|Date: _____________________________||Name: ___________________________________|
|Location/site: ______________________||Team: ____________________________________|
Write any additional comments or information at the end of this document.
Information and social mobilisation
The site is clearly identified (banner, other).
Informational messages are announced regularly at the site: vaccine, target, vaccination card, duration, etc. (megaphone, other).
The registrars inform the people accompanying children about the vaccination, including potential adverse effects and what to do about them.
After recording, the people accompanying children are informed of the importance of routine immunisation follow-up (EPI target groups).
The population covered by the site knows the target population, the vaccine and the dates of the campaign.
Vaccination site organisation
The site is well laid-out with organised queues and smooth traffic flow.
The flow path is logical (sorting, information, registration, vaccination and recording).
|Equipment is out of the public’s reach.|
|The vaccination team is complete.|
|Availability of vaccines, renewable supplies and equipment|
|There is a full complement of equipment (tables, chairs, benches, etc.).|
|The injection supplies and vaccines received are counted and the information copied onto the tally sheet at the beginning of the day.|
|The Equipment for one vaccination team module is complete.|
|There are enough vaccine doses for the day.|
The amounts of vaccine and diluent in the cold box match up.
There are corresponding quantities of injection supplies available (reconstitution syringes and needles, ADSs and sharps containers).
|Quality of activities|
|1. Cold chain|
|There is a full complement of cold chain equipment (1 cold box + thermometer, 1 vaccine carrier).|
|The number of ice packs is the recommended amount.|
|The storage temperature is appropriate.|
There are no vaccines whose VVM indicates heat damage (otherwise, specify how many).
|2. Vaccine reconstitution|
|Vaccines and diluents are checked (name, expiry date, appearance, VVM).|
|The diluent used corresponds to the vaccine (supplied by the same manufacturer).|
Vaccines and diluents are the same temperature at the time of reconstitution (between +2 and +8 °C).
|Reconstitution is performed with ONE syringe and ONE needle for each vial.|
After each vial is reconstituted, the injection supplies are discarded in the safety box.
The vial of reconstituted vaccine is stored in the slit in the vaccine carrier’s foam pad.
|3. Syringe (ADS) preparation|
|Aseptic technique is followed.|
|The syringes are purged.|
|The syringes contain exactly 0.5 ml.|
|The prepared syringes are given directly to the vaccinator.|
|The pace of preparation is appropriate to the flow of people to be vaccinated.|
The team is well-organised (see diagram); preparer/vaccinator coordination is good.
|Unused vials of reconstituted vaccine are disposed of at the end of the day.|
|4. Use of safety boxes|
All reconstitution syringes/needles and ADSs are thrown into safety boxes immediately after use, without recapping.
|The quantity of syringes disposed of in the safety box does not exceed the fill limit.|
|The full safety boxes are stored in an area out of the public’s reach.|
|5. Waste transport|
|Waste is transported to the storage and disposal site at the end of the day.|
|The person who transports the waste to the disposal area wears thick gloves.|
|Registration and data collection|
|General information (team, location, date, etc.) on the tally sheet is complete.|
|Everyone vaccinated is tallied correctly in their age group.|
|Totals are done and calculations checked at the end of the day.|
|Supplies are counted and the status of the VVMs copied onto the tally sheet.|
Tally sheets are collected and verified (total vaccinations, vaccines and utilisation rate, VVM status and injection supplies).
|The site is tidied up and cleaned by the team.|
|The waste is packaged for transport and stored in a protected area.|
There is a quick assessment of the day with the team at the site (results shared, difficulties encountered, things to improve, solutions, thanks for the work done).