do in this scenario? The Vaccine Vial Monitor (VVM) shows that the inner square is lighter than the ring, but it is already darker than the initial color. What should you do? 6| Rotavirus vaccine administration, Module 4 | 17 October 2021

How to prepare for vaccination? (1/3) Observation of the vaccine 1. Check the VVM and expiry date on the top connecting bar, and that the liquid is clear and free from particles Connecting bar Neck 2. Check that each individual tube is not damaged and is still sealed Do not use the BFS tubes if you notice anything unusual 7| Rotavirus vaccine administration, Module 4 | 17 October 2021 Body Tab

How to prepare for vaccination? (2/3) Separating a single oral tube 3. Hold the tab of one oral tube to separate it from the others 4. With your other hand, hold the tab of the tube next to it 5. Pull the tab of the tube you want to dislodge gently away from the tube next to it 8| Rotavirus vaccine administration, Module 4 | 17 October 2021

How to prepare for vaccination? (3/3) Opening the separated oral tube 6. Keep the separated oral tube held upright 7. Hold the tab of the separated oral tube in one hand the connecting bar in the other hand 8. Do not hold/press the body of the oral tube, as you may squeeze out some of the vaccine 9. Twist the separated oral tube and pull it from the connecting bar 9| Rotavirus vaccine administration, Module 4 | 17 October 2021

Can rotavirus vaccine (Rotarix. TM) be given at the same time as other childhood vaccines? l Rotarix. TM, as well as other rotavirus vaccines, can be administered with any of the following routine childhood vaccines without interfering with their effectiveness: – – – Diphtheria–tetanus–pertussis vaccine (DTP) Haemophilus influenzae type b vaccine (Hib) Inactivated polio vaccine (IPV) Hepatitis B vaccine Pneumococcal vaccine Oral polio vaccine (OPV) l Give the rotavirus (and OPV) vaccine first, then administer other injectable childhood vaccines 10 | Rotavirus vaccine administration, Module 4 | 17 October 2021

What should you do in this scenario? The infant is 6 weeks old. You give him/her OPV, rotavirus and pentavalent vaccines. In which order should you give the vaccines? 11 | Rotavirus vaccine administration, Module 4 | 17 October 2021

How to position the infant for rotavirus vaccination? l The infant should be seated leaning slightly backwards to take the vaccine orally 12 | Rotavirus vaccine administration, Module 4 | 17 October 2021

How to position the vaccine? l Open the infant’s mouth by gently pressing the cheeks together l Angle the tube towards the inner cheek 13 | Rotavirus vaccine administration, Module 4 | 17 October 2021

How to administer the vaccine? l Administer the Rotarix. TM vaccine by pressing the body of the tube – Squeeze the liquid gently into the side of the child’s mouth, towards the inside of their cheek l Make sure the infant is swallowing the vaccine – Hold the cheeks together and stroke him/her under the chin to help with swallowing 14 | Rotavirus vaccine administration, Module 4 | 17 October 2021

What should you do in this scenario? Is the infant in the right position to be vaccinated? 15 | Rotavirus vaccine administration, Module 4 | 17 October 2021

What to do if the infant spits out part of the rotavirus vaccine (Rotarix. TM)? l A dose of rotavirus vaccine (Rotarix. TM) is larger than a dose of oral polio vaccine – Rotarix™ = 1. 5 ml; Polio = 0. 1 ml l To prevent spitting – Open the infant’s mouth by gently pressing the cheeks together – Place the tip of the tube towards the inside of the infant’s cheek – Slowly administer the vaccine in small portions l A replacement dose is not needed if an incomplete dose is administered for any reason – e. g. infant spits or regurgitates the vaccine 16 | Rotavirus vaccine administration, Module 4 | 17 October 2021

How many vials to take for outreach? l Rotavirus vaccine can be given at the same time as other vaccines in the routine programme l For outreach take the same number of doses (tubes) of rotavirus (Rotarix™) vaccine as for pentavalent vaccine l Unopened and sealed rotavirus tubes brought back from outreach should be immediately kept in the refrigerator for use in the next session, provided that the VVM and expiry date have not passed the discard point and date 17 | Rotavirus vaccine administration, Module 4 | 17 October 2021

Key messages l Check and interpret vaccine vial monitor and check expiration date on the connecting bar before giving the rotavirus vaccine (Rotarix. TM) l When opening the rotavirus vaccine (Rotarix. TM) tube, separate the tube from the connecting bar and the other tubes by pulling and twisting the tube to be used as explained in the graphs l Give the oral vaccines – OPV and Rotarix. TM - first, then administer the injectable vaccines l Give OPV before Rotarix™ so the “sweeter” vaccine (Rotarix™) takes away the taste of the “bitter” OPV vaccine l Rotarix. TM vaccine dose quantity is larger than that of OPV (1. 5 ml vs. 0. 1 ml). To make sure that infants take the full dose at once – Seat the infant in a semi-reclining position, open the infant’s mouth by gently pressing the cheeks together, properly place the tip of the tube towards the inside of the infant’s cheek and slowly administer the vaccine in small amounts – If the infant spits out some or all of the vaccine, the dose does not need to be given again during that visit 18 | Rotavirus vaccine administration, Module 4 | 17 October 2021

End of module Thank you for your attention! 19 | Rotavirus vaccine administration, Module 4 | 17 October 2021