Back to the Future? Pre-Event Smallpox Vaccination John R. Lumpkin, MD, MPH, FACEP Illinois Department of Public Health.

Slides:

Advertisements

Similar presentations

Hospital Pandemic Influenza Planning by Ed Lydon, CVPH.

Advertisements

Smallpox Vaccination for Response Teams The Decision is Yours! of and.

Hospital Issues and Smallpox Vaccine Lisa G. Kaplowitz, M.D., M.S.H.A. Deputy Commissioner Emergency Preparedness and Response Virginia Department of Health.

Smallpox Pre-Event In-Service for Fire and Rescue Staff Bob Mauskapf State Emergency Planning Coordinator Virginia Department of Health Bob Mauskapf State.

Smallpox Vaccine Clinic Operations and Management Department of Health and Human Services Centers for Disease Control and Prevention December 2002.

1 Preparing for Smallpox: Post-event Smallpox Response.

Ebola Facts October 28, /28/14 Identify, Isolate, Inform: ED Evaluation and Management The following diagram provides guidance on evaluation and.

Prepared by Dr Alissar Rady, WHO Lebanon

DMC HVSH Guidelines for Suspected Smallpox Vaccine Adverse Events Evaluation Confirm that individual is smallpox vaccinee (should have PVN card) Those.

Influenza Prevention We anticipate that there will be two types of influenza illness and influenza vaccines this year Seasonal influenza – the usual flu.

NH Department of Health and Human Services Division of Public Health Services Influenza Seasonal and H1N1 Patricia Ingraham, MPH Communicable Disease Control.

Considerations for Hospitals: Developing a Smallpox Healthcare Response Team Prepared by Jane Siegel, MD Co-chair, Healthcare Infection Control Practices.

On October 4 th, IHAN broadcast a CDC national alert advising clinicians to contact all patients who had received injections of contaminated Methylprednisolone.

Maryland Department of Health and Mental Hygiene.

The Essentials of Perinatal Hepatitis B Prevention A Training Series for Coordinators and Case Managers.

Perinatal Hepatitis B Prevention

Hepatitis B and Hepatitis B Vaccine Epidemiology and Prevention of Vaccine- Preventable Diseases National Center for Immunization and Respiratory Diseases.

INFLUENZA (FLU) Management Presentation

Influenza Outbreaks and Cruise Ships Laura Martin 25 April 2002.

Influenza Prevention We anticipate that there will be two types of influenza illness and two different types of influenza vaccine this year Seasonal influenza.

Management of Smallpox Vaccine Adverse Events Department of Health and Human Services Centers for Disease Control and Prevention February 2003.

Site Care. Site Care Education Goals Review normal reactions after vaccination Provide site care instructions (oral and written) Provide contact information.

Pneumococcal Disease and Pneumococcal Vaccines Epidemiology and Prevention of Vaccine- Preventable Diseases National Immunization Program Centers for Disease.

U.S. Surveillance Update Anthony Fiore, MD, MPH CAPT, USPHS Influenza Division National Center for Immunizations and Respiratory Disease Centers for Disease.

Pandemic Influenza: Role and Responsibility of Local Public Health Richard M. Tooker, MD Chief Medical Officer Kalamazoo County Health and Community Services.

Smallpox Vaccination: Risk Assessment and Perspectives of the Health Care Provider, Institution, and State of Illinois.

Introduction to Developing a Vaccination Strategy for Smallpox Preparedness Department of Health and Human Services Centers for Disease Control and Prevention.

Health Care Personnel Influenza Vaccination [ORGANIZATION NAME] [ORGANIZATION LOGO]

Smallpox Vaccine Contraindications and Screening Department of Health and Human Services Centers for Disease Control and Prevention December 2002 Note:

Smallpox Vaccine Administration Department of Health and Human Services Centers for Disease Control and Prevention December 2002.

Vaccine Safety Epidemiology and Prevention of Vaccine- Preventable Diseases National Immunization Program Centers for Disease Control and Prevention Revised.

Nic Dibble, Consultant School Social Work (608) Department of Public Instruction

Smallpox Phase I Hospital Team Vaccination Seminar North Dakota Department of Health.

EMPLOYEE INFLUENZA VACCINATON. Influenza Vaccination (Your institution) is committed to keep both its employees and patients safe (Your institution) recognizes.

