Patient Group Direction for Varicella vaccine Version: Varicella Start Date: 1 st May 2014 Expiry Date: 30 th April 2017

Transcription

1 Patient Group Direction for Varicella vaccine Version: Varicella Start Date: 1 st May 2014 Expiry Date: 30 th April 2017 THIS PATIENT GROUP DIRECTION HAS BEEN AGREED BY THE FOLLOWING ORGANISATIONS: BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST CUMBRIA PARTNERSHIP NHS FOUNDATION TRUST EAST LANCASHIRE HOSPITALS NHS TRUST LANCASHIRE CARE NHS FOUNDATION TRUST NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST CLINICAL COMMISSIONING GROUPS: BLACKBURN WITH DARWEN BLACKPOOL CHORLEY AND SOUTH RIBBLE EAST LANCASHIRE FYLDE AND WYRE GREATER PRESTON LANCASHIRE NORTH WEST LANCASHIRE Change history Version number Change details Date Varicella Review April 2014 [Type text]

2 CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR VERSION: Varicella (Page 1 of 4) Patient Group Direction Details Date comes into effect 1 st May 2014 Date of expiry + review 30 th April 2017 or sooner in the light of significant changes in best practice Staff characteristics Registered nurse or Pharmacist employed by the NHS organisations above or independent contractors within them, who has completed immunisation and vaccination training (theoretical and practical) as per local policy, training in the recognition and treatment of anaphylaxis, including practical training in Basic Life Support (annual practice update session to be undertaken) and working under PGDs. Access to adrenaline and access to the complete updated relevant chapters in the current edition of the Green Book Immunisation against Infectious Disease. >> YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION << >> OF THIS PGD BEFORE WORKING UNDER IT << Clinical Details Indication Inclusion criteria This PGD is to be followed by all nurses and pharmacists who carry out immunisations in hospitals, clinics, schools, surgeries, patients homes or other locations. Facilities for treating anaphylaxis must be available. To protect those who are at most risk of serious illness caused by Varicella infection by immunising specific individuals who are in regular contact or close contact with those at risk. Pre Exposure Vaccination: Sero negative health care workers at risk of developing chicken pox (Varicella Zoster virus). Laboratory staff that may be exposed to varicella virus in the course of their work. Contacts of immunocompromised patients e.g. siblings of a child with leukaemia. Post Exposure Prophylaxis: Unvaccinated healthcare workers without a definite history of chicken pox or zoster and having a significant exposure to Varicella Zoster Virus. See Green Book. Exclusion criteria Confirmed anaphylactic reaction to any component or a preceding dose of Varicella vaccine. Precautions Management of excluded patients Action for patients not wishing/unable to receive care under this PGD Check the manufacturers information prior to administration of any vaccine/immunoglobulin re its latex content. If latex is a component of the vaccine/immunoglobulin or the administration system (e.g. vial or syringe etc.) then a latex-free alternative must be offered to patients with latex sensitivity. Absence of valid consent Aged under 1 year Pregnancy. Immunosuppressed patients. Family history of congenital/hereditary immunodeficiency unless immune competency of the individual is demonstrated. Patients under 16 years of age who are receiving aspirin or other salicylatecontaining medication under medical supervision due to theoretical risk of Reye s syndrome. Immunisation must be postponed in those patients with acute febrile illness. Patients who have received immunoglobulin or blood transfusion in the last 3 months (5 months for Varivax ) - delay vaccination because of the likelihood of vaccine failure due to passively acquired antibody to the varicella virus. Active untreated tuberculosis (Varivax only). Blood dyscrasias, leukaemia, lymphomas (Varivax only). Any patient treated with Varicella-Zoster Immunoglobulin within the preceding 3 months. Any patient treated with a live vaccine within the preceding 4 weeks Immunisation must be postponed in patients with acute febrile illness/infection. Give information about when the vaccine may be given or give a further appointment to attend for vaccination, or in the case of a previous severe allergic reaction be referred to the appropriate medical officer, e.g. CMO, GP Make patient aware of alternative, risks and potential consequences of not being vaccinated. Document refusal.

