School of Pharmacy South African Vaccination and Immunisation Centre

Sefako Makgatho Health Sciences University

Higher Certificate in Vaccinology Qualification

2018 Pharmaceutical Society of Southern Africa Conference Birchwood Hotel and OR Tambo Conference Centre, Boksburg

22 – 24 June 2018

Hannelie (JC) Meyer (BPharm, MSc(Med), PhD)

Email: hannelie.meyer@smu.ac.za

Background

• Vaccination Most cost-effective health care intervention Preventing morbidity and mortality associated with vaccine-

preventable diseases Pillar in prevention of antimicrobial resistance

• Evidence of poor vaccination coverage - Fully immunised under one year old coverage (FIC) South Africa Demographic and Health Survey 2016: 53%

reported1 Hospital-based survey: 55% reported2

• Evidence of poor data quality – discrepancies between figures generated by District Health Information System (DHIS) and World Health Organisation estimates3,4

• Disease outbreaks e.g. measles, diphtheria

Pharmacist’s role in immunisation

• National Health Insurance (NHI)

Prevention of illness

Promotion of health

Multi-disciplinary team approach

• International Pharmaceutical Federation (FIP)5

Promotes the role of the pharmacist as a vaccinator

Need to develop competence

Need to make vaccines more accessible

• Most South African pharmacists have limited training on vaccination

Pharmacist’s role in immunisation

Social mobilisation

Health promotion &

advocacy

Monitoring and evaluation

Reporting accurate statistics

Vaccine Pharma-covigilance

Adverse events following

immunisation

Immunisation administration

Safe administration

practices

Vaccine logistics and cold chain

Supply chain and cold chain

management

Immunisation promotion

Routine/special vaccination Campaigns

Pharmacy legislation Ethical Rule 22

• Currently there is no official required accreditation for pharmacist vaccinators

• According to the South African Pharmacy Council (SAPC) Rules relating to acts or omissions in respect of which the Council may take disciplinary steps, referred to as ‘Ethical Rules”:6

Rule 22: The performance by a pharmacist of professional acts for which he/she is inadequately trained or insufficiently experienced.

Pharmacy legislation 2.14 Minimum standards for immunisation services

… the pharmacist can be actively involved in the following activities:6

a) educating the public and other health care professionals about immunisation;

b) advocating paediatric immunisation;

c) providing immunisation for international travel;

d) screening patients who are at risk of preventable infectious diseases by occupation, life-style or an underlying disease state;

e) administering immunisation agents;

f) recording immunisation data; and

g) using the immunisation database to generate reminder letters for booster doses.

2.14.5 Training6

a) Pharmacists must ensure that they have adequate training, knowledge and skills to provide the service.

b) Pharmacists must be competent in cardio-pulmonary resuscitation techniques.

c) Pharmacists involved in this service must be aware of:

i. the importance of a professional manner;

ii. confidentiality of patient information;

iii. the benefits and risks associated with the use of immunisation agents;

iv. the instructions and requirements of individual vaccines; and

v. the necessity of record keeping.

Pharmacy legislation 2.14 Minimum standards for immunisation services

Need for Higher Certificate in Vaccinology (2014)

National Advisory Group on Immunisation (NAGI) meeting

• NAGI

• National Department of Health

• South African Vaccination and Immunisation Centre (SAVIC) Sefako Makgatho University (SMU)

• Vaccines for Africa (VACFA) (University of Cape Town)

• Amayeza Information Centre

• Sanofi Pasteur

Rationale

• Anyone with qualification in nursing – open-up a private sector clinic and vaccinate, including those qualified many years ago with no recent experience in EPI

• Newly qualified nurses - both private and public sector EPI clinics - not adequately trained

• Training and accreditation of vaccinators for both private and public sectors needed

Proposed HCert (Vaccinology) presented by SAVIC

Multi-stakeholder development of HCert (Vacc) (2015 – 2018)

2015 • Approved at all levels at SMU

2015

• Submitted to the Department of Higher Education and Training (DHET)

May 2016

• Approved by the Department of Higher Education and Training (DHET)

2016 • Registered with the Council for Higher Education (CHE)

Feb 2017

• SMU Institutional Academic Planning Unit successfully applied for Health Professions Council endorsement

June 2018

• Received full accreditation by South African Qualifications Authority (SAQA)

HCert (Vaccinology) Purpose, level & registration

• Purpose: Basic introductory programme for in-service EPI healthcare workers to equip them with the theoretical knowledge and practical expertise necessary for running an up-to-date EPI-SA clinic

• SAQA sub-framework: Higher Education Qualifications

• NQF level and credit value: NQF level 5 (30 weeks; 120 credits)

• Admission requirements: Registered General Nurse and Midwife with the SA Nursing Council, or a qualification in a relevant health science (i.e. in which training in vaccinating is included, e.g. medicine; pharmacy)

