POST 00913E : VACCINATION DECISION TOOL 19 April 2006
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Robert Steinglass (mailto:[email protected]) from
IMMUNIZATIONbasics in the United States, sends a tool (attached) to help
staff decide which vaccination to administer on a child's visit to the
health center.
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Staff in the field generally know what to do when a child comes for
vaccination at the ideal ages: birth, 6, 10, 14 weeks, 9 months. But over
and over again, I see that they frequently have difficulty interpreting
what to do when a child comes at odd or in-between ages.
In many countries, I continue to see OPV0 given at 8 months of age or even
older, which results in delayed pertussis protection by at least 4 weeks,
because staff incorrectly believe that the birth dose must come before any
of the others can be administered. Similarly, I continue to see measles
not given at 9 months of age because staff believe that it must be the
last vaccine in the series and not all vaccines have yet been given. And I
see many staff who believe that the series must be re-started if
interrupted by more than 2 months. And of course, staff are often
reluctant to give more than one injectable vaccination on the same visit.
This tool was originally developed for East Timor, then adapted for India.
I hope that it will be tested one day soon in a number of countries. I
believe it may be of use in other countries.
I am sending the tool because as the immunization schedule gets slightly
more complicated with the addition of new vaccines. I think we need to
re-focus efforts on aiding field staff to operationalize our directives.
Please feel free to use or adapt such a tool. I would also be curious to
know what you think of it.
Cheers,
Robert
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