A Review of Recommendations for Routine Immunization Services During COVID-19 Pandemic That are Relevant for Nursing Personnel Involved in the Implementation of Immunoprophylaxis

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Table 1 New Guiding Principles for Immunization Programmes During the COVID-19 Pandemic

Follow the existing guidelines on COVID-19 infection prevention measures during immunization sessions.

Prioritize primary series vaccinations (especially MMR vaccines, polio vaccines and other combination vaccines).

Avoid mass vaccination campaigns.

Vaccinate newborns according to the National Immunization Programme before they are discharged from a neonatal unit.

Prioritize pneumococcal and seasonal influenza vaccines for the vulnerable population groups.

Communicate clearly to the recipients of medical services, including the parents of the children scheduled for vaccinations, the rationale for the inclusion of immunization as one of the priority health services during the COVID-19 pandemic, and the risks from VPDs, and the benefits of vaccinations.

Figure 1 Decision-making algorithm for immunization services in the general population.

Table 2 Organization of Immunization Services and Vaccination Procedures During the COVID-19 Pandemic – Guidelines for Doctors and Nurses

Preparation for Immunization

Use available communication technology (eg: telephone medical advice) to communicate on immunization services and set appointments for sessions.

When setting an appointment for an immunization session for a child, it is important to inform the parent/guardian that only one person without any symptoms of infection can accompany the child during the visit at a healthcare facility. An initial prevaccinal qualification for vaccination must be conducted over the phone along with an epidemiological inquiry concerning other household members of the patient. Vaccination should be postponed if the inquiry reveals that a member of a patient’s household: Has a respiratory infection of unknown origin. Is under quarantine. Is self-isolating at home.

Immunization sessions for heathy patients should be scheduled for a specific time slot to avoid unnecessary crowding in waiting rooms (time separation).

Consider combining vaccination visits with well-child visits.

It is advisable to perform a medical examination and administer vaccination in the same room.

Prepartion of Medical Personnel to Administration of vaccines

Train medical personnel to prevent SARS-CoV-2 infection during immunization sessions.

Consider mobile vaccination posts or health outreach posts whenever feasible to improve an equal access to immunization, while minimizing the risk of infection.

Perform exposure risk assessment of healthcare personnel who have a history of contact with COVID-19 patients.

Healthcare personnel should receive all mandatory and recommended vaccinations as listed in the National Immunisation Programme.

Ensure that vaccination rooms are prepared according to the guidelines of the Ministry of Health, and that the rooms are properly adapted to the current situation of SARS-CoV-2 pandemic.

Perform a regular update of vaccine demand and maintain a safe level of vaccine stockpile, taking into account the available capacity of refrigeration equipment.

Tasks for the Healthcare Personnel Who Administer Vaccinations

Inform the parent/guardian who accompanies a child at the immunization session on COVID-19 measures, including the use of hand and respiratory hygiene and the importance of social distancing (maintaining a distance of at least 1 metre from others).

Use generally recommended personal protective equipment inside the facility which provides immunization services (face masks and disposable gloves) to minimize the risk of transmission of SARS-CoV-2 from a healthcare staff to a patient in the event of asymptomatic infection of personnel.

Conduct vaccinations in a dedicated immunization room, where patients with symptoms of acute infection are not admitted (spatial separation).

Healthcare personnel must adhere to all rules concerning the prevention of airborne infections and direct contact infections – hand hygiene, protective clothing that has not come into contact with patients showing symptoms of acute infection, disinfection of all surfaces that the patients and/or their parents/guardians come into contact with, and ventilation of the room after each vaccination.

In the absence of a waiting room and a room dedicated exclusively to well patients, immunization sessions should be scheduled in the first hours after the opening of the facility, before the admission hours for other patients.

All vaccinated persons should be kept under observation after administration of a vaccine. In order to maintain public trust in immunization, efficient systems for reporting, analysing and performing causality assessment of serious Adverse Events Following Immunization (AEFIs) should be put in place and information about the causes of AEFIs should be made available.