Principal s Package Immunization Clinics

Principal s Package Immunization Clinics 2015-2016 Important Information Regarding School-Based Immunization Clinics Human papillomavirus Hepatitis B Meningococcal Meningitis

Table of Contents Topic Page Introduction 3 - New process - Panorama - Consent Pick up - Vaccines Timelines 4 - Rounds 1-3 Scheduling Clinics 5 Clinic Space Requirements 6 - Safety Requirements Consent forms 6-7 - distribution - pick-up - consent forms - invalid consent forms Students with special needs 7 Day of Clinic Logistics 8 Missed Doses 9 Safety Following immunizations 9 Unwell Post Immunization 9-10 Resources 10 Letters For Parents 11-13 2

Introduction Immunizations: In Ontario, the Ministry of Health and Long-Term Care provide the opportunity for students in grade 7 and 8 to receive publicly funded vaccines. Registered Nurses from Peel Public Health administer the vaccines in school clinics. Two (2) vaccines are offered to all grade 7 students during the school year: 1. Hepatitis B (2 doses) 2. Meningococcal (1 dose) One (1) vaccine is offered to female grade 8 students 1. Human papillomavirus (HPV) (2 doses) or (3 doses) In Ontario, all students are required to be immunized against meningococcal disease Students 12 years and older are required to have the meningococcal ACYW-135 vaccine or provide a valid exemption. Hepatitis B and HPV are not required vaccines but are highly recommended. All three vaccines are safe and provide protection against serious disease. Immunization Registry: Panorama Peel Public Health use an immunization registry called Panorama in the school based clinics. Wi-Fi is required and has been negotiated and approved by each individual school board for use by Peel Public Health staff. Our staff will have laptops and a back-up internet hub to use Staff require adequate space and electrical outlets for the setup of equipment Consent pick up All consents will be picked up beginning September 16 th from each school. Consent forms will be reviewed in office by the nurses to determine if students require the vaccine. Vaccine Information: 1. Hepatitis B Vaccine Hepatitis B is a serious infection of the liver which can be transmitted in infected blood or body fluids, causing fever, disability and jaundice. Two (2) doses are given four to six months apart 2. Meningococcal Vaccine Meningococcal disease is a serious infection which can lead to meningitis (an infection of the lining of the brain and spinal cord) or meningococcemia (an infection of the blood). These bacteria are commonly found in the nose and throat and can be spread by direct contact with saliva that can happen by sharing drinks, utensils etc. Only one dose is needed for protection against four strains of meningococcal disease. 3

3. Human papillomavirus (HPV) Vaccine HPV is the name for a group of viruses that affect your skin and the moist membranes lining your body, for example, in your cervix, anus, mouth and throat HPV vaccine protects against four types of HPV, two of the strains are responsible for 70% of cervical cancers. The vaccine is most effective when given before an individual becomes sexually active and is exposed to an HPV infection 2 or 3 doses of HPV are effective based on age and health condition. A nurse will assess the child to determine the correct number of doses. Who should receive 2-doses of HPV? girls between the ages of 9-13. If the first dose is given before age 14, only 2 doses are needed Doses are given six months apart Who should receive 3-doses of HPV? Healthy girls who begin their HPV series at 14 years of age or older Girls whose immune system is weakened by medication or disease Doses are given at 0, 1 and 4 months Vaccine is offered to grade 8 female students at no cost Female students, who have not completed their HPV series or did not receive the HPV vaccine in Grade 8, will have an opportunity to complete the series (until the end of their grade 12 year) at one of our weekend clinics. Please refer these students to Peel Public Health at 905-799-7700 for information on how to complete the series. The immunization clinics team will book clinics three (3) times a year at each school. They are divided into three rounds. The first round occurs in the fall, the second in the winter and the third in the spring. The immunization clinics are scheduled as follows: Student Group Round 1 Round 2 Round 3 Grade 7 Students Hepatitis B- Dose 1 Meningococcal Vaccine Hepatitis B- Dose #2 Grade 8 Females HPV- Dose #1 HPV (catch-ups) HPV- Dose #2 *All Grade 8 students Hepatitis Catch-Up Menactra Catch- Up HPV Catch-Up Timelines Hepatitis Catch-Up Menactra Catch- Up HPV Catch-Up *if a student misses a dose in a previous round, they will be caught up in the following round. Hepatitis Catch-Up Menactra Catch- Up HPV Catch-Up 4

