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Residential Care Home Vaccination Programme

(RVP) 2015/16 Briefing to Visiting Medical Officers

(4 and 7 September 2015)

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Overview

• Background • RVP 2015/16 arrangement • Points to note

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Background • Free seasonal influenza vaccination (SIV) provided to all

residents of Residential Care Homes for the Elderly (RCHEs) since 1998 by the Department of Health

• The SIV programme extended to Residential Care Homes for Persons with Disabilities (RCHDs) in 2003 and to healthcare workers in these residential care homes (RCHs) in 2005

• Since 2009, free pneumococcal vaccination (23-valent pneumococcal polysaccharide vaccine, 23vPPV) was also provided to residents of RCHEs and those residing in RCHDs of age 65 years or above, who have not received pneumococcal vaccine before.

• Since 2010, vaccinations in RCHs provided under RVP • In 2015, one-off southern hemisphere SIV to all residents

of RCHEs (8 May to 31 August 2015)

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Residential Care Home Vaccination Programme (RVP)

2015/16

Overview of RVP

• Free vaccines are delivered to RCHs by the Government • RCHs invite private doctors enrolled to RVP – Visiting

Medical Officers (VMOs) to provide on-site vaccination in RCHs

- a form of public private partnership - a familiar and convenient place for residents and staff - 350 VMOs enrolled under RVP 2014/15 (list published in CHP website) • Injection fee of HK$50 per injection will be reimbursed to

VMOs through the eHealth System (eHS) after the injections

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Vaccination Period

– Seasonal influenza vaccination • From mid Oct 2015 to mid Dec 2014 (for protection

before peak influenza season; body needs 2 weeks to produce antibodies after vaccination)

• RCHs can start making vaccine orders after RCH briefing on 9 and 10 September

– Pneumococcal vaccination

• Ongoing since commencement in October 2009

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Seasonal influenza vaccine

• Quadrivalent, inactivated • Vaccine Composition -an A/California/7/2009 (H1N1)pdm09-like virus -an A/Switzerland/9715293/2013(H3N2)-like virus -a B/Phuket/3073/2013-like virus -a B/Brisbane/60/2008-like virus

FluarixTM Tetra (GlaxoSmithKline) • For persons aged 36 months or above • 0.5 ml pre-filled syringe (with needle) • Intramuscular (please contact Vaccination Office to order

trivalent influenza vaccine which can be used deep subcutaneously if clinically indicated for patients with bleeding tendency)

• Expiry date: end of month marked on package

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FluQuadri (Sanofi) • For children 6 months to 35 months • 0.25 ml pre-filled syringe (without needle; needle separately

provided) • Intramuscular (please contact Vaccination Office to order trivalent

influenza vaccine which can be used deep subcutaneously if clinically indicated for patients with bleeding tendency)

• Expiry date: date marked on package (e.g. 29 May 2016)

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Pneumococcal vaccine • Pneumo-23 (Sanofi): 23-valent pneumococcal polysaccharide

vaccine (23vPPV) • Expiry date: end of the month marked on package

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Eligibility for Vaccination • Seasonal Influenza Vaccine

– ALL residents and ALL healthcare workers in RCHs

• Pneumococcal (23vPPV) Vaccine: – All residents (irrespective of age) in RCHEs and residents aged

65 or above residing in RCHDs, who have never received pneumococcal vaccine (23vPPV or PCV 13) before, are eligible to receive one dose of 23vPPV under RVP

– Healthcare workers in RCHs are not eligible to pneumococcal vaccination

SCVPD Recommendation on Use of Pneumococcal Vaccine in High Risk Individuals (December 2014)

– For elders aged 65 years or above, a single dose of PCV 13 or 23vPPV is recommended.

– SCVPD will review the recommendation with latest scientific developments

– Latest SCVPD recommendation will be uploaded to CHP website

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Under RVP 2015/16, all residents (irrespective of age) of RCHE and residents of RCHD aged 65 years or above, who have not received any pneumococcal vaccine (PCV 13 or 23vPPV) before, are eligible for one dose of free 23vPPV.

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Before vaccination

– DH supplies and delivers consent forms, vaccines, sharp boxes and immunization cards to RCHs before the scheduled vaccination

– RCH send consent forms signed by eligible residents and staff

to VMO 10 days in advance for checking – VMO should perform prior checking of vaccination history

and eligibility for all recipients through eHealth System (delay vaccination if checking has not been done)

– Create account for new eligible clients if necessary – Confirm with RCH date and time for vaccination and that

adequate number of vaccines are ready and properly stored in RCH

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Vaccination in RCHs – Ensure the recipients’ vaccination record have been

checked through eHS, vaccination card or history from recipients or relatives (particular attention to those who are newly-admitted to the RCH)

– Oversee the whole vaccination process and ensure

personnel involved in vaccination are qualified/trained to perform vaccination duties

– Ensure the personnel involved in vaccination are qualified and trained in emergency management of severe immediate reactions and are equipped to do so and to supervise and stand-by for emergency

Vaccination in RCHs – Counterchecking identity of residents against consent form and

identity document before vaccination – Check medical conditions and contraindications (refer to product

insert for ingredients e.g. FluarixTM tetra contains gentamicin sulfate, eggs, sodium deoxycholate, formaldehyde, octoxinol 10, …etc.)

– Ensure correct vaccines (SIV or pneumococcal; SIV for ≧ or < 36 months) to be given to recipients and the vaccines are unexpired and in good condition

– Injection of one kind of vaccine to all recipients before the other vaccine

– Separate injection for SIV and 23vPPV (in different injection sites with different syringes, common practice: left SIV vaccine; right pneumococcal vaccine左流右肺)

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Date of vaccination

given to residents/staff

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After vaccination

• Proper record: vaccination card, put down vaccination date in consent form, check and sign on the consent list

• Make claims in eHS within seven days of injection (to keep records in eHS updated)

• Report vaccination incidents to VO as soon as possible • Report AEFI • Keep consent forms for seven years

Points to note

• Only use vaccines supplied by DH • Provide vaccination service on-site in RCHs only • Do not charge additional fee from residents or staff • Do not share the vaccination fee with RCH • Make Claims under RVP instead of Vaccination Subsidy

Scheme (VSS) • Pre- and post-payment checking

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Vaccination to mentally-incapacitated residents without consent form

• In-charge of RCHs confirmed that the guardian of the resident cannot be contacted and signed on the consent form

• For the benefit of the residents without consent form, VMO can provide vaccination to them after assessment and considers the vaccination is in the best interest of the them

• Other relatives of residents (if any) will be encouraged to sign on the consent form to acknowledge that VMO will provide vaccination to the residents.(Optional)

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Arrangement of mop up vaccination for SIV for staff and residents of RCHs

• Starting from 1.1.2016 • Done by existing VMO or other VMOs

(information of all VMOs is available in CHP website for public reference)

• If no VMO is available to provide mop up vaccination, RCH needs to contact Vaccination Office for arrangement of mop up vaccination in nearby General Out-patient Clinics under Hospital Authority (residents: all GOPC; staff: designated GOPC)

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Information prepared for VMOs • Terms and conditions of agreement • Doctors’ Guide (on-line version on CHP website) • FAQs • 5 steps of checking vaccination records in eHS

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RVP information http://www.chp.gov.hk/en/view_content/23543.html

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Contact us

Vaccination Office • Tel : 2125 2125

• Fax : 2713 6916

• Email : vacs@dh.gov.hk

• Address : 2/F, 147C, Argyle Street,

Kowloon

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THANK YOU