HEALTH ASSESSMENT ALGORITHM FOR GAMALEYA SPUTNIK V

of the Philippine National COVID-19 Vaccine Deployment and Vaccination Program

as of June 9, 2021

ASSESS THE VACCINE RECIPIENT: Is the patient any of the following?

● Aged below 18 years old?

● Previously vaccinated with another COVID-19 vaccine that is
not Gamaleya (Sputnik V Gam-COVID-Vac)?
NO ● With allergy to polysorbate or any other components (Tris YES
DO NOT VACCINATE
(hydroxymethyl), aminomethane, sodium chloride, sucrose,
magnesium chloride hexahydrate, sodium EDTA, ethanol) of
the Sputnik V vaccine?
● Had a severe allergic reaction or an autoimmune reaction
(i.e Vaccine-Induced Thrombotic Thrombocytopenia) after
the 1st dose of the SPUTNIK V vaccine?
● Pregnant and/or breastfeeding? SPECIAL PRECAUTION
● Has history of anaphylaxis or severe allergic reactions?
MONITOR FOR 30
NO YES MINS
With allergy to food, egg, medicine, or with asthma?
USE GAUGE 23-25;
APPLY FIRM
NO Have history of bleeding disorders or currently taking YES PRESSURE
anti-coagulants?

DEFER AND RESCHEDULE

NO If with history of hypertension, does the person currently have SBP>180 YES
and/or dBP >120, with signs and symptoms of organ damage? REFER TO MD AND BRING
TO ER

Symptomatic (Fever/ chills, Headache, Cough, Colds, Sore throat,

VACCINATE

NO Myalgia, Rashes, Fatigue, Weakness, Loss of smell/ taste, Diarrhea, YES REFER TO MD.
Shortness of breath/difficulty in breathing, Nausea/ Vomiting, RESCHEDULE 2-4 WEEKS
Jaundice, Chest pain, Uncontrolled Epilepsy, New Onset Neurological AFTER FULL RECOVERY
OR REMISSION
Deficit) OR with other symptoms of existing comorbidity?

RESCHEDULE AFTER
NO YES
With history of exposure to confirmed or suspected COVID-19 case in COMPLETION OF 14-DAY
QUARANTINE
the past 14 days?

RESCHEDULE AFTER
NO YES RECOVERY OR
Previously diagnosed with COVID-19 AND is still undergoing
TREATMENT
treatment/ recovery?
COMPLETION

RESCHEDULE AFTER
NO Has been vaccinated in the past 14 days or plans to receive another YES 14-DAY INTERVAL
vaccine 14 days following vaccination? FROM OTHER
VACCINE

RESCHEDULE 90 DAYS
NO Received convalescent plasma or monoclonal antibodies for YES FROM LAST PLASMA/
COVID-19 in the past 90 days? MAB ADMINISTRATION

Has been diagnosed with any of the following:

● HIV
● Cancer/Malignancy and currently undergoing chemotherapy,
radiotherapy, immunotherapy or other treatment
NO YES
● Underwent transplant RESCHEDULE ONCE WITH
● Under steroid treatment or medication CLEARANCE FROM
● Bed ridden, terminal illness, less than 6 months prognosis
● With autoimmune disease
ATTENDING PHYSICIAN
AND was not cleared by attending physician prior to vaccination?
* Vaccine recipients who will receive their dose in treatment hubs, etc. (such as people
living with HIV) may get their clearance from their attending physician on the scheduled
vaccination day prior to being inoculated with the vaccine