Dengue vaccine presentation for health workers (for orientation) copy

WHAT YOU NEED TO KNOW

Why get vaccinated?

•Dengue is one of the leading causes of illness in the Philippines. Worldwide.•Philippines rank 7th among countries and territories with the highest average number of Dengue cases reported to the World Health Organization (WHO) and 4th overall for the Asia Pacific region from 2004 to 2010.

Why get vaccinated?

DENGUE•Is a diseased caused by a dengue virus transmitted by an infected female Aedes mosquito•Signs and symptoms: Fever (>2 days), skin flushing, bleeding of nose or gums, loss of appetite, nausea, vomiting

DENGVAXIA (DENGUE VACCINE)What is DENGUE VACCINE?•Used to help protect a child against dengue caused by

dengue virus serotype 1,2,3, and 4. • It works by stimulating your body’s natural defenses

(immune system) which produces its own protection (antibodies) against the virus that causes dengue disease.

DENGVAXIA (DENGUE VACCINE)• Live, attenuated vaccine & contains 4 dengue virus serotypes-1,2,3, and 4• Preparation : 5-dose per vial (multi-dose), suspension for SQ injection • NO vaccine vial monitor (VVM) label • Indicated for use to children and adults from 9 years to 45 years old• Tetravalent vaccine

DENGVAXIA (DENGUE VACCINE)How many times should an individual get vaccinated?• Given every 6 months. • For Example if one gets the first dose in April, the person will receive

his second dose 6 months after, which is October. The third dose will be given 6 months after the second dose which is April of the following year.

DOSES MONTHS1st dose 02nd dose 63rd dose 12

DENGVAXIA (DENGUE VACCINE)Is the Vaccine effective to prevent dengue disease?

• Yes. Based on the clinical studies conducted in 10 countries across Southeast Asia and Latin America, the vaccine has been shown to be effective in:• Preventing severe dengueby 93.2%• Preventing hospitalized form of dengue by 80.8%• Preventing dengue due to any serotype by 65.6%.

• As with the vaccines, the dengue vaccine may not protect 100% the person who have been vaccinated.

• Dengue vaccination is not a substitute for the protection against mosquito bites and vaccinees are still encouraged to take appropriate precautions to prevent mosquito bites.

• Student beneficiaries will receive the vaccine during a school based immunization program in all public schools scheduled on April 2016 for free.

DENGVAXIA (DENGUE VACCINE)Does it cost anything (payment)?•DOH and DepEd is implementing the dengue

vaccination program for Grade 4 students aged 9 years old and above, enrolled in the School Year 2015-2016.•Student beneficiaries will receive the FREE vaccine

during a school based immunization program in all public elementary schools scheduled on April 2016 for FREE.

DENGVAXIA (DENGUE VACCINE)Where can we get the vaccine?•Vaccine will be available for grade 4 students 9 years

old and above, enrolled in the School Year 2015-2016 at the time of the vaccination in all public elementary schools during a school based immunization program scheduled in April. • Those who will not be eligible for this vaccination

program may ask their physician on how they can get vaccinated against dengue.

DENGVAXIA (DENGUE VACCINE)Who should receive the vaccine?•All 9 years old male and female students enrolled in Grade 4 public schools (SY 2015-2016) shall be vaccinated with 3 doses of the Dengue tetravalent vaccine following the recommended immunization schedule interval.•Only students with signed notification and consent letter shall be vaccinated. •In case of dengue vaccination refusal or the student received only one or two doses of dengue vaccines, he/she shall not be suspended, grounded or reprimanded.

DENGVAXIA (DENGUE VACCINE)Will it be distributed nationwide? If not, how did you consider the priority places?•Dengue vaccination program of the DOH will only be

available in the regions in the Philippines with the highest number of dengue cases annually namely Region III, NCR, and Region IV-A from April 2016-2017. •Nevertheless, the vaccine will be available nationwide

in the private sector. Please ask your physicians on how to access the vaccines.

