Vaccination Practical

Dr Hajer Elkout
National immunisation schedule
Why is it like that??
 Age
 Scheduled at an age range that is
considered optimal for the best immune
system response
 Balanced with the need to provide
protection to at the earliest possible age.
 Spacing
 Time needed to create a protective
response.

 Vaccines
Vaccine Type Route Diluent
BCG Live attenuated ID
OPV Live attenuated Oral
Hep-B Recombinant DNA IM
MMR Live attenuated SC/IM
DPT D,T: toxoid, P: inactive IM
IPV Inactive (killed) SC/IM
Hib Conjugated polysaccharide
Pneumococcal Conjugated polysaccharide IM
vaccine
Meningococcal Conjugated polysaccharide IM
vaccine
Rotavirus vaccine Live attenuated Oral
HPV Recombinant DNA IM
Hexa vaccine

 DPT, Hib, Hep-B and IPV.

 IM, given at 2,4,6 months of age.
Recommended vaccination sites
 Vaccines should not be given intravenously

 The anterolateral thigh is the recommended

site for IM vaccination in infants <12 months
of age, due to its larger muscle size.

 The deltoid muscle is the recommended site

for IM vaccination in children ≥12 months of
age.
 For SC injection:
 Fatty tissue over the Anterolateral thigh
in infants (under one year of age).

 Fatty tissue over triceps(upper arm) in

children one year or older.
 Positioning
 IM: Position limb to allow relaxation of muscle
injected

 Infants and Young Children:

 Hold securely in parent’s lap

 Older Children:
 Sit on parent’s lap or edge of exam table and hug
parent’s chest

 Adolescents and adults should be seated for

immunizations
 It is recommended to observe for 15 minutes after
immunization (s) while seated or lying down.
Proper technique: The check list
Routes of administration
The cold chain
Cold chain
Equipments and vaccines
Cold chain monitors
 Cold chain monitoring card
 Has a 3M Time Temperature Indicator with
the threshold temperatures + 10° C and +
34° C.
 Blue discoloration of the indicator, if the
temperature exceeds the threshold during
transport or storage.
Cold chain monitoring card
Thermometers
 Dial and liquid crystal thermometers
 Vapour dial thermometer

Gives immediate temperature reading and a reading

of the highest, or lowest temperature reached since
the last reading
Freeze watch indicators
 A small vial of red liquid attached to a white
card
 Vial breaks if the temperature drops below
0° C for more than one hour
 Has two
indicators. One
tells if
temperature has
raised above
+10°C. The other
indicates if
temperature has
dropped below -
4°C.
Vaccination Vial Monitor (VVM)
Frozen vaccine: The shake test
Cold chain equipments

Cold box
ILR

Cool room Vaccine carrier

Avoid Administration Errors

 Make sure you have the:

 Right child.
 Right schedule.
 Right vaccine & diluent (Label, expiry
date).
 Right dose.
 Right route.
 Right site.
 Errors and adverse events
 Delayed or missed vaccination date
 Catch up, do not restart.
 Complete the dose series.
 Minimum one month interval between
doses.

 Premature baby
 Start at birth, more vulnerable to
diseases.
 Errors and adverse events
 Wrong diluent
 Dose repeated using the correct diluent.

 Severe allergic reaction

 Shouldn’t have the vaccine.

 Frozen Hep B vaccine

 Discard.
Thank you