Training of immunization programme and health staff
Integration of training efforts into the broader framework of existing training plans and policies in the national health plan can be useful to limit costs. For campaign-style dissemination, the timing of the training should ideally be planned to take place as pre-service training and early programme in-service training.
Training plans should include an assessment of the existing knowledge, skills and practices of health-care workers to identify training needs and tailor the curriculum to target audiences. It is recommended that training on influenza vaccination should be integrated into existing training efforts or be part of ongoing supplementary training within supportive supervision visits to minimize the absence of health-care workers from their work.
All health-care workers should be trained in communicating information on the benefits and risks of influenza vaccine to the pregnant woman and family members (or other people) who accompany her, and in response to questions. For immunization programme staff, no additional skills are required for intramuscular influenza vaccine administration compared to other injected routine vaccines. Antenatal care workers should be involved in maternal influenza vaccination and therefore require training in vaccine administration and communication skills to encourage uptake among pregnant women. Health-care workers should apply strategies to mitigate pain during immunization sessions  . Encouraging vaccination of health-care workers themselves may be encourage uptake among pregnant women, but this would require that the vaccine is available or recommended for health-care workers (Toolbox).
What is the ideal timing of training for campaign-style dissemination?
|A. When questions arise from the public.|
|B. Pre-service and early programme in-service.|
|C. At the end of the last influenza season.|
|D. At the time of delivering vaccine.|
Answer B is correct.
Principles and considerations for adding a vaccine to a national immunization programme. Geneva: World Health Organization; 2014.
Section 3.7 provides information on training and supervision of health personnel.
Tailoring Immunization Programmes for Seasonal Influenza (TIP FLU). A guide for increasing health care workers’ uptake of seasonal influenza vaccination. Copenhagen: World Health Organization Regional Office for Europe: 2015.
Global Mid-level management modules (Cold chain, Partnering with communities, Immunization safety, Supportive supervision, Monitoring the immunization system, Making a comprehensive annual national immunization plan and budget, The EPI coverage survey, Making disease surveillance work).
Specific modules for use in the WHO African Region are also available.
- Global manual on surveillance of adverse events following immunization. Geneva: World Health Organization; 2014.
- National public health officials, immunization programme managers, and members of AEFI review committees can benefit from face-to-face training offered by WHO: https://www.who.int/initiatives/the-global-vaccine-safety-initiative
- E-learning courses on vaccine safety basics for vaccinating staff, national public health officials, immunization programme managers, and members of AEFI review committees.
Immunization in practice: a practical guide for health staff, cold chain, safe injections, microplanning to reach communities, managing immunization sessions, monitoring and evaluation, partnering with communities.
RED (Reaching Every District) strategy
- Microplanning for immunization service delivery using the Reaching Every District (RED) strategy. (Document WHO/IVB/09.11). Geneva: World Health Organization; 2009.
Training in preparation for maternal influenza vaccination should cover:
- Specific information on influenza disease in pregnant women and their infants (manifestations, disease burden, seasonality);
- Specific information on influenza vaccine for use in pregnant women and their offspring (composition, safety, efficacy, potential side-effects, injection site, use with other vaccines such as tetanus);
- The vaccine delivery strategy, microplanning, and the calling and recalling system, including tracking those who are not vaccinated;
- Timing and scheduling of vaccination and updating of vaccination records (if provided through antenatal care visits, national data on antenatal care coverage should inform the timing of immunization of pregnant women; in places where pregnant women often attend only one antenatal care visit, they should be offered vaccination at this visit (see );
- Proper storage, preparation and administration of influenza vaccine that are essential to ensure the quality of influenza immunization in view of the sensitivity of the vaccine to heat and freezing (see Toolbox);
- Briefing on updated vaccination records and tally sheets, reporting of doses and potential updates in the reporting of, and communications regarding, AEFI in pregnant women;
- Messaging on how to introduce maternal vaccination to increase vaccine acceptance and educate pregnant women and their families, including communication of risk and benefits of the vaccine, and to answer frequent questions;
- Locally-adapted guidance on how to communicate with pregnant women and their families in a manner that generates trust and provides reassurance (e.g. by demonstrating good listening and offering appropriate responses to questions);
- Procedures for monitoring coverage and vaccine wastage rates;
- Guidance on integrating the use of the vaccine with existing vaccines (e.g. tetanus).
Introducing influenza vaccination for pregnant women
in the Republic of Kazakhstan
The Government of the Republic of Kazakhstan introduced recommendations for influenza vaccination of pregnant women in 2011. Vaccination is recommended for pregnant women in the second and third trimesters and is provided from 1 October to 31 December at primary health care clinics as part of the country’s antenatal care programme.
The vaccination programme in Kazakhstan has been highly successful in overcoming barriers to vaccination uptake among pregnant women that have been observed in many countries of the WHO European Region. The achievements of the maternal influenza vaccination programme in Kazakhstan are the result of a number of training and communication initiatives involving both vaccine providers (health-care workers) and vaccine recipients (pregnant women), combined with strong commitment and support from the government and the Ministry of Health. Specific activities to promote influenza vaccination for pregnant women have included:
- workshops to enable health-care workers to develop theoretical and practical skills on the epidemiology, clinical picture, laboratory diagnosis, treatment and prevention of influenza in pregnant women;
- training of immunization nurses to ensure safe vaccination;
- annual awareness campaigns for women of reproductive age through a programme named Young Mother, as well as communication using different mass media outlets.
Since the introduction of the vaccination programme, the proportion of pregnant women vaccinated against seasonal influenza has increased significantly – from 4.6% in 2011–2012 to 92.3% in the 2015–2016 influenza season. Analysis of surveillance data indicated a decrease in the incidence of acute respiratory infections and confirmed influenza over this period not only among pregnant women but also among young infants.
Source: Committee of Consumer Rights Protection, Ministry of National Economy of the Republic of Kazakhstan