Purpose
To reduce morbidity and mortality from meningococcal disease 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 any of the criteria below.
Procedure
| 1.
|
Identify
adults in need of vaccination against meningococcal disease based
on any of the following criteria: |
| |
-
anticipated college enrollment, particularly
anticipated residence in an on-campus dormitory
- anticipated travel to a country
in the "meningitis belt" of sub-Saharan Africa or other location
of epidemic meningococcal disease, particularly if contact with
the local population will be prolonged
- anticipated travel to Mecca,
Saudi Arabia, for the annual Hajj
- diagnosis of a damaged spleen; splenectomy
- diagnosis of terminal complement
component deficiency (an immune system disorder)
- employment as a microbiologist with routine exposure to isolates of
N. meningitidis
- military recruits
- any other adult wishing to
decrease their risk for meningococcal disease
- age 55 years or younger with history of receiving
meningococcal polysaccharide vaccine
(MPSV4) at least
5 years earlier with continued risk for infection (e.g., living in epidemic disease areas).
|
| 2.
|
Screen
all patients for contraindications and precautions to
meningococcal vaccine: |
| |
- Contraindications: a history of a serious reaction (e.g., anaphylaxis) after a previous dose of
meningococcal vaccine or to a meningococcal vaccine component, including diphtheria toxoid for
meningococcal conjugate vaccine (MCV4). For a list of vaccine components, go to
www.cdc.gov/nip/publications/pink/appendices/b/excipient-table-2.pdf.
- Precautions: 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). Although
not required by federal law, it is prudent to 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
adults ages 55 years and younger, administer 0.5 mL MCV4 via
the intramuscular route (22–25g, 1–1 1/2" needle) in the
deltoid muscle. If MCV4 is unavailable, MPSV4 is an acceptable
alternative, although it must be given subcutaneously. For
adults older than age 55 years, administer 0.5 mL MPSV4 via
the subcutaneous route (23–25g, 5/8" needle) in the
posterolateral section of the upper arm.
|
| 5.
|
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.
|
| 6.
|
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.
|
| 7.
|
Report all adverse reactions to meningococcal vaccine to the
federal Vaccine Adverse Event Reporting System (VAERS) at
www.vaers.hhs.gov or (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___________________
clinic or practice until rescinded or
until __________________ (date). Medical
Director's signature: _______________________________ Effective date:
______________
Item
#P3081 (5/06)
www.immunize.org/catg.d/p3081.pdf |
1573
Selby Avenue