JE vaccine eligibility CD-JEV Japanese Encephalitis Vaccine Introduction Training Modules for Health Care Workers Module 3 JE vaccine eligibility

Learning objectives At the end of the module, the participant will be able to: Describe the recommended immunization schedule for CD-JEV. Describe when a child is eligible for CD-JEV and when he/she is not eligible. Describe the contraindications for vaccination. Duration: 15 minutes

Key issues 1 2 What is the schedule for CD-JEV? What are the contraindications for vaccination? 2 To the facilitator: Explain to the participants the key issues raised in this module. In this module you will learn more about JE vaccine eligibility. We will provide you with answers to the following questions: What is the schedule for CD-JEV? What are the contraindications for vaccination?

What is the CD-JEV schedule? CD-JEV can be given in a single dose from 8 months of age or older, or to children or adults who intend to enter endemic areas from non-endemic areas. JE vaccine To the facilitator: Explain to the participants the CD-JEV schedule. CD-JEV can be given in a single dose from 8 months of age or older, or to healthy children or adults who intend to enter endemic areas from non-endemic areas. Birth 8 months

CD-JEV eligibility Children 8 months of age or older. Adults travelling to endemic areas. A child who has received a different JE vaccine in the past (e.g., mouse brain-derived JE vaccine), even more than once, can be vaccinated with CD-JEV. To the facilitator: Describe to the participants CD-JEV eligibility Children 8 months of age or older. Adults travelling to endemic areas. A child who has received a different JE vaccine in the past (e.g., mouse brain-derived JE vaccine), even more than once, can be vaccinated with CD-JEV. 5

Can CD-JEV be given at the same time as other childhood vaccines? According to WHO, it is acceptable to give CD-JEV with other vaccines, such as measles and measles-rubella. No safety concerns have been identified in co-administration. The preferred time to administer CD-JEV to children in JE- endemic areas is: Close to the earliest recommended age (for maximum protection) During other routine immunizations (for ease of administration) To the facilitator: Explain to the participants whether CD-JEV can be administered with other childhood vaccines. According to WHO, it is acceptable to give CD-JEV with other vaccines, such as measles and measles-rubella. No safety concerns have been identified in co-administration. Administering CD-JEV to children in JE-endemic areas as close to the earliest recommended age as possible during other routine immunizations offers maximum benefit of protection. 6

Precautions and contraindications (1/2) Mild illness, such as an upper respiratory tract infection, is NOT a contraindication. If a recipient has a mild illness, it is okay to give them CD-JEV. To the facilitator: 7

Precautions and contraindications (2/2) A very severe adverse reaction or a severe hypersensitivity reaction (anaphylaxis) to a prior dose of CD-JEV, or to any vaccine component (e.g., gelatin, gentamicin, kanamycin). Fever higher than 38.5⁰C. Vaccination should be postponed and an appointment should be made for vaccination as soon as possible after the fever settles. Immunosuppression (due to disease or medication) or having the signs and symptoms of AIDS. Pregnant and lactating women: If the JE risk is sufficient to warrant vaccination of pregnant women, inactivated Vero cell-derived vaccines should be used preferentially over CD-JEV. To the facilitator: Explain contraindications to the participants. Note: There are no data yet available on administration of CD-JEV in HIV-positive children. Data from use of other live-attenuated vaccines in HIV-positive people not showing signs and symptoms of AIDS show no problems with receiving live-attenuated vaccines. Until data are available, an individual exhibiting the signs and symptoms of AIDS should not be given CD-JEV. An inactivated vaccine should be used instead. 8

Key messages CD-JEV should be given in a single dose at 8 months of age or older. Vaccination should be postponed when a fever is higher than 38.5⁰C and not given if there has been a prior severe hypersensitivity reaction to any vaccine component. It is safe to give CD-JEV to a patient with a mild illness. To the facilitator: Explain to the participants that these messages are the main information to keep in mind.

Thank you for your attention! End of module Thank you for your attention! To the facilitator: This is the end of the module. You have been introduced to “CD-JEV vaccine eligibility”. The following module is titled “CD-JEV vaccine administration”. Thank you for your attention! Next is Module 4: JE vaccine administration