Posted: June 27th, 2015

A vaccination program

Introduction

Influenza has been identified as one of the most common diseases affecting children. The symptoms for the disease include headache, fever, and pain in the body. Among the children victims, they may also experience nausea and vomiting. Influenza is associated with considerable illnesses among children. In Australia, influenza accounts for most of the hospitalization for diseases that can be prevented through vaccination. It has been established that young individuals stand a high chance of contracting influenza compared to adults. Notably, about 70 per cent of the children contact influenza whenever there is a pandemic. Having noted that influenza incidences are high among children, it is possible that children account for most of the transmission of the disease within the society. It has been estimated that about 1500 children in Australia are hospitalized every year due to influenza (Newell and Scuffham, 2008). There are numerous ways in which influenza can be controlled among children. Nonetheless, vaccination of the children has been identified as the most effective way of managing the condition. The other ways of reducing the risk of contracting influenza involves maintaining personal hygiene and avoiding crowded places especially during the times when influenza is prevalent. Since it is difficult for children to observe hygiene and avoid crowded areas, vaccination remains the best option in reducing influenza incidences among children. This paper presents a vaccination program that will be carried out among Australia’s school going children. The focus will be on the public schools within the Northern Territory State. The programme shall be developed right from the initiation phase to completion. The vaccination program is set to be implemented within a certain timeline and budget.

Influenza

Influenza, also known as “the flu” can be described as an acute viral disease of the respiratory system. This disease has various symptoms including muscle pains, fever, and headaches among others. In most instances, influenza is often self-limiting. Nonetheless, this condition can lead to severe and life threatening illnesses that may require hospitalisation. Many people have confused influenza with other respiratory complications such as a bad cold. However, the two complications are distinctly different. The table below indicates the differences between influenza and cold:

Influenza viruses include the orthomyxoviruses that are categorised based on the antigens as A, B and C. The most common form of influenza is A. This form of influenza is usually related to severe forms of the disease, and is occurs in large waves. On the other hand, influenza B occurs in small outbreaks. There are virus strains that have been observed in the influenza causing pathogens. There are two types of proteins found on the viruses that cause influenza. These proteins are often referred to as the haemagglutinin (H) and neuraminidase (N) antigens. These proteins get altered to form new strains of the viruses in a process known as “antigenic drift”. When there is a significant change in the structure of the virus, this is called “antigenic shift”. There are two forms of influenza A that are currently in circulation around the world. These include the A(H1N1) and A(H3N2). It has been noted that those at a great risk of influenza include those who have pre-existing medical conditions like heart disease among others. Nonetheless, incidences of severe complications from influenza have been reported among healthy individuals. Pneumonia and myocarditis have been known to emanate from influenza infection (Treanor, 2010).

Transmission

Influenza is an airborne disease. In this case, the disease is spread through sneezing and coughing. It can be argued that influenza viruses are spread through droplets that can be found on surfaces thereby being able to be passed from one person to another. Notably, those individuals suffering from influenza are said to be infectious starting from a day before they show any symptom. They may also continue to be in factious for several days once the symptoms show up. However, the infectiousness of these individuals diminishes as time lapses. It has been noted that influenza is quite common among children where between 10 and 40 per cent get infected annually. Also, about one per cent of the infected children end up being hospitalised (Treanor, 2010).

Diagnosis

Diagnosis of influenza is done through collecting a nose or throat swab, or collecting blood samples for analysis. When then throat or nose approach is used, the test should be done in less than three days after the symptoms are exhibited. These tests are normally carried out in a hospital setting on individuals who are suspected to be suffering from the condition.

Treatment and prevention

Influenza treatment is aimed at minimising and preventing symptoms. In most instances, treatment involves bed rest, high fluid intake, and use of pain relieving medicine like aspirin. The use of anti-viral medication can also be adopted. This helps in reducing the severity and duration of symptoms of the condition. However, the antiviral medication should be administered within 48 hours after the symptoms are exhibited (Treanor, 2010). Influenza can be prevented through two ways. The first one is through prevention of contact with the infected person. The other way is through vaccination. Vaccination has been identified as the best strategy to prevent infection. This is especially among the children who may find it difficult to observe the stringent measure in an effort to prevent the contraction of the disease.

Epidemiology

Influenza is a seasonal illness that occurs during the cold weather conditions. In Australia, the condition is prevalent during the winter period, especially during the June and September. The condition is reportedly accountable for over 80 deaths and about 4000 hospitalisation in Australia annually. These figures are conservative as the influenza cases are likely to surpass the estimates. Historically, there have been various influenza outbreaks. These include the 1918 Spanish flu, the 1957 Asian flu, and the 1968-9 Hong Kong flu. These historical influenza outbreaks led to disastrous outcomes where high mortality was reported (Block, 2004).

Influenza vaccination among children

It is recommended that influenza vaccination should be carried out among individuals who are at least six months old. This is important as it reduces the chance of these individuals contracting influenza. For children who are ≥6 months old, it is advisable for them to be vaccinated each year. This is for as long as they do not have a medical contraindication to the immunisation. For children who are ≤9 years of age, and have never received the influenza vaccine before, the immunisation should be administered in double dosage. The administration of the dosage should be done within a span of four weeks. For children who are between ≥6 months and <3 years of age, a smaller dosage of the vaccine is administered compared to that administered to older children and adults. The common influenza vaccines should not be used in the immunisation of children who are <6 months. These include the Fluvax and Fluvax Junior (CSL) vaccines. The 2011 seasonal vaccine includes the H1N1 influenza A strain vaccine. Essentially, children who are 6 months to <5 years of age must not be immunised using the 2011 Fluvax vaccine. Notably, children should be immunised using the seasonal influenza vaccine that is suitable for their age.

