Curriculum Vitae

DR. Dr. Sukamto Koesnoe, SpPD, K-AI, FINASIM

• Staf pengajar dan tenaga medis di FKUI-RSCM, Divisi

Alergi - Imunologi Klinik Departemen Ilmu Penyakit
Dalam
• S1, Sp1 dan Sp2 di FKUI, S3 di Epid FKM UI
• Ayah dari Fahd Faikar
• Anggota Satgas Imunisasi Dewasa PAPDI
• Anggota Tim Advokasi Vaksin Covid-19 IDI
• Anggota Bidang Penanganan Kesehatan Satgasnas
Covid-19
• Ketua Tim Surveilans KIPK RSCM
• Ketua Pelaksana Vaksinasi Covid-19 di RSCM
• KaBid Organisasi PB PAPDI,
• Praktek di RSCM, RSU Hermina Depok dan HGA Depok
PROSEDUR VAKSINASI
PADA ORANG DEWASA
Lingkup Bahasan

 Pendahuluan
 Prosedur Vaksinasi
 Penyimpanan dan Transportasi
 Kedaluwarsa
 Aturan Umum Vaksinasi
 Kewaspadaan Umum
 KIPI
PENDAHULUAN
PROSEDUR VAKSINASI
 Prosedur Vaksinasi

Health Age

Lifestyle Occupation

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi pada orang
dewasa 2017
 Persiapan Pasien

■ Riwayat vaksinasi sebelumnya

■ Penapisan kontraindikasi dan perhatian khusus
■ Komunikasi keamanan imunisasi
■ Persiapan anafilaksis
■ Posisi dan kenyamanan pasien
■ Pengendalian nyeri dan infeksi

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi pada orang dewasa 2017
 Kuesioner penyaringan untuk
vaksinasi dewasa
■ Apakah Anda sakit hari ini?
■ Apakah Anda mempunyai alergi obat, makanan, atau vaksin?
■ Apakah Anda pernah mengalami efek simpang berat setelah mendapat vaksinasi?
■ Apakah Anda menderita kanker, leukemia, AIDS, atau masalah kekebalan tubuh
lainnya?
■ Apakah Anda mengonsumsi kortison, prednison, atau steroid lain, atau obat anti
kanker atau apakah Anda baru saja mendapat pengobatan sinar X?
■ Dalam beberapa tahun terahkir, apakah Anda pernah mendapat transfusi darah atau
produk darah, atau Anda pernah mendapat obat yang disebut imuno(gama) globulin?
■ Untuk wanita: Apakah Anda hamil, atau kemungkinan akan/mau hamil dalam
beberapa bulan berikut?
■ Apakah Anda pernah mendapat vaksinasi dalam 4 minggu sebelum ini?

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi pada orang dewasa 2017
 Persiapan Vaksin

■ Pemeriksaan vaksin
■ Pengenceran/pelarutan
■ Factory pre-filled syringes vs manually pre-filled
syringes
■ Pelabelan
■ Teknik pemberian

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi pada orang dewasa 2017
 Reconstituted Vaccines

Winulyo EB, Sejati A. Penyimpanan, transportasi, dan pembuangan vaksin. Pedoman imunisasi pada orang dewasa 2017
Prefilled Syringes Samples
 Jarum
Hu Glu Canu
b e la

Disposable
Needle

Softpack
needle
Needles conditioned by
5 into a soft plastic
Hardpack packaging. They are
used for syringe by 10
needle packs.
Sole needle conditioned into a
hard plastic packaging. They
are only used for syringe by
onepacks.
 Jarum

Needle size 23G1.

Diameter : 0.6 mm ; length : 25 mm.
Usually for adults andadolescents.

Needle size 25G5/8.

Diameter : 0.5 mm ; length : 16 mm.
Usually for pediatric vaccines.

Needle size 25G1.

Diameter : 0.5 mm ; length : 25 mm.
Usually for paediatric vaccines.

Other needles may be used but these 3 needles are the more common ones
 Contoh Ampul/Vial

Need to be reconstituted
Rute Pemberian Vaksin

WHO Vaccine Safety Basics 2017

 Rute
Pemberian
Vaksin

Karjadi TH. Tata cara pemberian imunisasi.

Pedoman imunisasi pada orang dewasa 2017
 Cara Penyuntikan IM

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi

pada orang dewasa 2017
Cara Penyuntikan Subkutan

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi

pada orang dewasa 2017
PENYIMPANAN DAN
TRANSPORTASI
 Monitoring Suhu & Kedaluwarsa

Winulyo EB, Sejati A. Penyimpanan, transportasi, dan pembuangan vaksin. Pedoman imunisasi pada orang dewasa
2017
Penyimpanan
Vaksin

Winulyo EB, Sejati A. Penyimpanan, transportasi, dan pembuangan vaksin.

Pedoman imunisasi pada orang dewasa 2017
 Rantai
Dingin

Winulyo EB, Sejati A. Penyimpanan, transportasi, dan pembuangan vaksin. Pedoman imunisasi pada orang dewasa 2017
 Transpor Vaksin
■ Be sure to place an insulating barrier
between the refrigerated/frozen packs and
the vaccines to prevent accidental freezing.
■ The layer should be as follows
refrigerated/frozen packs - barrier - vaccine -
thermometer - barrier additional
refrigerated/frozen packs.

