院舍防疫注射計劃2017/8



Residential Care Home Vaccination Programme 2019/20

Measles Vaccination Mop-up Programme

Information about Measles, Mumps and Rubella (MMR) Vaccination

Measles

Measles is caused by the Measles virus and spreads through the air, by droplet or direct contact with nasal or throat secretions from infected persons, and less commonly, by articles soiled with nose and throat secretions. Affected persons will present initially with tiredness, fever, cough, red eyes and white spots inside the mouth. This is followed by a red blotchy skin rash 3 to 7 days later, which usually spreads from the face down to the rest of the body. In severe cases, middle ear, lungs and brain can get involved and lead to serious consequences or even death. Measles infection in pregnancy can result in adverse pregnancy outcomes, including pregnancy loss, preterm birth and low birth weight. Vaccination against measles is the most effective preventive measure.

Who should get vaccinated?

MMR vaccine* is the main measles-containing vaccine provided in Hong Kong, and it can effectively prevent three infectious diseases, namely measles, mumps and rubella. All people who are non-immune to measles should receive two doses of MMR vaccine, separated by an interval of at least four weeks.

According to the recommendation of the Scientific Committee on Vaccine Preventable Diseases, individuals are recommended to receive two doses^ of MMR vaccine in consideration of vaccination record if they:

1. are born in 1967 or after; and

2. did not have laboratory evidence of immunity (i.e. no laboratory test ever done or tested negative/indeterminate for measles immunoglobulin G); and

3. did not have laboratory confirmed measles infection in the past; and

4. have never been vaccinated with two doses of measles-containing vaccine or have unknown vaccination status.

The following individuals should NOT receive MMR vaccine or should wait

1. Pregnancy: Women should avoid pregnancy for three months after vaccination and take appropriate contraceptive measure

2. Serious allergic reaction to a previous dose of MMR vaccine

3. Known history of severe allergy to any vaccine component (e.g. gelatin or neomycin)

4. Individuals with severe immunosuppression from diseases or treatment (e.g. on current cancer treatment such as chemotherapy and radiotherapy, taking immunosuppressive medicines such as high dose corticosteroid, etc.)

5. Has received immunoglobulin or other blood products (e.g. blood transfusion) within the past 11 months

6. Has received other live-attenuated vaccines in the past four weeks

7. Fever or any illnesses on the day of vaccination

8. Person with severe allergic reaction (e.g. anaphylaxis) to eggs should consult a healthcare professional for vaccination in an appropriate setting

* The “Measles, Mumps and Rubella Vaccines” (MMR vaccine) used in the Mop-up Programme were procured by the Government of the HKSAR from one of the suppliers of registered MMR vaccines in Hong Kong, Merck Sharp & Dohme (Asia) Ltd (MSD). As this batch of vaccines was originally not intended for supply to Hong Kong, the packing are only labelled in Spanish. Nonetheless, they were manufactured by the same manufacturer with the same master formula (including gelatin originated from porcine skin collagen as one of the inactive ingredients) and finished product specifications as the MMR vaccine registered in Hong Kong by MSD.

^ Only one dose is required for those who had already received one dose of measles vaccination in the past.

It is safe to receive MMR vaccination

• It is safe to participate in the mop-up programme even if you do not know whether you are immune to measles. Additional doses of MMR vaccine will not cause physical harm to persons who had measles infection or received two doses of measles-containing vaccine before.

• MMR vaccine will not cause measles, mumps or rubella, and you will not transmit these viruses to others after vaccination.

• Possible reactions after MMR vaccination (e.g. fever, rash, etc,) are in general mild and transient.

• There is a 1 in 3 million chance of developing encephalitis or meningitis after receiving MMR vaccine, but this does not usually have long-lasting adverse effects after recovery.

|Statement of Purpose |

|Purposes of Collection |

|The personal data provided will be used by the Government for one or more of the following purposes: |

|for creation, processing and maintenance of an eHealth (Subsidies) account, payment of injection fee, and the administration and monitoring of the |

|Residential Care Home Vaccination Programme, including but not limited to a verification procedure by electronic means with the data kept by the |

|Immigration Department; |

|for statistical and research purposes; |

|any other legitimate purposes as may be required, authorised or permitted by law; and |

|for monitoring the arrangement of the MMR vaccination. |

|The vaccination record made for the purpose of this visit will be accessible by health care personnel in the public and private sectors for the purpose of |

|determining and providing necessary healthcare service to the recipient. |

|The provision of personal data is voluntary. If you do not provide sufficient information, you may not be able to receive the vaccination under the |

|Programme. |

|Classes of Transferees |

|The personal data you provided are mainly for use within the Government but they may also be disclosed by the Government to other organisations, and third |

|parties for the purposes stated in paragraphs 1 and 2 above, if required. |

|Access to Personal Data |

|You have a right to request access to and to request the correction of your personal data under sections 18 and 22 and principle 6, schedule 1 of the |

|Personal Data (Privacy) Ordinance. A fee may be imposed for complying with a data access request. |

|Enquiries |

|Enquiries concerning the personal data provided, including the making of access and correction, should be addressed to Vaccination Office, Centre for |

|Health Protection, Telephone No.: 2125 2553. |

Measles Vaccination Mop-up Programme

Screening Questionnaire for Measles, Mumps & Rubella (MMR) Vaccination for Healthcare Workers of Residential Care Home for Persons with Disabilities

and Residential Child Care Centre

Please answer the following questions before receiving Measles, Mumps & Rubella (MMR) vaccination and put a “(” in the appropriate boxes.

