Giving the right vaccine safely

DURING A SESSION Registering the clients Assessing the client Preparing vaccines Giving immunizations - practise positioning a client (A doll ) - administering each vaccine AFTER A SESSION

1. Reconstituing vaccine
Vaccine that require reconstitution
Vaccine BCG Measles Powder Freeze- dried Freeze- dried Diluent vial Liquid provided with vaccine vial Liquid provided with vaccine

MMR YF
JE Hib DTP-HepB+Hib

Freeze- dried Freeze- dried

Freeze- dried Freeze- dried Freeze- dried Hib

vial Liquid provided with vaccine vial Liquid provided with vaccine
vial Liquid provided with vaccine vial Liquid provided with vaccine vial Liquid DTP-HepB vaccine

2. Reconstituting BCG, measles, MMR, MR, YF, JE, and Hib vaccines
1.
2. 3. 4. 5. 6.

Wash your hands Inspect the vaccine vial or ampoule (VVM, Exp date) Flick the vial or ampoule Open the vaccine vial or ampoule Inspect the diluents ampoule or vial Read the label on the diluents ampoule or vial

Flicking a vaccine ampoule

Lift the center of the metal cap

Ampoules and metal file

7. Open the glass ampoule

Scratching the neck of the ampoule

Breaking off the neck of an ampoule

8. Draw diluents into a mixing syringe

9. Reconstitute the vaccine

10. Handling reconstituted vaccines

Injection equipment

Parts of a syringe and needle

Handling syringes and needles safely

Do not touch: the shaft of the needle the bevel of the needle the adaptor of the needle the adaptor of the syringe the plunger seal of the syringe the plunger shaft of the syringe You may touch: the barrel; the plunger top.

4. Administering vaccine for infants

Name of vaccine Where given BCG DTP or DTPHepB, HepB Outer mid-thigh in infants/ outer upper arm if older Intramuscular injection 0.5 ml Measles/ yellow fever

OPV

Outer upper left arm or shoulder

Outer midOral thigh/upper arm depending on the age Subcutaneous injection 0.5 ml

How given Dose Needle size Type

Intradermal injection 0,05 ml 10mm, 26 gauge Powder + diluents

Oral dropper 2 drops

25mm, 23 gauge 25mm, 23 gauge Ready to use Powder + diluents

Vial with oral dropper

Different needle positions

INTRADERMAL

INTRAMUSCULAR

SUBCUTANEOUS

0 2 3 4 9

Age 7 day month month month month

Expanded Program Immunization Indonesia Schedule: birth at Hospital

Visit 0 1 2 3 4

Vaccine HepB, BCG, Polio1 Polio2, DTP/HepB Polio3, DTP/HepB Polio4, DTP/HepB Measles

0 1 2 3 4 9

Age 7 day month month month month month

Expanded Program Immunization Indonesia Schedule: birth at Home

Visit 0 1 2 3 4 5 Vaccine HepB BCG, Polio1 Polio2, DPT/HepB Polio3, DPT/HepB Polio4, DPT/HepB Measles

Immunization schedule for infants recommended by the Expanded Program on immunization

Vaccine Birth BCG OPV DTP x x* Age 6 wks 10 wks 14 wks 9 mo x x x x x x x x

Hep B: (A) Hep B: (B) Hib Yellow Fever Measles

x x x

x x x x** x

X* : in polio-endemic countries x**: in countries where yellow fever poses a risk (A): in countries where perinatal transmission of virus hepatitis B is frequent (B): in countries where perinatal transmission of virus hepatitis B is less frequent

BCG vaccine

OPV

DTP or DTP-HepB or HepB, Hib vaccine

HepB vaccine

Measles vaccine, yellow fever, JE