Vaccinator Training Course Standards
Version
Date
Comments
Version 6.0
January 2015
3 yearly review
Authorised by the IMAC Education Review Group
Page 1 of 17
Date revised: January 2015
Contents
Introduction ............................................................................................................................................ 3
Resources ................................................................................................................................................ 4
Course objective ..................................................................................................................................... 5
Vaccinator training courses (VTC) ........................................................................................................... 5
Prerequisites ........................................................................................................................................... 5
Assessment procedures .......................................................................................................................... 5
Unit timing .............................................................................................................................................. 6
Model programme .................................................................................................................................. 7
Unit 1: Vaccine preventable diseases ..................................................................................................... 8
Unit 2: Legislation, approval and authorisation...................................................................................... 9
Unit 3: The immune system .................................................................................................................. 10
Unit 4: The National Immunisation Schedule ....................................................................................... 11
Unit 5: Composition of vaccines ........................................................................................................... 12
Unit 6: Vaccine safety ........................................................................................................................... 13
Unit 7: Storage and handling of vaccines.............................................................................................. 14
Unit 8: Informed consent and immunisation conversations ................................................................ 15
Unit 9: Vaccine administration ............................................................................................................. 16
Unit 10: Improving immunisation coverage ......................................................................................... 17
Page 2 of 17
Date revised: January 2015
Introduction
These standards set the minimum education requirements which underpin safe vaccination practice
in New Zealand; to ensure equity and consistency of course delivery nationally.
Vaccinator training courses are designed for health professionals to have the appropriate
competencies to vaccinate safely within their scope of practice.
The courses are in line with the:

Immunisation Standards for Vaccinators and Guidelines for organisations offering
immunisation service, in the appendices of the current Immunisation Handbook (Ministry of
Health - MoH)

Authorisation of Vaccinators and criteria for Pharmacist vaccinators administering vaccines
in the appendices of the current Immunisation Handbook
o Maintaining authorisation vaccinator status or approved vaccinator status is the
responsibility of the individual
o Approval of authorised vaccinators is the responsibility of the regional Medical
Officers of Health (MOHs) and requirements are in the current Immunisation
Handbook
o Pharmacist Vaccinators administering specific reclassified vaccines are approved by
completing the Ministry of Health process outlined in the current Immunisation
Handbook
o N.B Vaccinators who are not prescribers, pharmacists, or authorised vaccinators may
only administer vaccines on a prescription or standing order
o Maintaining scope of practice is the responsibility of the individual practitioner and
their employer; issues should be addressed with the appropriate regulating body
The Vaccinator Training Course covers the vaccines on the New Zealand National Immunisation
Schedule and consists of:

Theory (16 hours minimum). Flexible learning option with 12 hours self study and four hours
tutorial is available

Open book assessment of a minimum one hour duration consisting of a combination of
multiple choice and short answers (80% pass rate is required)

Open book assessment can be oral at the Regional Immunisation Advisor/National
Manager's discretion
Page 3 of 17
Date revised: January 2015
Resources websites

MoH coded resources cited can be ordered from www.healthed.govt.nz

Other MoH resources available from www.health.govt.nz

IMAC resources cited available from www.immune.org.nz

Medsafe datasheets available from www.medsafe.govt.nz

CARM resources available from nzphvc.otago.ac.nz

Brighton Collaboration resources available from www.brightoncollaboration.org

Health and Disability Commissioner website resources available from www.hdc.org.nz

Guidelines for nurses on administration of medicines available at www.nzno.org.nz
© No part of these standards may be reproduced without the
written permission of the copyright owner
Disclaimer:
The Immunisation Advisory Centre has taken all reasonable steps to ensure that information
contained is reliable and accurate; it accepts no liability or responsibility for any acts of omissions,
done or omitted in reliance in whole or in part, on the information.
This publication is intended to support education sessions provided at Vaccinator Training Courses
and should be used in conjunction with other evidence based immunisation publications.
The Immunisation Advisory Centre takes no responsibility for the manner in which this information is
subsequently used.
Page 4 of 17
Date revised: January 2015
Course objective
To provide participants with the knowledge and skills required to provide quality, safe and effective
delivery of vaccines on the National Immunisation Schedule and to meet the minimum legal
requirements for vaccinators.
Vaccinator training courses (VTC)

Vaccinator training course flexible learning – includes pre-reading, 12 hours self study, a
four hour tutorial and an open book assessment

Vaccinator training course two day – includes pre-reading, two study days and an open book
assessment
Prerequisites

Current health professional practicing certificate (APC)

Pre-reading of the current Immunisation Handbook
o Introduction
o General immunisation principles
o Processes for safe immunisation
o Vaccination questions and concerns
o Immunisation of special groups
o All appendices
Assessment procedures
Course assessment
Assessment is by combination open book assessment lasting a minimum of one hour.