Who should not receive the vaccine(pregnant, allergies and other diseases)?The vaccine should NOT be given to the following:Children less than 9 years old and adults older than 45Individuals who have known allergies to active substances in the vaccineIndividuals weakened immune system due to genetic defect, HIV infection, or therapies that affect the immune system such as high dose-corticosteroids or chemotherapy.Pregnant or breastfeeding mothers;Individuals suffering from a disease with mild to high fever or acute disease(the vaccine can be given once the individual has recovered)

DENGVAXIA (DENGUE VACCINE)

If someone had already dengue, can they still avail the vaccine?•Yes. Dengue disease is caused by 4 serotypes. Natural infection caused by one of the 4 serotypes confers lifelong immunity from that only serotype but not from the other serotypes. Dengue vaccination can still provide protection against dengue disease. •The vaccine has to be administered at least 3-6 months from the acute episode of dengue. Like all medicines, the dengue vaccine can cause side effects but it is manageable.


What are the possible side effects from being vaccinated? What are the cures for these?Like all medicines, the dengue vaccine can cause side effects but it is manageable.Serious Allergic Reactions:If any of these symptoms occur after leaving the place where your child received the injection, you must consult a doctor IMMEDIATELY:•Difficulty of Breathing•Blueness of tongue or lips•Low blood pressure causing dizziness or collapse•Swelling of the face or throat•A rashWhen these signs or symptoms occur they usually develop quickly after the injection is given while the vaccinee (individual) is still in the vaccination area. Serious allergic reactions are very rare, (may affect up to 1 in 10,000 people) after receiving any vaccine.


Other side effects:The following side effects were reported during the clinical studies in children, adolescents and adults. Most of the reported side effects occurred within 3 days after injection of the vaccine.

Very Common (May affect more than 1 user in 10)•Headache•Generally feeling unwell•Injection site pain•Muscle pain•Fever•Feeling of weakness

Common (May affect up to 1 user in 100)•Injection site: reactions redness, bruising, swelling, and itching

Uncommon•Infections of the upper respiratory tract•Dizziness•Cough•Nausea•Sore Throat•Runny nose

If the vaccinee experience any side effects after vaccination, they are advised to seek immediate medical attention


GENERAL GUIDELINES• DOH shall provide the necessary vaccines and other immunization logistics

(e.g. N/S, safety collector boxes, immunization cards, recording and reporting forms) following the routine system of the distribution of the immunization logistics.• Department of Education (DepEd) shall determine the most appropriate

timing of the immunization sessions, inform teachers/parents/students of the vaccination, provide additional human resource for vaccination, and ensure each eligible student vaccinated and appropriately refer missed students for vaccination. • The Local Government Units (LGUs) health personnel (MDs. Nurses,

midwives, volunteers) shall lead the vaccination in collaboration with schools, hospitals and other partners within the catchment areas.

VACCINATION STRATEGY• What is the vaccination strategy?• School-based, classroom per classroom• Rolling–phase

• When? • Starting April 2016 up to June 2017• April – offer protection to the target population before the PEAK SEASON

• Number of vaccination rounds?• 3 Rounds • Round 1 (Dose 1) : Year 2016 -April, May, June• Round 2 (Dose 2) : Year 2016 - October, November, December • Round 3 (Dose 3) : Year 2017 - April, May, June

Specific Guidelines: Target Eligible Students

ALL 9 years old and above students enrolled in Grade 4 public schools (SY 2015-2016) with consent in Regions NCR,III and IVA (except

participating students in clinical study from San Pablo City, Laguna.

Grade 4 student aged less than 9 years old : DO NOT GIVE DENGUE VACCINE

Specific Guidelines: Target Eligible Students

• All vaccinators shall conduct a quick health assessment of every eligible students before vaccination. ASK if the student had/has : ACTIONS REQUIRED, if present

Fever If any is present, DEFER

vaccination until child is well.

Refer for medical management.Set a definite date for the

vaccination.

