New Vaccine Post-Introduction Evaluation - libdoc.who.int - World ...

Health-care workers responsible for administering the new vaccine are a key component
in the success or failure of a vaccination programme, and strongly influence the success
of the programme. Discussions with health-care workers should demonstrate knowledge
in several key areas.
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Basic knowledge of the disease targeted by the new vaccine, and the potential
impact of routine childhood immunization on disease burden (e.g. meningitis,
pneumonia, diarrhoea).
Knowledge of clear take-home messages for parents and guardians, e.g. when
to return for the next dose, normal side-effects and management, severe adverse
events in the event of which the child should be taken to the health facility or
nearby hospital.
Vaccine safety and the public’s perception of safety which could influence vaccine
demand.
Transport, storage, preparation and administration of vaccine, including an
understanding of the impact of inappropriate storage and handling; familiarity
with vaccine reconstitution (if applicable), and use and disposal of auto-disable
(AD) syringes.
2.7 Injection safety and waste management
Waste-management policies may vary from country to country; the evaluator should
find out if a waste-management policy exists and modify questions in the PIE tool to
be consistent with the national policy. During observation of the immunization session,
PIE team members should:
• Assess the skills of the health-care worker in administering the vaccine. The site
of vaccination should be cleaned with water if visibly dirty. Pentavalent vaccine is
given intramuscularly at the anterolateral (front outer) part of the thigh. Vaccines
should not be administered to the buttocks.
• Observe use and disposal of AD and reconstitution syringes and vials. All needles
and syringes should be used only once. Used needles and disposable syringes
must be immediately discarded into the safety box without recapping.
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Ask if personnel dedicated to waste disposal are on site or at the central level.
• Observe whether safety boxes are sent for incineration, or burning and burial at
the end of the session, or only when they are full.
• If possible, observe whether all empty or used vials are counted (to verify use
and wastage).
• Find out if waste disposal is onsite. If offsite, a policy for frequent transport
should be in place and enforced.
• The waste-disposal area should be fenced off; if burial pits are used they should
be deep — at least two metres deep.
• There should be no loose vials or syringes in the waste-disposal area.
WHO/IVB/10.03
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