• Registration: Students must register for the academic year at the beginning of the year before the closing date, as specified in the SMU General Calendar

Immunisation promotion

Immunisation administration

Vaccine logistics and cold chain

Monitoring & evaluation

Vaccine Pharma-covigilance

Social mobilisation

Higher Certificate (Vaccinology)

Module 7: Cold chain

management

Module 10: Advocacy & social

mobilisation

Module 5: Vaccine preventable

diseases & vaccines

Module 6 & 8: Schedules and safe

admin practices

Module 9: Adverse events following

immunisation

Module 11: Monitoring &

evaluation of EPI

Module 2: Introduction to vaccinology

Module 4: Expanded Programme on Immunisation

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Programme contents and duration

Two blocks consisting of 11 modules over 30 weeks

Block 2 (Modules 6 to 11)

• 14 weeks combined theory and practice

• Final Portfolio of Vaccinology Theory and Practice

End of Year Summative Assessment

End of Week 30

Block 1 (Modules 1 to 5)

• 14 weeks of theory

• Draft Portfolio of Vaccinology Theory and Practice

Mid-Term Formative Assessment

At end of Week 15

Mode of delivery

• Mode of delivery: Mainly online

• Online Learning Management System (LMS): Blackboard

• All modules online, except

Contact sessions: workshops for practical assignments (Modules 6 to 11)

• Automated progression

Through each module

From one module to the next

• Online formative and self-assessment used as important teaching tools

Course materials

• Course materials on Online LMS: Blackboard

• For each module

Study guide

Summary lecture video and transcript

Literature review including PDF journal articles, and links to Internet articles published by agencies such as CDC, WHO and the Vaccine Safety Net

Educational online videos from other universities (i.e. open access lectures) or agencies

Portfolio of Vaccinology Theory and Practice

• Developed throughout the programme

• Enhances learning experience through pre- and post-module assignments and self-assessments

• Allows revision and reflection on learning, which helps to

embed knowledge

increase understanding

allow for application of this knowledge to their vaccinology practices

• Facilitator available (email or telephonically)

HCert (Vaccinology) Practical assignments

• Recognition of prior learning (RPL)

Modules 6 to 11 – include practical assignments based on vaccination practices

Students already competent will submit evidence and be exempt from completing these assignments

• Certificate of practice for each Module

Certificates form part of the Portfolio of Vaccinology Theory and Practice

• Practical training – SMU Skills Centre

Safe vaccination techniques

Sterile injection practices

Alternative options

• Not all pharmacists / healthcare workers want to gain a qualification, but they do want to stay up-to-date in the field of vaccinology

Vaccinology Short Courses – contact

sessions

Certificates of attendance with Continuing Professional Development (CPD) points

accredited by the Health Professions Council of South Africa

On-line individual modules

Contact for more information

Ms Varsetile Nkwinika

Health Programme Coordinator

Tel: +27 12 521 4044 or 3880

Fax: +27 12 521 5794

Email: varsetile@savic.ac.za or info@savic.ac.za

Become a member of the National Vaccinators Forum

Send the following information to vaccinatorforum@gmail.com:

• Name and surname

• Email address

• Name and location of the clinic and/or pharmacy in which you work

References

1. National Department of Health, Statistics South Africa, South African Medical Research Council and ICF. South Africa Demographic and Health Survey 2016. Key Indicator Report. 2017. http://www.statssa.gov.za/publications/Report%2003-00-09/Report%2003-00-092016.pdf.

2. Burnett RJ, Mmoledi G, Ngcobo NJ, Dochez C, Seheri LM, Mphahlele MJ. Impact of vaccine stock-outs on infant vaccination coverage: a hospital-based survey from South Africa. Int Health. 2018 May 11. doi: 10.1093/inthealth/ihy036.

3. World Health Organization. South Africa: expanded programme on immunisation and vaccine preventable disease surveillance. 2017. http://www.afro.who.int/countries/south-Africa.

4. World Health Organization. South Africa: WHO and UNICEF estimates of national immunization coverage: 2016 revision; 2017. http://www.who.int/immunization/monitoring_surveillance/data/zaf.pdf.

5. International Pharmaceutical Federation (FIP). An overview of current pharmacy impact on immunisation A global report 2016. The Hague: International Pharmaceutical Federation; 2016.

6. South African Pharmacy Council (SAPC). Good Pharmacy Practice in SA. 4th edition. 2010.

Twitter: @SMU_PHPM Facebook: SMU Public Health Pharmacy

Department of Public Health Pharmacy and Management

Thank you

South African Vaccination and Immunisation Centre

Visit: http://www.savic.ac.za/ Twitter: @SAVICinfo Facebook: SAVICinfo