DENGUE SCHOOL-BASED IMMUNIZATION (FOR HEALTH WORKERS)

1. WHAT IS DENGUE VACCINE?
Dengue vaccine is used to help protect a child against dengue caused by dengue virus serotypes 1,2,3, and 4. It is administered via subcutaneous injection in the upper arm (deltoid).2.  Is the vaccine effective to prevent dengue disease
2. Is the vaccine effective to prevent dengue disease?
Yes.  Based on clinical studies conducted in countries across Southeast Asia and Latin America, the vaccine has shown to be:
• effective in preventing severe dengue by 93.2%,•  effective in preventing hospitalized form of dengue by 80.8%,
• and effective in preventing dengue due to any sero type by 65.6%.
Reminder:
Just like any other vaccine, the dengue vaccine may not protect all the persons who have been vaccinated and may not provide 100% protection to vaccinees.  Dengue vaccination is not a substitute for protection against mosquito bites, and vaccinees are still encouraged to take appropriate precautions to prevent mosquito bites.
3. Who should receive the vaccine?
Children nine (9) years and older enrolled in Grade IV for the school year 2015-2016 in public schools in Regions III, IV-a, and NCR will be vaccinated.
4. How many times should a pupil get vaccinated?

DOSES MONTHS
1st dose At the time of first visit of the health worker
2nd dose 6 months after the 1st dose was given with a window period of 20 days before or after the target vaccination date for the 2nd dose
3rd dose 6 months after the 2nd dose with a window of 20 days before or after the target vaccination date for the 3rd dose
5.  Where can we get the vaccine?
The Department of Health (DOH) will provide the vaccine for enrolled pupils nine (9) years and older and are in Grade IV in all public schools in Regions III, IV-A and NCR for the school-based immunization. Those who are not qualified to be vaccinated under the program can avail of the vaccine from their private doctors.
6. Is the vaccine given for free?
Yes. The DOH in partnership with the Department of Education and the Department of Interior and Local Government will provide FREE vaccination to all Grade IV pupils nine (9) years and older in all public schools in Regions III, IV-A, and NCR starting April 2016.
7. Will it be distribued nationwide? If not, how were the priority areas selected?
The dengue vaccine shall be initially introduced in Regions III, IV-A, and NCR. These three (3) regions were reported to have the highest number of dengue cases.

8. Who should NOT receive the vaccine?
Dengue tetravalent vaccine is not recommended for the following individuals:
• Children less than nine (9) years of age and adults above 45 years of age
• Anyone who is allergic or has had an allergic reaction to a prior dose or to any component of the dengue vaccine
• Immunocompromised individuals, due to but not limited to genetic defects, HIV infections, or therapies that affect immune system such as high dose costicosteroids or chemotherapy
• Pregnant or breastfeeding women
9.   If the pupil had past dengue infection, can they still avail of the vaccine?
Yes. Dengue disease is caused by 4 serotypes. Natural infection caused by one of the 4 serotypes confers lifelong immunity from that specific serotype but not from the other serotypes. Dengue vaccination can still provide protection against dengue disease from the other serotypes.
10. What are the possible reactions from being vaccinated?
Like all medicines, the dengue vaccine may cause the following mild and temporary reactions which  are manageable. The  following  reactions  were  reported during the clinical studies in children, adolescents, and  adults. Most of the reported temporary and mild reactions occurred within the 3 days after injection of the vaccine.
Very common (may affect more than 1 user in 10):
-  Headache                                         - Muscle pain
-  Generally feeling unwell                 - Feeling of weakness
-  Injection site pain                            - Fever
Common (may affect up to 1 user in 10):
-  Injection site/reactions; redness, bruising, swelling, and itching
Uncommon: (may affect up to 1 user in 100):
-  Infections of the upper respiratory tract
-  Dizziness                                - Sore throat
-  Runny nose                            - Nausea
-  Cough                                     - Lymphadenopathy
-  Migraine                                  - Rash
-  Urticaria                                   - Neck pain
-  Arthralgia                                - Injection site induration
-  Influenza like illness
Below are some suggestions on how to manage some mild and temporary reations:
FEVER
• Keep the child comfortable at all times
• Encourage the child to drink plenty of water
• Give paracetamol every 4 hours until fever subsides
SWELLING
• Apply alternately cold and warm compress every 15 minutes using clean cloth until swelling disappears on the injection site
• Do not massage the injection site
RASHES
• Once rashes appear, bring the child immediately to the nearest health facility for consultation
PAINTING
• Ensure that the child has eaten before vaccination
• Keep the child lying down with his/her feet slightly elevated
The mild and temporary reactions usually occur after the injection is given, or while the vaccinee (individual) is still in the vaccination area.  These can also occur up to 14 days after vaccination.  If the vaccinee experiences any of these, seek the attention of health personnel immediatly.  Serious allergic reations are very rare after receiving any vaccine.
DOH Hotline: 711-1001 to 02
DOH Advisory on Dengue School-Based Immunization (Regions III, IV-A, NCR)
• Advisory for School Administrators
• Advisory for Health Workers
• Advisory for Teachers
• Advisory for Parents and Guardians. # Source – www.doh.gov.ph