Scheduling Clinics Scheduling Step 1: Peel Public Health will schedule all clinics at your school ahead of time. To ensure a smooth process please assign a Main Contact that the Peel Public Health Immunization Clinics Team can connect with to schedule clinics. Please provide the first and last names of the contacts including their title to the Scheduler. o the Main Contact will communicate with Peel Public Health staff and update the school administrative staff on clinic dates and discussions o If there are issues or concerns, Peel Public Health will communicate with the Principal or Vice- Principal. The Scheduler at Peel Public Health will fax your Main Contact a Clinic Date Confirmation form with proposed clinic date(s). Please return the form by fax with the following information: o Confirm the clinic date if possible, if you need to decline the date please contact the scheduler by phone at 905-791-7800 ext. 2710 or fax back the form requesting a change of date. o Please include the grade 7 (boys & girls) and grade 8 female population numbers expected at your school for the upcoming round. If there are concerns or questions regarding scheduling or logistics please contact us at 905-791-7800 ext. 2710. Step 2: Approximately 1-3 weeks before your scheduled clinic date, a Nurse from Peel Public Health will connect with your Main Contact to confirm details of the upcoming clinic. The following items will be discussed and confirmed via phone, email or in person each round: o Special needs student requirements o Vaccines that will be administered o Number of classes per grade o School hours and break times o Other activities planned on clinic date at the school o Location of clinic within the school (Please see space requirements below) o Preparation needed for clinic location (tables, adult sized chairs, gym mats, garbage cans, electrical outlets, access to a phone, fax and photocopier) o After the clinic details have been discussed please notify your custodial staff of the preparations that will be required for the clinic. o Please list food restrictions or sensitivities at your school for Peel staff o General logistics 5

Clinic Space & Requirements School Based Clinics Each clinic will be staffed by Peel Public Health Nurses and Admin Support Staff. The ideal location for an immunization clinic is a gymnasium or classroom. The clinic location should have a separate entry and exit door to allow for better flow, less disruption and more privacy for students. Safety Requirements Open stages and areas that require stair accesses are not safe for clinics. Falls are a major concern since many students can become dizzy post vaccination. o Stages with solid wall (no curtains) will be considered if there is appropriate lighting and a ramp (no stairs) leading off the stage) o children should not go up or down stairs immediately after immunizations If there are stairs to get to the location for the clinic, we require elevator access for our supplies The clinic location must have adequate lighting Approximately 3 electrical outlets are needed for vaccine and equipment. It is important that there are no other activities in the selected room during the clinic as this can pose a safety risk for both students and clinic staff. It can also create delays and disruptions that may interfere with clinic completion within the allocated time frame. Throughout the clinic day, the clinic team will need to communicate with the school office staff either via phone or 2-way radio about calling classes down etc. Consent forms Consent Forms and Distribution Your School Plays an important role in ensuring consent forms are distributed and returned to the school Nurses cannot administer vaccines without a valid, signed consent form. Please read the following information closely to prevent students from missing their vaccines on the day of clinic. If you receive an inadequate amount of consent forms please call Peel Public Health to request additional forms. There is 1 consent form for both (Hep B & Meningococcal) vaccines for grade 7 students on a single page with a fact sheet attached There is 1 consent form for grade 8 females on a single page with a fact sheet attached Consent forms will be dropped off to each school at the end of August All consent forms are to be distributed to students on the first day of school If a student requires a consent form in French, please contact Peel Public Health Consent form Pick-Up All signed consent forms are to be returned to the school by September 16 th 2015. Consent forms will be picked up from the school beginning September 16th. The Peel Public Health Nurse will connect with the school s Main Contact to negotiate a pick-up date. 6

Each class to use a class list to tick the name of each student that returns consent from home The same class list will be used by Peel staff to verify the consents being picked up The individual picking up consents will need to account for all consents and will require space to count the consents picked up and compare it to the class list. At this time, the staff picking up the consents will also request 2 additional class lists (grid format per class). For grade 8 s, two (2) class list of females only. After the first clinic, any child requiring additional consents should be referred to Peel Public Health. Consent Forms Information requested on the consent form includes: Student information Previous vaccination information Signing yes or no for the vaccine(s) Signature section indicating who is providing consent. Consent forms are required to be signed in order for the student to receive a vaccine. Consent forms can be signed by the following individuals for students under the age of 14 (see list below). Students over the age of 14 may sign their own consent forms. Parent/Step Parent Foster Parent Legal Guardian Grandparent Sibling (over 18) Children s Aid Society Worker (CAS) Handwritten notes and verbal consents over the phone are not acceptable forms of consent. Invalid Consent Forms Consent forms for prior years should not be distributed, please return them to Peel Public Health Forms are invalid if photocopied versions are handed in Students with Special Needs Assessment Questions for Students with Special Needs forms are distributed to each school. It is important that the parents/legal guardians of these students receive this additional form with the consent. This additional form is given to students who are not able to communicate and respond appropriately to the assessment questions asked by the Nurse. 7

