5 Updated_Vaccine Administration__Ghana200825.pptx

HPV vaccination essential training package

1. Essential Training Package for HPV Vaccine Introduction HPV Vaccine Administration

2. Learning Objectives At the end of this module, you would have learned to: - identify eligibility criteria and contra-indications describe activities carried out before, during and after a vaccination session describe how to ensure that vaccine is of good quality describe the technique to administer the vaccine

3. What is the schedule  for Gardasil TM ? 1 3 What are the  contraindications ? Key issues 1/2 Who is   eligible for HPV vaccine? 2

4. How to ensure that the vaccine is of good quality ? 1 How to prepare for vaccination ? 2 Key issues 2/2 How to administer the vaccine? 3 What to do after completing the vaccination session? 4

5. What is the schedule for Gardasil vaccine 1/2 1-dose schedule is used for Gardasil™ Ghana's schedule Single-dose schedule 1 - Dose

6. What is the schedule for Gardasil Vaccine 2/2 *Girls known to be immunocompromised ( eg HIV+) should get two doses Schedule for immunocompromised clients Dose 1 Dose 2

7. Who should get HPV vaccine? (Campaign)   9-14 years old Younger than 9 years old  Older than 14 years old ​

8. Who should get HPV vaccine ? (Routine)  9 years old 10-14 years old (catch-up)  Older than 14 years old ​ 

9. HPV vaccine is not recommended for: Are there contraindications to HPV vaccination? SEVERE FEBRILE ILLNESS A minor infection such as cold is not a contraindication

10. What should be done in this scenario? A 12-year old girl visit the clinic during routine vaccination session and asks to get HPV vaccine because she missed the vaccination campaign

11. Response to scenario After the campaign, there will be catch-up period to cover those missed during the campaign Therefore, the 12-year-old girl will be vaccinated

12. Immunization sessions: phases & critical activities Phase 1 Before girls come for vaccination Phase 2 When girls come for vaccination Phase 3 After girls leave vaccination session

13. Phase 1: Before girls come for vaccin ation 1. Estimate the number of girls to be vaccinated per day based on the micro-plans done 2. Pick vaccine carriers, remove frozen ice packs out of freezers for conditioning and vaccine vials out of the refrigerator into zip-lock bags 3. Check expiry date and VVM status for each vaccine vial 4. Collect, arrange supplies and monitoring tools for vaccination session 5. Prepare an AEFI Kit (hydrocortisone, water for injection, syringes/needles) Vaccine Expiration Date: 02/12/22 Note : Use through December 2, 2022. Do NOT use on or after December 3, 2022.

14. How to ensure that vaccine is of good quality? Check the temperature inside the refrigerator(+2 to +8 0C ) Check VVM status on the vaccine vials Check the expiry date on the vaccine vials

15. How to check VVM status? Before administering the vaccine, you need to check the Vaccine Vial Monitor (VVM) on the vaccine via l

16. What should be done in this scenario? The vaccine vial monitor shows that the inner square is lighter than the outer circle? What should you do?

17. Answer to the scenario Use these vaccines first, as their VVM has already started to change

18. Checklist of supplies and monitoring tools needed for HPV vaccination Supplies Vaccines and syringes IEC materials (e.g. fact sheet, jingles, posters etc) Chairs and tables Water and soap for washing hands Trays and receivers Safety boxes Containers for used vials Receptacles for used cotton buds, syringes and needle wrappers etc Drugs to manage allergic reactions- 'AEFI kit’ (Hydrocortisone with water for injection) Chairs/Benches to rest after vaccination (15 mins) Pens, pencils Monitoring tools Vaccination register T ally sheets Vaccination cards AEFI reporting form

19. AEFI KIT Hydrocortisone, water for injection, syringes and needles Hydrocortisone is in a powder form for injection and comes in 100 mg in a vial, to be dissolved in 2 ml water for injection, for Intramuscular injection or slow IV injection or infusion Child: 1 month to 11 years: 2-4 mg/kg stat (repeat after 8hours) Adolescent: 12 -18 years give 100mg stat (repeat after 8hours)

20. Phase 2: When girls come for vaccination Check eligibility of girls (9 -14 years) and locate their names in the register (register them) Educate eligible girls on HPV key messages (Triple “A” ) 4 . Administer HPV vaccine intramuscularly on the left upper arm 6. Complete vaccination card, tally sheet& complete register 3. Prepare HPV injection using aseptic techniques 9-14 years old 5. D ispose used AD syringes immediately into the safety box after each injection

21. The flow for vaccination session 1.Greet the girl 2.Verify age, register/tally, explain HPV vaccine benefits 3.Tell them the key messages 4. Prepare and Inject IM at the left upper arm 5.Document on Vaccination card 6.Give out the vaccination card 7.Observe the girl for at least 15mins

22. How to prepare for vaccination 1/2 Thorough hand washing with soap under running water Mix the vaccine suspension by shaking the vaccine vial Open AD syringe package and remove the syringe and needle from plastic wrapping Ensure that you do not touch any part of the needle

23. How to prepare for vaccination 2/2 Take off the needle cap when you are ready to give the vaccine Insert the needle into the vaccine vial and draw vaccine from the vial into the 0.5ml syringe Inject intramuscularly in the left upper arm

24. Site and Route of administration Injection site: injection in the left upper arm Injection route: Intramuscular The injection angle: 90-degree angle Follow measures to reduce pain and anxiety (by communicating with the girl, proper positioning – sitting upright etc. )

25. Phase 3: After all girls leave immunization site 1 . Complete Immunization Tally sheet by aggregating the totals 2 . Return unopened vaccine vials to the refrigerator 3 . Put safety box in a safe location 4 . Inform class/school head/community of the next session and activities planned to reach unvaccinated girls

26. Points to remember: Girls 9 to14 years old are the target for the HPV vaccination campaign - 9-year-olds are the targets in routine immunisation - HPV vaccine is given in a single-dose schedule Two doses ( @ 2 months apart for girls known to be immunocompromised  eg. HIV infection Contraindications for HPV vaccination are: Known allergy to a component of the HPV vaccine or after a previous dose Pregnancy Severe febrile illness

27. Points to remember Ensure that HPV vaccine is of good quality Adhere to Infection Prevention and control measures The technique to administer the vaccine (IM)

28. Thank you for your attention !

29. References Gardasil: product overview https://extranet.who.int/pqweb/content/gardasil Guide to introducing HPV vaccine into national immunization programmes. WHO 2016: https://www.who.int/publications/i/item/9789241549769 Comprehensive Cervical Cancer Control. A guide to essential practice (C4 GEP). WHO 2014: https://www.who.int/publications/i/item/9789241548953 Reducing pain at the time of vaccination: WHO position paper – September 2015 WER9039_505-510.PDF (who.int) WHO position paper on HPV vaccines (2022) https://apps.who.int/iris/bitstream/handle/10665/365350/WER9750-eng-fre.pdf