Cough Rashes Headache Received any vaccine for the last 1

month Enrolled in Dengue clinical study

from San Pablo City, LagunaDO NOT GIVE the dengue

vaccine. Recipient of blood products for the

last 3 months With history of allergy to previous

dose Taking corticosteroids or

chemotherapy Pregnant or Breastfeeding

Specific Guidelines: Schedule of Administration of Dengue

Vaccines • All eligible students shall be vaccinated with the dengue vaccine,

0.5ml, subcutaneous, (SC) at the LEFT deltoid arm following the recommended vaccination schedule:

First Dose : At time of visit with the healthworker, at 9 or 10 years old

Second Dose : At least 6 months after the 1st doseThird Dose : At least 6 months after the 2nd dose

NOTE: Health workers must ensure that those who received the dengue vaccine first dose shall be given the 2nd dose after 6 months and the 3rd dose 6 months after the 2nd dose

Specific Guidelines: Follow-up of Deferred Eligible

Students • Teacher-in-charge shall follow-up the deferred students

but willing to be vaccinated and refer to the catchment health facility.• Students who will be referred and vaccinated at the health

facility shall be accompanied by the school nurse and shall be included in the accomplishment report as vaccinated.

Specific Guidelines: Before Vaccination…

• Clinic/school nurses/teachers shall list all the enrolled students in Grade 4 using the Recording Form 1 (Masterlist of Grade 4 ).

• All clinic/Grade 4 teachers/school nurses shall issue a notification letter indicating the following:• 3 doses of Dengue • Schedule of Vaccination

• All clinic/Grade 4 teachers/school nurses shall ensure the retrieval of the signed notification and consent form.

Specific Guidelines: Adverse Event Following Immunization

(AEFI)• Fear of injections resulting to fainting has been commonly observed in school immunization. Thus it is recommended that the vaccination sites are situated in areas not conspicuous to the students. Immunization session shall be conducted after recess to ensure that these eligible students have taken their snacks/food to rule-out fainting secondary to hypoglycemia.

• Adverse Events after the receipt of the vaccines, even if it is not clear that the vaccine caused the adverse events should be reported following the existing DOH Issuance Administrative Order No. 2010-0017, “ Guidelines in Surveillance and Response to Adverse Events Following Immunization (AEFI).

• However, a linelist of the minor reactions shall be recorded and submitted to gather information on the various AEFI rates for the Philippines setting.

Specific Guidelines: After Vaccination…

• All vaccinators shall provide all the students with key messages on…• Expected reactions after vaccination •Where to report in case of any vaccine reaction • Issue an immunization card• Indicate the specific dates of next doses

Mild and Temporary ReactionsFAINTING

• Due to fear of injection, or sight of blood, or having not eaten prior to immunization.

• May last for a minute or less.• Keep the child lying down with her feet slightly elevated.• If the symptoms persist, it may require immediate

attention. Bring the child to the nearest health facilities.

SWELLING• Apply alternately cold and warm compress every 15

minutes using clean cloth until swelling disappears in the injection site.

• Do not massage the injection site.

RECORDING AND

REPORTING FORMS

Recording Form1: MasterlistingRegion: _______________________________ Name of School: _____________________________________________________________________________ Section: _______________________________________

Province/City: _________________________ Division: _______________________

Municipality: __________________________ Date:__________________________

Y N Y N 1st dose 2nd dose Age 3rd dose Age Y N

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Note;

Every child ask the following:

1. Cough 5. Recipient of the blood products

2. Fever 6. Taking corticosteroids/ chemotherapy

3. Rashes 7. Pregnant/ breastfeeding

4. Headache 8. Resident of San Pablo City, Laguna/ Cebu City

Grade 4 Students (9 years old)