National Smallpox Vaccination Update Joseph M. Henderson Centers for Disease Control and Prevention.

Smallpox Vaccination: Federal Activities Walter A. Orenstein, M.D. National Immunization Program Centers for Disease Control and Prevention.

Managing Pre-Hospital Exposures PRODUCED BY RI Department of Health, Division of EMS & Hospital Association of Rhode Island.

Page Up to Reverse  Employee Health  Page Down to Advance  Employee Health 

Pan American Health Organization.. Protecting the Health of Health Care Workers: Experience from the Americas Marie-Claude Lavoie Decision Making for Using.

Viral Hepatitis - Historical Perspective A “Infectious” “Serum” Viral hepatitis Entericallytransmitted Parenterallytransmitted F, G, ? other E NANB BD.

H1N1 Flu Update (Swine Flu) Source of Information: PA Dept of Health as of August 21, 2009.

Smallpox Vaccine Safety and Reporting Adverse Events Department of Health and Human Services Centers for Disease Control and Prevention February 2003.

1 Influenza Vaccination of Health-care Personnel: An Initiative to Improve a Serious Public Health Problem Anand Parekh, MD, MPH Office of Public Health.

1 DoD Smallpox Vaccination Program Policy – Training – Standards – Communication – Safety Assurance – Safety Assessment Science – Quality – Confidence.

Influenza Update September 2015

Smallpox Vaccination Mark Upfal, MD, MPH Detroit Medical Center Emergency Medicine Grand Rounds Detroit Receiving Hospital February 13, 2003 Collaborators:

DoD Smallpox Vaccination Program Science – Quality – Confidence – Care 3 June 2003 COL John D. Grabenstein, RPh, PhD Military Vaccine (MILVAX) Agency U.S.

CDC Guidelines for Use of QuantiFERON ® -TB Gold Test Philip LoBue, MD Centers for Disease Control and Prevention Division of Tuberculosis Elimination.

Smallpox Vaccine General Information. Dryvax Smallpox Vaccine  A live virus vaccine, as are the measles/mumps/rubella and chicken pox vaccines used.

Severe Acute Respiratory Syndrome (SARS) and Preparedness for Biological Emergencies 27 April 2004 Jeffrey S. Duchin, M.D. Chief, Communicable Disease.

Smallpox Vaccine Safety and Reporting Adverse Events Department of Health and Human Services Centers for Disease Control and Prevention December 2002.

Smallpox Vaccine Administration  Learning Objectives Demonstrate appropriate vaccine administration techniques Demonstrate appropriate vaccine administration.

1 Vaccines Contraindications. Contraindications to any routine active immunization procedure An acute febrile illness, malaise, cough, diarrhea, or other.

What is influenza? Influenza (also called "the flu") is a viral infection in the nose, throat and lungs. About 10% to 20% of Americans get the flu each.

Security Overview Staff assigned to the Security Unit should be familiar with the job duties in all areas of the clinic where Security is assigned since.

Preventable Outbreak of Pneumococcal Pneumonia Among Unvaccinated Nursing Home Residents-- New Jersey, 2001 Tina Tan, MD CDC/EPO/State Branch New Jersey.

Adult Immunizations August 23, 2004 Vinod Kurup, MD

Chapter 11: Nursing in Pandemics and Emergency Preparedness.

Infection Control Q and A APIC Greater NY Chapter 13 May 17, 2017 Beth Nivin BA MPH NYC DOHMH Communicable Disease Program

CDC Guidelines for Use of QuantiFERON®-TB Gold Test

Child Health Evaluation and Research Unit

Mark Lobato, MD Division of TB Elimination

JE vaccine eligibility

Smallpox Vaccine Clinic Operations and Management

Smallpox Vaccine Contraindications and Screening

Smallpox Vaccinee Evaluation and Follow-Up

Caring Through communities

WHAT IF THE VACCINE IS NOT A GOOD MATCH?