Nurses are obligated to assess whether or not it is safe to immunize any student before they can administer vaccines. The purpose of the form is to ensure the nurse has the required information prior to vaccinating the child with special needs The form does not give consent for immunization. A valid consent must accompany the special needs form Before the clinic begins Please ensure the tables, chairs, gym mats, garbage cans are set up prior to the arrival of the team. The team will arrive approximately 30-60 minutes prior to the clinic start time Please inform the Clinic Team of any grade 7 or female grade 8 students that have transferred in or out of your school. They will require the name of the student, the date of birth and the name of the school that the student has moved to or from. During the clinic During the clinic, students are called down by class. Before the Injection The students will be met by a Nurse in the hallway to: o Explain the purpose of the vaccine and where the vaccine is administered. o Advise them to sit in the hallway for 15 minutes after the injection o Answer any other questions the students may have The Teacher should: o Have students bring something to read while waiting prior to and after the immunization. o Wait with the students in the hallway, outside the clinic area o Ensure students remain calm and quiet in the halls During the injection The students will enter the clinic one at a time to meet with a Nurse A Nurse will assess the student and answer any questions the student may have, a translator may be used if necessary. A translator may be a student, parent or staff member at the school. A Nurse will administer the injection should the child require it After the Injection What Happens on The Day of Clinic? The Teacher should: o Ensure students remain seated for 15 minutes in the hallway after receiving the needle. o Ensure the students remain calm and quiet in the halls (e.g. ask them to bring a book to read while waiting) 8

Missed Doses If a student missed a dose of a vaccine in grade 7, Peel Public Health will call them down on clinic day when they are in grade 8 to catch them up. If a grade 8 girl misses her last dose of HPV in grade 8 she will be encouraged to attend one of our Saturday clinics. A flyer will be handed out to these students at the end of the school year. Common reasons for missing a dose of the vaccine are as follows: The student is absent when the clinic takes place The student does not return his/her consent form The student did not receive a consent form initially The student fell ill The student was anxious/nervous and refused the vaccine. Missed doses will be administered at subsequent clinics at your school. For schools with large numbers of students who may have missed the vaccine for various reasons a catch-up clinic at the school may be scheduled There are over 200 schools in the Region of Peel where clinics are held; therefore it is important that we work closely together to minimize the number of students that need a catch-up dose of vaccine. Safety Following Immunizations Students need to be observed for 15 minutes after receiving an injection. This is done to ensure the student is not having a reaction to the vaccine. Although serious reactions are rare, when they occur, they require immediate medical intervention. Since the students must wait for 15 minutes, vaccines must be given at least 15 minutes before breaks, lunches and the end of day. There are no activity restrictions after students have waited the 15 minutes. They can resume their normal activities and are encouraged to move their arms. If a student feels unwell after receiving an immunization If the clinic nurses are still at your school, students who feel unwell should be sent back to the clinic with a buddy. The student will be assessed by a nurse at the clinic. After the nurses have left your school, students who feel unwell should be treated as other students who feel unwell for any medical condition. 9

This should be done based on the policies and procedures of your school. o Contact parents to pick the student up and seek medical attention o for serious medical events arrange for immediate medical intervention Some signs and symptoms of serious adverse events that are considered an emergency may include (but not limited to): o Flushed face, hives and/or itching o Swelling of the eyes, lips, face or tongue o Difficulty breathing Once the student is attended to, report any reactions to Peel Public Health at 905-799-7700. More information can be found on the Region of Peel s websites: www.immunizepeel.ca http://www.peelregion.ca/health/shp/2008/shrg-topics/immunization/index.htm Letter inserts to parents/guardians can be copied and sent home with the consent forms. September (PDF, 1 page) Mid-Year (PDF, 1 page) End of Year (PDF, 1 page) Resources 10

September Immunization News from Peel Public Health Dear Parent/Guardian, Registered Nurses from Peel Public health will be coming into your son/daughter s school between September and June to offer immunizations against three serious diseases. Grade 7 boys and girls will be offered the hepatitis B and meningococcal vaccines. As of July 1, 2014 students 12 years of age and older are required to have meningococcal ACYW-135 or provide a valid exemption. Students that get the vaccine at school will meet this requirement. Grade 8 girls will be offered the human papillomavirus (HPV) vaccine. If you would like to have your child immunized, please complete the consent form that was sent home in September. The school will give the health department the consent form once you return it to the school. For more information regarding immunization please call Peel Public Health at 905-799-7700 or visit www.immunizepeel.ca. 11

Mid Year Immunization News from Peel Public Health Dear Parent/Guardian, Registered Nurses from Peel Public Health will be in your son/daughter s school over the next few months to provide immunizations. Grade 7 students will be receiving the required meningococcal vaccine. Any student that missed a dose of Hep B, meningococcal, or HPV vaccines will receive the dose(s) at subsequent clinics. If you would like your child to be immunized, and you have not signed a consent form, please call Peel Public Health at 905-799-7700. Written consent is required for students to receive the vaccines. For more information regarding immunization please call Peel Public Health at 905-799-7700 or visit www.immunizepeel.ca. 12

End of Year Immunization News from Peel Public Health Dear Parent/Guardian Thank you for a successful year from Peel Public Health Nurses. We have been in the school immunizing students against three serious diseases - hepatitis B, Meningococcal, and human papillomavirus (HPV). If your child missed any doses of these vaccines, or for more information please call Peel Public Health at 905-799-7700 or visit www.immunizepeel.ca 13