British Columbia’s Immunization Competency Program Cheryl McIntyre BC Centre for Disease Control March 21, 2005

BC Infant Immunization Program DaPT/IPV/Hib Hepatitis B MMR Varicella Meningococcal C conjugate Pneumococcal conjugate Influenza Mixed delivery system ~ 1000 Public Health Nurses

Immunization Competency To support health care professionals in their role as vaccine providers, educators and advocates for immunization Goal: vaccine providers will demonstrate the knowledge and skills necessary to provide safe and effective immunization programs

Process Original examination, paper-based, open book, developed 2001 Working group 2003 Revisions Web-based format Access to the University of British Columbia on-line learning WebCT Pilot testing

Immunization Competency Vaccinology Vaccine Preventable Diseases Contraindications and Precautions, Adverse Events Scheduling Specific Vaccines Special Populations Informed Consent, Benefit-Risk Communication

Overview Document Benefit – Risk Communication Canadian Immunization Guide: www.hc-cs.gc.ca/pphb-dgspsp/publicat/cig-gic Addressing Parents’ Concerns: Do multiple vaccines overwhelm or weaken the immune system. Dr. Paul Offit et al: http://pediatrics.aapublications.org/cgi/reprint/109/1/24

Competency on - line

Original Examination Vaccinology Protection from infectious disease is described as immunity. What are the two basic mechanisms for acquiring this protection? Explain how these mechanisms work and give examples of how each are acquired. Explain the difference between humoral immunity and cell-mediated immunity.

Vaccinology: True or False Inactivated vaccines are usually effective with the administration of only one dose Passive immunity produces a response similar to disease Immunologic memory produced by vaccination is not always detectable by serologic testing

A healthy 12 month old received a first dose of DaPT/IPV/Hib and Hepatitis B vaccine at 6 months of age. What vaccines is he eligible for today? DaPT/IPV/Hib, PCV7, MMR, Hep B DaPT/IPV/Hib, PCV7, MMR, Hep B, meningococcal C conjugate, varicella DaPT/IPV/Hib, MMR, Hep B MMR, Hep B, PCV7, varicella

Examination - Student

Examination - Instructor

Skills Checklist Clinic set up Client assessment Determination of vaccines to be given Informed consent Vaccine preparation and administration Documentation Reminders

From the nurses… “…these materials have been an excellent resource for all of us in the field, to ensure that Public Health Nurses have the best practice knowledge and skill sets to provide the immunization program.”

Acknowledgements Immunization Competency Working Group: Karen Pielak, Mary Margaret Proudfoot, Margot Smythe, Anne Carten, Carol Harrison, Elaine Klassen, Denise McKay, Gillian Youngberg, Claire Coombs, Myrna Klein, Gerry Barnes, Shirley Jones, Valery Dubenko, Karen McColgan Fred Zhang, University of Victoria, School of Health Information Science Maryjane Trepanier, BCCDC Surveillance Analyst University of British Columbia

Thank you cheryl.mcintyre@bccdc.ca