Presentation transcript:

Back to the Future? Pre-Event Smallpox Vaccination John R. Lumpkin, MD, MPH, FACEP Illinois Department of Public Health

Is it safe to defer pre-event vaccination? Vaccination within 3 days of exposure to a case prevents or significantly mitigates disease IDPH and the Governor have prioritized health-care worker vaccinations in the setting of a smallpox outbreak 30% of young adults vaccinated in the fall of 2001 at the CDC had to take 2 days off due to side effects of the vaccine

What’s the purpose of Phase I vaccination? Immunize public health and healthcare workers who might be exposed to some of the earliest smallpox cases or be essential in caring for them Phase I will not immunize all health-care workers who may or will be exposed to a smallpox case

HICPAC-ACIP Recommendations October 2002 Smallpox Health Care Teams (SHCTs) Screening for contraindications Vaccination site care Administrative leave

HICPAC: SHCTs Each acute care hospital should identify a SHCT Purpose of the SHCT  Evaluate and manage patients in the ED  Provide in-room care for first 7 to 10 days  Need to cover all shifts

HICPAC: SHCTs (cont’d) ED and ICU physicians and nurses, including pediatric expertise General medical staff, including ob and surgeons House staff Subspecialists (ID, dermatologists, pathologists) Infection control professionals Respiratory therapists, radiology technicians, environmental services

HICPAC: SHCTs (cont’d) “ Although it is not recommended that emergency medical technicians (EMTs), as a group, be vaccinated in this first phase, individual hospitals may identify and include hospital-based EMTs (i.e., personnel who would be dispatched to transport patients with suspected smallpox)”

HICPAC-ACIP: Site Care Daily dressing checks by staff designated by the hospital “Health-care workers involved in direct patient care should keep their vaccination sites covered with gauze…and a semi-permeable dressing …until the scab separates.” At home: gauze dressing

HICPAC-ACIP: administrative leave “Administrative leave is not required routinely for newly vaccinated healthcare workers unless they are physically unable to work…or if they do not adhere to the recommended infection control precautions.” “It is important to realize that the very close contact required for transmission of vaccinia to household contacts is unlikely to occur in the healthcare setting.”

Pre-event contraindications 1. Pregnancy: current or planned within 4 weeks 2. Breast-feeding 3. Immunosuppression (including immunosuppressive diseases [HIV], conditions [lupus], therapies [post- transplant])

Pre-event contraindications (cont’d) 4. Eczema or atopic dermatitis 5. Serious skin conditions not under control (psoriasis, severe acne, large burns, etc) 6. Close contact with people who have conditions noted in numbers 1 through 5

Pre-event contraindications (cont’d) 6. Significant allergies to any of the antibiotics used in the manufacture of the vaccine (streptomycin, tetracycline, chloramphenicol) or latex 7. Close contact with children less than 1 year old

Implementation of Phase I Exact date still uncertain IDPH will receive the vaccine and distribute to local health departments (LHDs) LHDs will establish vaccination clinic hours, administer vaccine Follow-up (dressing checks and assessment of “take”) at the hospital

What will happen at the vaccination clinic? Volunteers will watch a 20 minute video provided by the CDC Volunteers will be asked to sign an informed consent form Vaccination given intradermally above right deltoid Vaccinees given site instructions and proof-of-vaccination card

Follow-up Each hospital will designate a hospital-assigned physician (HAP); this person will be your resource if you have questions prior to vaccination or complications after

Expected Side Effects Temp up to 102º Malaise Erythema, tenderness up to10 cm Axillary adenopathy 30% of the young adults vaccinated at the CDC in the fall of 2001 had to take 1- 2 days off because of side effects; this peaked at day 8 after the vaccination

Assessing “take” The HAP at each hospital will evaluate “take” on day 7, 8, 9, or 10 after vaccination

Complications 1000 per every million vaccinees in the past  Most common complications: autoinnoculation and disseminated vaccinia, both usually self-limited and insignificant  Eczema vaccinatum (30:1,000,000)  Progressive (necrotizing) vaccinia in people with cellular immunodeficiencies 1 death per million for first time vaccinees; 1 in 4 million for previously vaccinated

Liability Issues People administering vaccine protected by Homeland Security Act Vaccinees who inadvertently innoculate another person (patient, household contact)--HSA does not offer liability protection

Compensation for days off due to expected side effects?

Miscellaneous information Duration of immunity: 3 to 5 years (you’ll need to be revaccinated if smallpox remains a threat) What about the “new” vaccine? It will still be a live virus, just produced in cell culture instead of on the side of a cow.