A set of training materials for professionals working in intervention epidemiology, public health microbiology and infection control and hospital hygiene.
1. The immune system and vaccines
1.1 Vaccine immunology
1.1.1 Familiarity of basics of vaccines immunology–cell types involved in immune response of vaccines. Main effectors of vaccine responses.
1.1.2 Describe how the vaccines mediate protection: Cell mediated and humoral immunity in response to natural infection and vaccination.
1.1.3 List the main host immunological factors and medical conditions that affect the immune response
1.1.4 Describe the difference between the primary and memory induced immunity.
1.1.5 Debate vaccine induced immunity versus naturally gain immunity
1.1.6 Describe the difference in the immune response between a primary series and a booster/revaccination
1.1.7 Be familiar with kinetics of vaccine induced antibodies.
1.2 Types of immunizing agents, their composition and use
1.2.1 Describe the different type of vaccines, immunoglobulins and other immunizing agents.
1.2.2 Describe the vaccines types in use including advantages and disadvantages (nature of antigen, combination, adjuvants, and routes of administration).
1.2.3 Describe how the vaccines induce immunity (killed, inactivated live pathogens, genetic engineering, recombinant methods, and synthetic peptide vaccines).
1.2.4 Be familiar with interaction between live and inactivated vaccines.
1.2.5 Demonstrate knowledge on the presentation of vaccines (glass vial and pre-filled syringe) and special concerns regarding storage and handling.
1.3 Vaccine preventable diseases and Population based prevention
1.3.1 Describe the clinical presentation of vaccine preventable disease (carriage, complication, diagnostic tests).
1.3.2 Demonstrate the basic of dynamics of vaccine preventable diseases in the population.
1.3.3 Be familiar with the concept of control, elimination and eradication.
1.3.4 Understand the principles and benefit of immunization.
1.3.5 Describe the effect of vaccination to the community as whole (herd immunity).
1.3.6 Be familiar with the immunization needs of special risk groups in population (travellers, migrants, vulnerable population, immunocompromised host, health care worker, high risk population for underlying conditions).
2 Vaccine logistics management
2.1 Cold chain, storage and logistics
2.1.1 Demonstrate sound knowledge on vaccine management including vaccine supply/shortage, cold chain, storage and logistics
2.1.2 Collaborate with health centres in order to supply, deliver and store the vaccines in the best way.
2.1.3 Elaborate storage, handling and monitoring plans/ guidelines for routine and emergency vaccination.
2.1.4 Promote innovative approach to build and apply a public-private partnership model for vaccine cold chain, storage and delivery to ensure the best available economical approach.
2.2.1 Settles that client records/ immunization registries (paper or e-records) are kept secure and confidential and maintained consistent with national standards (guidelines/policies)
2.2.2 Provide technical expertise in the methods of immunization information through introduction of electronic immunization registers.
2.3 Administration of vaccines
2.3.1 Prepare/ outline the periodical meeting with the vaccinators related to routine vaccination/pre vaccination campaigns, to inform them on the main technical and organizational updates.
2.3.2 Provide a checklist for the vaccinators for the patient / client assessment including precautions, contraindications and indications for rescheduling.
2.3.3 Establish/make available for vaccinators the steps involved in vaccine preparation, including reconstitution, administration and discarding.
2.3.4 Develop waste management procedures.
2.3.5 Demonstrate knowledge on the appropriate vaccine administration (route, hygiene, preparation, and reconstitution).
3 Communication and behaviour science related to vaccine preventable disease and immunization
3.1 Communication of VPD&I related information
3.1.1 Use effective communication skills including written, verbal and non-verbal skills.
3.1.2 Use culturally appropriate communication methods and techniques for specific settings and risk groups.
3.1.3 Be knowledgeable about communication and be able to be involved in it.
3.1.4 Use information technology and other media to receive and disseminate VPD&I related information.
3.2.1 Raise awareness and influence public opinion on VPD&I through stakeholders involvement
3.2.2 Engage with and influence stakeholders to develop and sustain PH action in the area of VPD&I
3.2.3 Collect relevant information from appropriate stakeholders about communities needs in the area of VPD&I and advocate for them
3.3 Behaviour science
3.3.1 Be familiar with behavioural science principles to understand the more effective ways to influence and change behaviour on vaccination.
3.3.2 Develop, implement and evaluate behavioural change strategies in the area of VPD&I.
3.3.3 Build and be able to maintain trust in groups whose confidence is of collective importance: the public, the health workers and political and policy stakeholders.