3 CLINICAL CONTENT OF PATIENT GROUP DIRECTION FOR VERSION: Varicella (Page 2 of 4) Description of Treatment Name of medicine Varicella-zoster vaccine:varilrix or Varivax Formulation and route Varilrix - deep subcutaneous injection in the deltoid region or anterolateral thigh. Varivax - given by injection either intramuscularly (IM) or deep subcutaneously (SC) Prepare as per manufacturers instructions. Strength Not applicable Dosage 0.5ml Repeated dose Pre - exposure vaccine instructions All individuals aged one year and older should receive two doses of varicella vaccine, 4-8 weeks apart. Post exposure prophylaxis Varivax -(Dosage as above) may be given up to 5 days post-exposure. Duration of treatment As above Quantity to supply See above Legal status Prescription only medicine (POM) Special Precautions DO NOT give intravascularly or intradermaly. If vaccinee comes into contact with a case of chickenpox or shingles before both doses have been given or within about six weeks after the second dose, the vaccine may not be able to prevent chickenpox. Vaccinees MUST avoid close contact with susceptible high-risk individuals for 6 weeks if they develop a cutaneous rash and maintain avoidance until it has completely disappeared. Vaccinees should try and avoid close contact even in the absence of a rash. Varicella Zoster Immunoglobulin (VZIG) or other immunoglobulin s should be avoided for 1 month after vaccination unless considered essential. Other live vaccines may be given concomitantly if required; otherwise one month should elapse between vaccination with live vaccines. Any patient who develops a rash post vaccination should be advised to return to their health care provider. Up to 10% of adults and 5% of children develop a vaccine-associated rash within one month of immunisation. The rash maybe papular or vesicular. It is important to determine whether the rash is due to the vaccine or to coincidental wild-type chickenpox. Samples from rashes following vaccine should be sent for analysis to the HPA Varicella Zoster Reference Service at Barts and the London NHS Trust Explain indications, contraindications and cautions (refer to Green Book) Adverse effects Most common side effects are pain, redness and swelling at injection site. Other reactions may include-tiredness, raised temperature, headache, rash. Severe reactions are rare. This list is not exhaustive. Refer to BNF and SPC for complete list. If noted, complete & submit a Yellow Card via For drugs - Report all suspected adverse drug reactions For up to date SPCs and PILs Advice necessary Ensure that the patient information leaflet is available & offered to every patient/parent/guardian. Advice on the prevention and management of fever and local reactions and other adverse effects. Avoid use of salicylates for 6 weeks after vaccination. The patient should avoid pregnancy between the 2 doses and for 3 months after the second dose. May also need to undergo pregnancy testing prior to vaccination. Common post-vaccination adverse effects. Date of next vaccination as required. Records and Follow Up Referral arrangements Records to be kept Follow up Prior to vaccinating, any health professional administering a vaccination must be able to identify and contact an appropriate medical officer, e.g. CMO, consultant paediatrician, GP, as necessary, e.g. in the case of an immunocompromised child. As per local documentation requirements. Record the brand name of the vaccine given, date and time of administration, batch number, expiry date and immunisation site and route, supply/administration under PGD. Document any reaction in patient s medical notes. Subsequent vaccination as required as per UK schedule Patient Group Direction, organisation and individual authorisation signatures can be found on the managerial content sheet along with other non-clinical details relating to this patient group direction.

4 MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR Patient Group Direction Owner Details of Patient Group Direction owner Patient Group Direction Details VERSION: Varicella (Page 3 of 4) Name: Martin Samangaya Position: Screening and Immunisation Manager Contact Address: Public Health England, Lancashire Area Team Contact Telephone: Contact msamangaya@nhs.net Date comes into effect 1 st May 2014 Date of expiry + review 30 th April 2017 or sooner in the light of significant changes in best practice Staff characteristics Registered nurse or Pharmacist employed by the NHS organisations above or independent contractors within them, who has completed immunisation and vaccination training (theoretical and practical) as per local policy, training in the recognition and treatment of anaphylaxis, including practical training in Basic Life Support (annual practice update session to be undertaken) and working under PGDs. Access to adrenaline and access to the complete updated relevant chapters in the current edition of the Green Book Immunisation against Infectious Disease. Patient Group Direction Authorisation Lead Doctor >> YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION << >> OF THIS PGD BEFORE WORKING UNDER IT << Name: Dr Steven Gee Position: Consultant in Health Protection, C&LPHEC Lead Pharmacist Lead Nurse Organisational Authorisation for Lancashire CCGs by Organisational Authorisation by Signature: Date: 07/04/2014 Name: Julie Lonsdale Position: Head of Medicines Performance, Staffordshire and Lancashire CSU Signature: Date: 07/04/2014 Name: Ms Kate Brierley Position: Consultant Nurse Health Protection, C&LPHEC Signature: Date: 07/04/2014 Name: Dr J Gardner Position: Medical Director, Lancashire Area Team, NHS England Signature: Name: Position: Date:07/04/2014 Authorisation by Independant Contractor (for PGDs being used by the staff of Independant Contractors only) Signature: Name: Position: Signature: Patient Group Direction Peer Reviewed By Name Position Signature Date Cumbria and Lancashire Vaccine PGD Sub-Group (on behalf of group) Date: Date:

5 MANAGERIAL CONTENT OF PATIENT GROUP DIRECTION FOR Individual Authorisation VERSION: Varicella (Page 4 of 4) BY SIGNING THIS PATIENT GROUP DIRECTION YOU ARE INDICATING THAT YOU AGREE TO ITS CONTENTS AND THAT YOU WILL WORK WITHIN IT PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY IT IS THE RESPONSIBILITY OF EACH PROFESSIONAL TO PRACTICE ONLY WITHIN THE BOUNDS OF THEIR OWN COMPETENCE IF THIS IS AN UPDATED OR REPLACEMENT PGD ENSURE THAT ALL OLDER VERSIONS ARE WITHDRAWN FROM USE WITH IMMEDIATE EFFECT IT IS YOUR REPONSIBILITY TO MAKE SURE YOU ARE USING THE CURRENT VERSION NOTE TO AUTHORISING MANAGERS: AUTHORISED STAFF SHOULD BE PROVIDED WITH AN INDIVIDUAL COPY OF THE CLINICAL CONTENT OF THE PGD AND A PHOTOCOPY OF THE AUTHORISATION SHEET SHOWING THEIR AUTHORISATION Name of Professional Signature Authorising Manager Date

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