| Vaccination
of Public Health and Health Care Response Personnel |
- The
timeline for accomplishing vaccination of core smallpox public
health response teams and medical care teams has accelerated
due to the concern for potential use of biological weapons.
- The
CDC requires that every state submit preparedness smallpox vaccination
plans by December 9, 2002.
- Vaccination
of public health care workers in New Jersey will be voluntary
and will not be required as a condition of employment.
|
| Stages
of Preparedness Smallpox Vaccination |
| The
federal Government is considering that vaccination against smallpox
in the absence of an intentional release of smallpox (preparedness
vaccination) proceed in three stages. They are as follows: |
- The
first stage is intended for approximately 500,000 health care
workers nationally (up to 15,000 in New Jersey), those based
in acute care hospitals where a case of smallpox might be admitted
and those who are part of public health response teams.
- The
second stage would expand the offer of preparedness vaccination
to 10 million health care and public safety workers nationally.
- In
the third stage, newly licensed vaccine would be offered to
the US general population (anticipated in 2004).
|
| Rationale
for Smallpox Vaccination |
| Preparedness
smallpox vaccination of certain categories of healthcare workers
is strongly encouraged for several reasons: |
- It
is likely that any initial case(s) of smallpox may be unsuspected
and take some time to be recognized and diagnosed.
- Vaccination
and appropriate use of personal protective equipment are the
only ways that healthcare workers can be protected against any
confirmed case of smallpox.
- In
a small percentage of persons, initial vaccination may not "take".
Preparedness vaccination enables re-vaccination of those without
a "take" before they are at risk of exposure.
|
| Public
Health Response Team (PHRT) and Five Regional Vaccination Clinic
Sites |
- New
Jersey will have five PHRTs and clinic sites. The five regional
sites will be located in the North East, North West, Central
East, Central West and Southern parts of the state. An additional
clinic will be in Newark, a Metropolitan Medical Response System
site.
- Each
team will consist of both NJDHSS and LINCS agency personnel
and will include but not be limited to:
- Physician
Team Leader (NJDHSS)
- Epidemiologist
(LINCS)
- Public
Health Nurse/Vaccinator (LINCS)
- Laboratory
Worker (NJDHSS)
- Law
Enforcement Agent (State Police)
- Regional
Planner/Coordinator (NJDHSS)
- LINCS
Planner/Coordinator (NJDHSS)
- Industrial
Hygienist (NJDHSS)
- The
five region sites will be staffed by NJDHSS, LINCS, and local
health departments' staff.
- The
first stage of vaccination will be administered at the six clinic
sites using the NJ Smallpox Vaccination Data Management System.
Follow-up evaluation will be conducted seven days after vaccination
at the clinic sites to evaluate vaccination take and to assess
any adverse events.
|
| Hospital
Health Care Response Teams (HHCRT) |
- Based
on guidance from CDC, the MEDPREP/Terrorism Advisory Committee,
the Infectious Disease Society of New Jersey and the Advisory
Committee on Immunization Practices (ACIP), NJDHSS recommends
that all 85 acute care hospitals have a core team of healthcare
workers pre-identified who would care for a smallpox patient
admitted to their facility.
- During
December 2002, hospitals will begin the process of identifying
potential healthcare workers within these groups who are eligible
for vaccination and would consider participating in preparedness
vaccination to become part of the HHCRT.
- The
team should include sufficient inpatient staffing to take care
of an adult or pediatric patient requiring intensive care for
7 days.
- In
addition, there is a "vaccinator/occupational health"
category. This includes nursing and employee health staff who
would be involved in monitoring vaccinees, changing dressings,
and potentially assuming a lead role in vaccination should smallpox
occur. The team should include a significant number of emergency
department staff.
- Approximately
up to 150 personnel at each hospital should be members of their
HHCRT and will be vaccinated at one of the six vaccination clinics.
- The
following list shows the suggested composition the HHCRT for
each hospital.
- Healthcare
Worker Positions:
- ED
Nurse
- ED
Physician/PA/NP
- ED
Technicians
- Intensive
Care Unit staff
- Housekeeping/laundry
staff
- Security
staff
- Respiratory
therapy staff
- Infection
control staff
- Lab
workers
- Sub-specialists:
Pulmonologist, Dermatologist, Ophthalmologist, ID Specialist,
Pediatrician, Adult Intensivist, Neprologist
- Engineering/HVAC
- Vaccinators/Occupational
Health
- Radiology
technicians
- Dialysis
nurse
|
| Timelines |
- Clinic
staff will be trained on all aspects of clinic operations during
the first two weeks of January 2003.
- During
the first week of the implementation phase, a clinic will be
established to vaccinate the PHRTs and the clinic staff from
the six sites.
- Each
regional clinic will conduct 2 - 4 clinic sessions over a period
of approximately four weeks to vaccinate HHCRTs during the Implementation
Phase.
- Approximately
2,700 - 3,600 individuals will be vaccinated weekly.
- Clinic
site staff will be responsible for coordinating scheduling with
hospitals and other agencies.
|
| Vaccine
Safety Monitoring, Reporting, Treatment and Patient Referral |
- NJDHSS
will follow the protocol for vaccine monitoring, reporting,
treatment and referral as outlined in the Supplemental Guidance
for Planning and Implementing the National Smallpox Vaccination
Program (NSVP).
- The
NJDHSS will coordinate training.
- NJDHSS
will utilize the New Jersey Smallpox Vaccination Data Management
System and provide appropriate data to the CDC's Pre-Event Vaccination
System.
|