Influenza vaccination should not be carried out among children who are <6 months of age. Also, vaccination should not be carried out among children who have experienced anaphylaxis when an influenza vaccine was administered in the past. Children who are aged between six months and less than five years should not be given the 2011 Fluvax influenza vaccine. This is because this vaccine is not appropriate for this age group. In Australia, the available influenza vaccines include the split virion and subunit vaccines. These vaccines are derived from embryonated hens’ eggs. The vaccines may have bits of egg proteins. Most influenza vaccines comprise some elements of antibiotics. In most instances, influenza vaccines have the various strains of the virus (Bridges, et al, 2008).

Preparing a School Based Influenza Vaccination Program

Initiating the process

This is a critical stage for any program that is to be implemented. Having realised that influenza is a very common disease among Australian children; a vaccination program should be initiated to address the issue. In this respect, there are various elements that should be observed. The first one is the clarification of the purpose and justification of the vaccination programme. Secondly, the needs of the stakeholders should be analysed. It is also important to determine the broad scope of the vaccination programme. Establishment of clear and shared project objectives is also critical. In addition, the governance structures for the vaccination program have to be established. All these aspects have to be documented as a project proposal.

In respect to the purpose and justification of the vaccination programme, it is important for the two aspects to be clearly outlined. This is important to ensure that the time, cost and quality of the programme are not compromised. Influenza has been identified as one of the most common ailments affecting children. This is the case all over the world including Australia. Since vaccination has been identified as the most appropriate method of managing the condition, the program should be carried out in Australian schools. The reasons for carrying out the influenza vaccination programme are varied. It has been noted that influenza causes serious illnesses such as pneumonia. In some incidences, these illnesses may require hospitalisation or lead to death of the victims in worst scenarios. Although influenza is common among individuals with pre-existing medical conditions, healthy people are not immune to this condition. Therefore, vaccination stands out as the best method that can be adopted in protecting individuals against influenza especially among children. According to research, there are new strains of the disease that are emerging. Therefore, vaccination should be carried out frequently to ensure that individuals are continuously protected from influenza.

Influenza vaccinations are recommended for children aged between 6 months and 18 years. This includes school-aged children, and the vaccination program can be essential in helping to reduce the rate of absenteeism among school-going children. It has been identified that school-based vaccination programs are the best in achieving established immunization goals and objectives. Such programmes have been identified as the most practical and effective (Cawley, Hull and Rousculp, 2010).

Liaising with the school

The principals of slightly over 60 primary public schools the Northern Territory State, who will participate in the vaccination program, shall be contacted. This will be done before the start of the new academic year in order to discuss the implementation of the program in the next year. The vaccination program is set to start in the month of February after the schools open for the new academic year. The vaccination program will run for four months. The vaccine will be administered in the evening after classes to avoid interfering with the usual school program, and will last for a quarter an hour.

1. Objectives

The objectives of this vaccination program include the following:

• Ensure that school going children under the age of fifteen are immunised against influenza.
• Sensitise parents on the importance of vaccination against influenza.
• Establish a close working relationship among the various stakeholders in promoting child health.

2. Scope, Constraints, Assumptions

3. Work Breakdown Structure (WBS)

A work breakdown structure is defined as a chart that is critical during the brainstorming of activities that will have to be accomplished. This tool is critical in developing estimations, assigning the staffs, tracking of the programme’s progression, and showing the scope of the programme. In essence, this tool is critical in breaking the work into small tasks that can be managed effectively. For the influenza vaccination programme, the work breakdown structure will appear as shown below:

4. Timeline

This vaccination program is set to take a period of four months. Therefore, the vaccination program will begin in February of 2013 and end in June 2013. In the first month, training for those who will facilitate the programme shall be conducted. This will ensure that the facilitators are a ware of the vaccination programme in a comprehensive manner. In the second month, the project manager will identify the children who qualify to be vaccinated during the programme. In addition, the consent forms shall be distributed to students who are qualified for the vaccination. These forms will be required to be filled and signed by the parents or legal guardians for the children. This is because the vaccination programme targets children who are not adults to consent. Nonetheless, the vaccination programme shall be explained to the children. In the third month, the consent forms shall be collected and children who have been approved to partake in the programme identified. In addition, the process will be explained to the children. Also, the programme will be initiated during the third month. This will see the administration of the influenza vaccination to children who are fifteen years and below.

5. Budget

6. Quality plan

7. Risk Management – Risk Assessment and Management Table

http://www.implementationscience.com/content/pdf/1748-5908-6-47.pdf

http://www.immunizationforwomen.org/practice_management/office-based_vaccine_program

http://www.health.wa.gov.au/flu/docs/Western_Australia_Paediatric_Influenza_Vaccination_Program_and_immunisation_of_pregnant_women_2012_Information_for_Health_Providers.pdf

http://www.projects.uts.edu.au/resources/pdfs/StepbyStepGuide2009.pdf