Parents' ConsentRemarks

Screened*

To be filled up by the Vaccination Team

DeferredDate Vaccinated with Dengue Tetravalent

Recording Form 1 MASTER LISTING FORM for School-based Dengue Vaccination

To be filled up by the School Nurse/ Class Adviser

No.Name

(Surname, First Name, MI) Complete Address Dare of

Birth MM/DD/YY

Age Sex

Name and Signature of RecorderName and Signature of School Nurse/Class Advisor

____________________________________________________________________ ________________________________________________

Name and Signature of Vaccinator

________________________________________________

Reporting Form1: Daily Reporting Form

Region: _______________________________ Name of School: ___________________________________________ Section: _______________________________________



1st dose of Dengue vaccine

%2nd dose of

Dengue vaccine

%3rd dose of

Dengue vaccine

%1st dose of

Dengue vaccine

%

2nd dose of Dengue vaccine

%

3rd dose of

Dengue vaccine

%Sick (cough,

fever, rashes, headache)

Recipient of the blood

products

Taking corticosteroids/ chemotherapy

Pregnant/ breastfeeding

Resident of San Pablo City, Laguna/ Cebu

City, Cebu

No Consent

TOTAL

Prepared by: Name: Noted by: Name:Position: Position:

Reasons for deferral

Reporting Form1

Daily Reporting Form for School-based Dengue Vaccination Grade 4 Students (9 years old)

Total no. of eligible students

Total no. of students vaccinated Total no. of deferred

____________________________________________________________________

__________________________________________________________________________ __________________________________________________________________________

_____________________________________________________________

Reporting Form2: Daily Consolidation FormReporting Form2

Region: _______________________________ Name of School: ________________________________________________ Total no. of eligible:______________




%2nd dose of

Dengue vaccine

%3rd dose of

Dengue vaccine

%1st dose of

Dengue vaccine

%


%

3rd dose of

Dengue vaccine

%1st dose of

Dengue vaccine


3rd dose of Dengue vaccine

TOTAL


No. of AEFI

Daily Consolidation Form for School-based Dengue Vaccination Grade 4 Students (9 years old)

Name of Section

Total no. of students vaccinated Total no. of deferred

____________________________________________________________________

__________________________________________________________________________ __________________________________________________________________________

______________________________________________________

Reporting Form3: Weekly Consolidation Form(Please tick reporting level) Region:__________________Province/ City:___________________________Municipality:_____________________ Barangay:___________________________ Date: __________________


%2nd dose of

Dengue vaccine

%3rd dose of

Dengue vaccine

%1st dose of

Dengue vaccine

%2nd dose of

Dengue vaccine

%3rd dose of

Dengue vaccine

%1st dose of

Dengue vaccine

%2nd dose of

Dengue vaccine

%3rd dose of

Dengue vaccine

%

Total


Reporting Form3

Grade 4 Students (9 years old)

Total no. of schools

Name of Municipalities and Cities/

Facilities (RHU/BHS)

Total no. of students enrolled

Total no. of students vaccinated

Remarks

Total no. of AEFITotal no. of deferred

Weekly Consolidation Report Form for School-based Dengue Vaccination

____________________________________________________________________

__________________________________________________________________________ ________________________________________________________________

_____________________________________

Flow of Reporting/Deadline School

RHU

Province/City

Regional DOH

National DOH

Preimplementation •Notification/Consent•Masterlist

Implementation•Weekly accomplishment•Final accomplishment per round•AEFI

Flow of Reporting/Deadline (Notification/Consent and Masterlist)

School (March 9, 2016) –School Nurse

RHU/Municipality (March 11, 2016) - EPI Coordinator

Province/City (March 16, 2016) – EPI Coordinator

Regional DOH (March 22, 2016) – EPI/Dengue Coordinator

National DOH (March 26, 2016)

Flow of Reporting/Deadline of Accomplishment starting April 1

School (everyday before 12pm) –Vaccination Team

RHU/Municipality (everyday before 2pm) - EPI Coordinator

Province/City (everyday before 4pm) – EPI Coordinator

Regional DOH (everyday before 5pm) – EPI/Dengue Coordinator

National DOH

THANK YOU

Health & Medicine

Dengue vaccine presentation for health workers (for orientation) copy