3.4 Social marketing
3.4.1 Increase awareness on Understand what social marketing can bring into PH projects in the VPD area
3.4.2 Contribute to social marketing approaches design, implementation and evaluation in the area of VPDC
4 Research and development / Science and evaluation
4.1 Immunization programme evaluation
4.1.1 Develop and conduct a plan to evaluate an immunization programme
4.1.2 Contribute with/monitor vaccine efficacy, effectiveness and impact of vaccines
4.1.3 Present the conclusions to stakeholders in order to prioritize programme activities based on the results collected.
4.1.4 Be familiar with the concept of cost-effectiveness and cost-benefit
4.2 Vaccine safety
4.2.1 Be familiar with the licensing process at European and national level
4.2.2 Be familiar with the concept of plausibility and causality in relation to adverse events.
4.2.3 Provide scientific evidence for protection level and vaccine safety related concerns
4.2.4 Appreciate difference in safety outcome in pharmaco-vigillance vs. clinical trials (Understand that clinical trial databases allow for detection of common adverse events while uncommon events may occur when vaccine used in real life in a large population)
4.2.5 Be familiar with aspects of live attenuated vaccines such as shedding, transmission of the attenuated agents to close contacts, risk for pregnant women and reversion to virulence.
4.2.6 Perform analysis of AEFI based on the core variables
4.2.7 Conduct research to test the hypothesis generated by the post marketing surveillance /investigations
4.2.8 Produce technical report with conclusions and recommendations based on the results of investigations and data analysis
4.2.9 Conduct analysis focussed on identifying gaps in immunization programme as it will lead to operational and policy decisions on management
4.2.10 Assess immunization uptake and its determinants.
4.3 Evidence based medicine
4.3.1 Critical appraisal, judging validity and applicability of a study (including ability to see the limitation of the study)
4.3.2 Evaluating evidence, levels of evidence and strength of recommendations
4.3.3 Translate the study implications into the population
4.4 Science and guideline development
4.4.1 Ability to provide up-to-date information on immunization science.
4.4.2 Ability to develop/ enhance immunization strategies/ programmes/ various immunization related guidelines when requires using evidence based principles.
4.4.3 Ensure that there is adequate professional development and in-service training for all staff
4.4.4 Demonstrate the appropriate techniques for vaccination if available by preparing short demo films
Develop operation guideline for vaccination services
5 Immunization programme management
5.1.1 Demonstrate deep, thorough knowledge on the national health legislation related to vaccines and immunization programmes.
5.1.2 Ability to discuss the ethical issues arising from mandatory versus voluntary immunization, individual rights, privacy, informed decision and informed refusal.
5.1.3 Describe the national immunization programme
5.1.4 Be able to advice on the organizational aspects of the vaccination programme in the country.
5.1.5 Demonstrate capability of cooperation/collaboration among multidisciplinary institutions with possible involvement and responsibilities in VPD & I.
5.2 Vaccine resource management
5.2.1 Contribute to the functionality of immunization services by proposing immunization programme budget and estimating resources needs.
5.2.2 Ensure the optimal quantity of vaccine based on population data in the area of supply/jurisdiction.
5.2.3 Coordinate the immunization program in accordance with its objectives and according to national standards, policies, and guidelines at different administrative levels.
5.2.4 Manage the professional staff that provides immunization services to clients at different administrative levels
5.2.5 Assist and guide staff both in routine vaccination activities and in outbreak situations in a timely manner.
5.3 Strategy development and immunization schedules
5.3.1 Demonstrate knowledge on immunization programme strategy development
5.3.2 Demonstrate sound knowledge on the elements of success of national immunization strategy.
5.3.3 Demonstrate knowledge on the values of an immunization registry.
5.3.4 Demonstrate knowledge on principles of decision-making process for introduction of new vaccines or making decisions on optimal immunization schedules.
5.3.5 Ability to set up/define research priorities to conduct appropriate studies (cost benefit analysis, studies on vaccines safety, etc.) before and following development or adjustment of an immunization strategy or certain elements of the strategy.
5.4 Adverse Events Following Immunization (AEFI)
5.4.1 Demonstrate knowledge on the AEFI (immunization safety) surveillance system at different functional levels: national, regional, vaccine provider level)
5.4.2 Understand the pre-marketing regulation and post-marketing vaccine safety bodies that that monitor vaccine safety.
5.4.3 Demonstrate knowledge on detection, reporting, management and investigation of AEFI (when, who, to whom and how should report/investigate).
5.4.4 Define an adverse event following immunization (AEFI), serious adverse event and how they can be classified.
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