Introduction
Immunization makes a major contribution to public health worldwide, by providing both individuals and populations with long-lasting immunity against diseases that can have serious long-term health complications and that are potentially fatal. Vaccines are usually very safe and have a high protection rate, but it is important to remember that injecting a vaccine is an invasive procedure, that is undertaken on a healthy individual. Adhering to proper standards for vaccine storage, handling and administration is critical to ensuring maximum protection, while minimizing risks and potential complications. This chapter provides basic information for setting up an adult immunization clinic in India.
Stepwise Approach in Setting Adult Immunization Clinic
Setting-up an adult immunization clinic requires stepwise approach.
The following steps should be followed in order to establish vaccine clinic:
- Create a workspace for vaccine clinic
- Proper vaccine storage and handling
- Determine the personnel
- Administrating vaccines
- Documentation.
Step 1: Create a Workspace for Vaccine Clinic
Decide in advance where the vaccinations will actually take place. Plan for a waiting area and a vaccination area. Make sure there is good lighting and ventilation. Standard precautions should be in place. An area that can be considered private should be available, if clothing needs to be removed to access immunization site.
Step 2: Proper Vaccine Storage and Handling
You will need a dedicated refrigerator and freezer unit, for your vaccines. The proper temperature for vaccines and diluents is 2–8°C, and the vaccine refrigerator should be kept at this temperature. The temperature should be checked daily using a thermometer. Vaccines should be kept in the middle area of the refrigerator, and diluents should be kept on the lower racks. No vaccines or diluents should be kept in the door compartment as the temperature of these compartments can rise above 8°C when the refrigerator door is opened.
Step 3: Determine the Personnel
A physician may delegate to any qualified person to administer a vaccination and that person will be working directly under that physician's orders. Healthcare providers, who administer vaccine should preferably have evidence of immunity or be immunized against measles, mumps, rubella, varicella, hepatitis B, influenza, tetanus diphtheria and pertussis.
Step 4: Administering Vaccines
Without proper administration, vaccines are unable to provide your patients with the maximum protection, they need against vaccine‐preventable 2disease. Prior to vaccination, screen everyone for possible contraindications and precautions for vaccination.
Utilize the 5 rights of vaccine administration:
- Right vaccine
- Right patient
- Right route
- Right site
- Right dose.
Step 5: Documentation
All vaccines administered should be fully documented in the patient's notes and should be signed and dated by the healthcare provider who administered the vaccine. Patients should be instructed to store such documents safely and to bring the documents with them for their next visit. Information to be recorded includes:
- Date of administration
- Name of the vaccine
- Next due date for the vaccine
- Vaccinator's signature.
Conclusion
Vaccination opportunities in the community continue to change, and physicians who adapt to provide excellent patient care can drive their services in new directions. By providing knowledgeable vaccine services, physicians can remain trusted health professionals and improve public health at the same time.
Bibliography
- Immunization Action Coalition (IAC). Adults Only Vaccination: A Step-by-Step Guide. St. Paul: Centers for Disease Control and Prevention, 2004.
- World Health Organization. Welcome to the WHO course on Vaccine Safety Basics. [online] Available from www.vaccine-safety-training.org/home.html [Accessed January, 2014].