|If the answer to any of the following questions is “Yes”, the person does not need to receive MMR vaccination1 under this Programme. |

|Have you received 2 or more doses of MMR vaccines before? |□Yes □No |

| |(□1 dose □Uncertain) |

|Do you have laboratory-confirmed measles infection in the past? |□Yes □No □Uncertain |

|Do you have laboratory evidence of measles immunity? |□Yes □No □Uncertain |

|If the answer to any of the following questions is “Yes” or “Uncertain”, the person should not receive MMR vaccination. |

|Do you have history of severe allergic reactions, including breathing difficulty or even shock, to|□Yes □No □Uncertain |

|previous dose of MMR vaccine, neomycin or gelatin? | |

|Do you have history of cancer, leukemia, HIV infection or other illness of the immune system? |□Yes □No □Uncertain |

|Are you receiving high dose steroid, anti-cancer drugs or radiotherapy? |□Yes □No □Uncertain |

|If the answer to any of the following questions is “Yes” or “Uncertain”, the person has to delay MMR vaccination. Please consult your family doctor |

|for further advice. |

|Are you pregnant or possibly pregnant? (women only) |□Yes □No □Uncertain |

|When is the first date of your last menstrual period: |(YY) (MM) (DD) |

| |□Menopausal |

|Do you have fever or any illness today? |□Yes □No |

|Did you receive blood transfusion, plasma or immunoglobulin in the last 11 months? |□Yes □No □Uncertain |

|Did you receive live-attenuated vaccine in the past four weeks e.g. MMR vaccine, Varicella |□Yes □No □Uncertain |

|(chickenpox) vaccine, Combined Measles, Mumps, Rubella and Varicella (chickenpox) vaccine (MMRV), | |

|Bacille Calmette-Guerin (BCG), Japanese encephalitis vaccine, or live-attenuated influenza vaccine| |

|(nasal)? | |

|Do you have bleeding disorder or condition of decreased platelet? |□Yes □No □Uncertain |

|Do you have severe allergic reaction (e.g. anaphylaxis) to eggs? |□Yes* □No □Uncertain |

|*If yes, please consult a healthcare professional for vaccination in an appropriate setting. | |

1 The MMR vaccine used in the Mop-up Programme were procured by the Government of the HKSAR from one of the suppliers of registered MMR vaccines in Hong Kong, Merck Sharp & Dohme (Asia) Ltd (MSD). As this batch of vaccines was originally not intended for supply to Hong Kong, the packing is only labelled in Spanish. Nonetheless, they were manufactured by the same manufacturer with the same master formula (including gelatin originated from porcine skin collagen as one of the inactive ingredients) and finished product specifications as the MMR vaccine registered in Hong Kong by MSD.

|RCH/RCCC Code | |eHS(S) Transaction No. |

|(To be completed by RCH) | | |

| |Department of Health | |

| |Residential Care Home Vaccination Programme | |

| |Vaccination Consent Form | |

| |for Measles, Mumps & Rubella (MMR) Vaccination | |

| |under Measles Vaccination Mop-up Programme | |

|       | |TR |

| | |TR |

| | |Type of |Vaccination Date |

| | |Vaccines* |in 2019/20 (DD/MM/YY) |

| | | | |

| | |MMR (1st) |/ / |

| | |MMR (2nd) |/ / |

| | |Name of VMO: |

| | |Signature of VMO: |

|Note: |Please complete this form in BLOCK LETTERS using black or blue pen. |

| |Duly completed and signed consent form should reach Visiting Medical Officer (VMO) at least 20 working days prior to vaccination for checking |

| |vaccination record of the recipient. |

| |This form is to be retained by the VMO after vaccination. |

|Part A　Personal Particulars of the Recipient (as stated on the identity document) |

|Name |              |(English) |              |(Chinese) |

|Date of Birth |  |Sex | Male | Female |

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|Hong Kong Identity Card No. |  |Date of Issue |  |

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|Chinese Commercial Code |  |

|(if applicable) |  |

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|Rank: |Contact Tel. No.: |

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|Part B　Undertaking and Declaration |

|To Be Completed by the Recipient |

|I am a staff of residential care home for persons with disabilities / residential child care centre. I consent to receive Measles, Mumps & Rubella (MMR) |

|Vaccine2. |

| |

|I have read the appended Information about MMR Vaccination, Undertaking and Declaration and Statement of Purpose of Collection of Personal Data and consent to |

|receive MMR vaccine provided by the Government. |

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|I understand I should avoid pregnancy for three months after MMR vaccination. (For women only) |

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|I declare the information provided in this consent form is correct. I agree to provide my personal data in this consent form and any information provided to |

|health care professional for the use by the Government for the purpose set out in the “Statement of Purpose” of Collection of Personal Data. I note that the |

|Department of Health may contact me or the residential care home / residential child care centre I work for to verify whether myself has received the MMR |

|vaccination. |

| |

|This consent form shall be governed by and construed in accordance with the laws of Hong Kong Special Administrative Region and I and the Government shall |

|irrevocably submit to the exclusive jurisdiction of the Courts of Hong Kong Special Administrative Region. |

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|I have read this consent form carefully and fully understood my obligations and liability under this consent form. |

|Signature of Recipient | |Date |         |

2 The MMR vaccine used in the Mop-up Programme were procured by the Government of the HKSAR from one of the suppliers of registered MMR vaccines in Hong Kong, Merck Sharp & Dohme (Asia) Ltd (MSD). The packing is labelled in Spanish. This batch of MMR vaccines contains gelatin originated from porcine skin collagen as one of the inactive ingredients.[pic][pic]

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