Purpose:
To reduce morbidity and mortality from the hepatitis A virus (HAV) infection by vaccinating all adults
who meet the criteria established by the Centers for Disease Control and Prevention's Advisory Committee on
Immunization Practices.
Policy:
Under these standing orders, eligible nurses may vaccinate adults who meet the criteria below.
Procedure
| 1.
|
Identify
all adults in need of vaccination against hepatitis A based on the
following criteria: |
| |
-
anticipated travel to a country with intermediate or high endemicity for hepatitis A (i.e., all except the United States, Canada, Japan, Australia, New Zealand, and Western Europe)
- a male who has sex with other
males
- users of street drugs (injecting
and non-injecting)
- diagnosis of chronic liver
disease, including hepatitis B and C
- diagnosis of a clotting-factor
disorder, such as hemophilia
- employment in a research laboratory requiring work with HAV or HAV-infected primates
- any adult wishing to obtain
immunity
|
| 2.
|
Screen
all patients for contraindications and precautions to hepatitis A
vaccine: |
| |
-
Contraindications: a history of a serious reaction after a previous dose of hepatitis A vaccine or to a hepatitis A vaccine component. For a list of vaccine components, go to
www.cdc.gov/nip/publications/pink/appendices/b/excipient-table-2.pdf
- Precautions: a moderate or severe acute illness with or without fever
|
|
3.
|
Provide all patients with a copy of the most current federal Vaccine Information Statement (VIS). You must
document in the patient's medical record or office log, the publication date of the VIS and the date it was given to the
patient. Provide non-English speaking patients with a copy of the VIS in their native language, if available. These can
be found at www.immunize.org/vis
|
| 4.
|
For patients less than 19 years of age, administer 0.5 mL hepatitis A vaccine and for patients 19 years of age and
older, administer 1.0 mL hepatitis A vaccine. Give vaccine intramuscularly (22–25g, 1–1½" needle) in the deltoid
muscle.
|
| 5.
|
Provide a subsequent dose of hepatitis A vaccine to complete
each patient's 2-dose schedule by observing a minimum interval
of 6 months between the first and second doses.
|
| 6.
|
Document each patient's vaccine administration information and
follow up in the following places: |
| |
-
Medical chart: Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site and route, and the name and title of the person administering the vaccine. If vaccine was not given, record
the reason(s) for non-receipt of the vaccine (e.g., medical contraindication, patient refusal).
- Personal immunization record
card: Record the date of vaccination and the name/location of the
administering clinic.
|
| 7.
|
Be
prepared for management of a medical emergency related to
the administration of vaccine by having a written emergency
medical protocol available, as well as equipment and
medications.
|
| 8. |
Report all adverse reactions to hepatitis A vaccine to the federal Vaccine Adverse Event Reporting System
(VAERS) at www.vaers.hhs.gov or by calling (800) 822-7967. VAERS report forms are available at
www.vaers.hhs.gov |
This policy and procedure shall remain in effect for all patients of the___________________
(name of practice or clinic) until rescinded or
until __________________ (date). Medical
Director's signature: _______________________________ Effective date:
______________
Item
#P3077 (7/06)
www.immunize.org/catg.d/p3077.pdf |
1573
Selby Avenue