■ Pack vaccines in their original packing on top

of the barrier. Do not remove vaccine vials from
boxes.

Vaccine Storage Practice in Vaccine Storage and Handling Tool Kit by NCIRD
Disposal
■ Dispose of sharps immediately after
use at the point of care.
■ Needles and syringes must be
disposed of as a single unit.
■ Do not over fill the sharps bin or fill
beyond the fill line.
■ Lock and tag the bin to identify the
clinic source whenfull for disposal.
■ Full sharps bins must be stored in a
secure locked area away from the
public.

Storage, Distribution and Disposal of Vaccines Policy. North East London NHS. June 2007
Unsafe Immunization Practices

WHO. Immunization Practice. Module 4:Ensuring safe injections ;2004

KADALUWARSA
 Expiration Date (1)

Vaccine may be used up to and including the expiration date

Vaccine storage and handling toolkit. National Centre for Immunization and Respiratory Diseases. Vaccine Inventory Management. Centers
for Disease Control and Prevention. Downloaded at: http://www2a.cdc.gov/vaccines/ed/shtoolkit/pages/inventory_management.htm (
Accessed 10 Nov 2009)
 Expiration Date (2)

EXP: EXP BY: EXP

10/2020 10/2020 BEFORE:
10/2020

Expiry would Expiry would Expiry would

be be be 30/9/2020
31/10/2020 30/9/2020

Use through
Use through 30/9/2020.
31/10/2020. DO NOT use on or after 1/10/2020
DO NOT use on
or after
1/11/2020

NHS. Vaccine Handling Recommendations for Clinics, Hospitals, Community Pharmacies and GP Practices July 2007.
ATURAN UMUM VAKSINASI
Pemberian Vaksin Hidup Bersamaan

 Pemberian 2 jenis suntikan atau lebih vaksin hidup

secara bersamaan menghasilkan antibodi yang
adekuat untuk perlindungan.

 Pemberian 2 jenis suntikan atau lebih vaksin hidup

yang tidak bersamaan harinya akan menghasilkan
antibodi yang tidak adekuat untuk perlindungan.

 Bila akan memberikan 2 jenis vaksin hidup hendaknya

diberikan pada waktu yang bersamaan atau jeda 28
hari, kecuali vaksin Campak dan Yellow Fever boleh
diberikan kurang dari 28 hari.
 Minimum Intervals and Ages

Vaccine doses should not be administered at

intervals less than the minimum intervals or earlier
than the minimum age.

Vaccination in school: class or age

Ex: HPV minimum age 10 (4th class)

Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 2 General Recommendation. National Center for Immunization and Respiratory Diseases. CDC. Revised April 2009.
 Violation of Minimum
Intervals or Minimum Age
■ ACIP recommends that vaccine doses given up to four
days before the minimum interval or age be counted
as valid.
■ Immunization programs and/or school entry
requirements may not accept all doses given earlier
than the minimum age or interval.

Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 2 General Recommendation. National Center for Immunization and Respiratory Diseases.
CDC. Revised April 2009.
Extended Interval Between Doses

■ Not all permutations of all schedules for all

vaccines have been studied.
■ Available studies of extended intervalshave shown
no significant difference in finaltiter.
■ It is not necessary to restart the series or add doses
because of an extended interval between doses.

Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 2 General Recommendation. National Center for Immunization and Respiratory Diseases. CDC. Revised April
2009.
Vaksinasi Multipel

■ Lebih dari satu macam vaksin berbeda boleh

diberikan pada saat bersamaan
■ Semprit terpisah
■ Beda ekstremitas atau beri jarak 1-2 inchi
■ SK dan IM boleh di ekstremitas yang sama
■ Jika imunisasi aktif + pasif sekaligus (vaksin+Ig), lokasi
harus berbeda

Karjadi TH. Tata cara pemberian imunisasi. Pedoman imunisasi pada orang dewasa 2017
KEWASPADAAN UMUM
Vaccination During Acute Illness

■ No evidence that acute illness reduces vaccine efficacy

or increases vaccine adverse reactions.

■ Vaccines should be delayed until the illness has

improved.

■ Mild illness, such as otitis media or an upper respiratory

infection, is NOT a contraindication to vaccination.

Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 2 General Recommendation. National Center for Immunization and
Respiratory Diseases. CDC. Revised April 2009.
 Invalid Contraindications
to Vaccination
■ Mild illness
■ Antimicrobial therapy
■ Disease exposure or convalescence
■ Pregnant or immunosuppressed person in the household
■ Breast-feeding
■ Preterm birth
■ Allergy to products not present in vaccine or allergy that is not
anaphylactic
■ Family history of adverse events
■ Tuberculin skin testing
■ Multiple vaccines

Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 2 General Recommendation. National Center for Immunization and Respiratory Diseases. CDC. Revised April 2009.
Terima Kasih