Appendix 29. Vaccination team member roles

See Toolbox

Crowd control

– To inform the population: age groups targeted, vaccination site hours and number of vaccination days, availability of water.
− To organise the influx of people and the queue.
− To check the age (no vaccination before age 6 months).
− To move the people to be vaccinated toward the registrars.
− To maintain order.
− To inform the team leader in case of difficulty.

Registrar

– To prepare the equipment and supplies: table and chairs, cards, pens, date stamp and inking pad.
− To pre-stamp or write the dates on the vaccination cards, along with other necessary information (lot number).
− To ask the person accompanying the child for the information needed to fill out the vaccination card:
• last and first name;
• age in months (if under 1 year) or years;
• address.
– To write legibly in pen.
− To give the card to the person accompanying the child, stressing the importance of keeping the card and presenting it at each health centre visit.
− At the end of the day: to tidy up.

Vitamin A dispenser

– To prepare the equipment and supplies: table and chair, vitamin A, needle and hand towel.
− To check the child’s age to determine the appropriate dose (vaccination card):
• Age 6 to 11 months: 4 drops from the capsule, then discard it;
• Age 1 to 5 years: 8 drops (a whole capsule).
– To ask the person accompanying the child for help and to explain what is being administered.
− For children age 6-11 months: to take a capsule, puncture it with a needle and administer the dose.
− To make sure that the child swallows the dose (and if the child spits it out, to give another dose).
− To wash hands often.
− At the end of the day: to tidy up.

Preparer

– To give the registrars the lot number of the vaccine at the beginning of the day.
− To set up in a calm location, in the shade, near the vaccinator.
− To set up the work table with the equipment and supplies: table and chair, cold box with vaccines and diluents, vaccine carrier, injection supplies, etc.
− To prepare the sharps containers according to the procedure.
− To check the cold chain on a regular basis: cold box and vaccine carrier temperatures.
− To reconstitute the vaccine:
• checking the vaccine name, the diluent, the expiry date, the appearance of the vaccine and diluent (colour, clarity) and the vaccine vial monitor (VVM);
• using aseptic technique;
• diluting only one vial of vaccine with one vial of diluent at a time;
• storing the reconstituted vaccine in the slits in the vaccine carrier’s foam pad;
• discarding the syringe with the needle in the sharps container after reconstitution;
• placing the used vaccine and diluent vials into separate buckets with lids.
– To fill the auto-disable syringes with the reconstituted vaccine according to the recommended procedure and then give it to the vaccinator.
− To wash hands often.
− At the end of the day:
• to dispose of unused reconstituted vaccine, which is NEVER USED THE NEXT DAY;
• with the vaccinator, to count the remaining supplies, vaccines and diluents;
• to tidy up and clean the site and package the waste for transport.

Vaccinator

– To set up near the preparers, in the shade.
− To set up the equipment and check that all supplies are present: vaccine carrier, gloves, kidney dish, trash bags and sharps container.
− To wear gloves and change them regularly (every 50 vaccinations), and to wash hands with each change of gloves.
− To explain to the accompanying person how to hold the child. To ask for help, if necessary.
− To clean the injection site with cotton wool and clean water.
− To inject the vaccine in accordance with injection technique and aseptic technique.
− To discard the used syringe directly into the safety box located close by, out of the flow of people traffic. To never re-cap the needle.
− To direct the people to the recorder.
− At the end of the day:
• to close the safety box in accordance with safety rules;
• to count the number of vaccine and diluent vials and enter them on the tally sheet, check the VVMs and count the remaining supplies;
• to tidy up and clean the site and package the waste for transport.

Recorder

– To set up after the vaccinator.
− To arrange the work table with the supplies: table and chair, tally sheets, pens, etc.
− To fill in the general information on the tally sheet: team, location, date, lot number, etc.
− To check the age on the vaccination card.
− To make a tick mark in the appropriate age column.
− At the end of the day:
• to total up by age group and overall;
• to give the tally sheet to the team leader/supervisor;
• to tidy up.

Vaccination team leader

If there is no team leader, these duties are distributed among the team members, subject to the supervisor’s approval.
The team leader is familiar with the campaign process and its practical organisation.

Every morning
– To take delivery of and verify the supplies received (quantities).
− To verify that the site is clean and well-organised:
• there are shaded areas for waiting and the team;
• the flow path is well-marked and each station arranged correctly.
– To make sure that everyone is at his station.
− To check that the cold chain supplies are protected from the sun.
− To designate a waste storage location, out of reach of the population.

Before the vaccination session starts
– To make sure that the crowd control people are carrying out their duties: messages to broadcast, target age group and organisation of the flow path.
− To make sure that the registrars have filled in a certain number of cards ahead of time.
− To make sure that the preparers have started reconstituting vaccine.
− To make sure that the recorder has filled in the general information on the tally sheet: team, location, date, lot number, etc.

During the vaccination session
– To ensure the smooth flow of people (no excessive waiting at each station).
− To check the quality of each person’s work.
− To check the quality of the recording (reliability of the immunisation coverage calculation).
− To check the cold chain.
− In case of difficulty, to immediately inform the supervisor or the logistician, depending on the need.

At the end of the day
– To collect and check the tally sheets and calculate the coverage, the vaccine utilisation rate and the supplies used.
− To check the cold chain.
− To make sure the site is tidied up and clean.
− To check that the waste has been collected in accordance with the safety rules and given to the logistician in charge of collection.
− To review the day with the team: results obtained, strengths and difficulties, suggestions for improvement. To thank the team.
− To take stock with the supervisor: analyse and assess the day’s results, corrective measures suggested and necessary means.