Pass mark is 80%. The current Immunisation Handbook may be used to assist participants;
however, not all answers will be found in this source but will have been covered during the
course. Re-sits as required are possible.

Open book assessment is to be completed ideally within 5 working days, contact Education
Administrator if exception required
Clinical Assessment
On completion of the vaccinator training course it is recommended that all participants demonstrate
clinical competency through a clinical assessment. A qualified assessor (nominated by the Medical
Officer of Health) will undertake this and the participant is responsible for negotiating this.
A copy of the completed clinical assessment is will be a requirement for the Medical Officer of
Health when applying for vaccinator authorisation or for pharmacist vaccinators to complete their
process.
Participants are responsible for negotiating a mutually convenient time with the assessor. The
assessor will complete the clinical assessment, usually in the clinical environment, for a minimum of
Page 5 of 17
Date revised: January 2015
two persons separate vaccination events, as relevant to the vaccinator area of practice. For early
childhood vaccinators at least one will be a child 15 months of age or younger. The assessment will
be based on the Standards for Vaccinators found in the appendices of the current Immunisation
Handbook (MoH).
The clinical assessment form is located in “Appendix One” of the Vaccinator Training Manual. It is
suggested that the participants familiarise themselves with this document prior to their clinical
assessment.
Unit timing
Unit
Topic
Minimum timings
1
Vaccine preventable diseases
60 minutes
2
Legislation, approval, and authorisation
15 minutes
3
The immune system
60 minutes
4
The National Immunisation Schedule
45 minutes
5
Composition of vaccines
60 minutes
6
Vaccine safety
75 minutes
7
Storage and handling of vaccines
45 minutes
8
Informed consent and immunisation conversations
60 minutes
9
Vaccine administration
120 minutes
10
Improving immunisation coverage
60 minutes
Page 6 of 17
Date revised: January 2015
Model programme
Day One
Unit
08:30
Introduction and housekeeping
08:45
Vaccine preventable diseases (including VPD video - 10 minutes)
10:00
Break
10:15
The immune response (including Cold War DVD)
3
11:30
National Immunisation Schedule (including MOH DVD)
4
12:30
Lunch
13:15
Composition of vaccines
5
14:15
Legislation, approval, and authorisation
2
14:30
Catch-ups
10
15:00
Break
15:15
Catch-ups continue
16:30
Questions and answers / Clinical myths DVD
16:30
Close
Day Two
1
10
Unit
08.30
Review and recap/questions/activity/evaluations
08.45
Improving Immunisation coverage
10
09:30
Storage and handling of vaccines
7
10.15
Break
10:30
Vaccine safety
6
11:45
Improving immunisation coverage
10
12:30
Lunch
13:15
Vaccine administration
15:15
Break
15:15
Informed consent and immunisation conversation
16:15
Open book assessment preparation, evaluations
16:30
Close
9
8
Page 7 of 17
Date revised: January 2015
Unit 1: Vaccine preventable diseases
Purpose
To provide an overview of vaccine preventable diseases, associated complications, long term
outcomes, and the impact of vaccines historically.
Learning outcomes
At the end of this session attendees will be able to:

Describe briefly the global burden of disease due to vaccine preventable diseases and the
impact of immunisation

Outline briefly the disease process, potential complications and long-term outcome for each
vaccine preventable disease on the current National Immunisation Schedule

Identify the process to notify vaccine preventable diseases

Identify appropriate resources about vaccine preventable diseases to provide to vaccinees or
parents/caregivers

Access further information about each disease when required
Course content should include

Global burden of disease

History of vaccines and vaccination

Epidemiology, modes of transmission and clinical features of each of the vaccine
preventable diseases on the national immunisation schedule

Introduction to the concept of coverage

Notification of vaccine preventable diseases

How to access recommended resources
Resources
Refer to resource website list at beginning of document

Childhood Immunisations booklet MoH code HE1323

Immunise your children on time pamphlet MoH code HE1327

Infectious Disease MoH code HE1215

Meningococcal Diseases causes meningitis MoH code HE2417

Vaccine preventable diseases DVD if available

Medical Officer of Health, or Communicable Disease specialist if available

Current Immunisation Handbook (MoH)
Page 8 of 17
Date revised: January 2015
Unit 2: Legislation, approval and authorisation
Purpose
To provide an overview of legislation, regulation and authorisation for immunisation practice.
Learning outcomes
At the end of this session attendees will be able to:

Identify the limitations and requirements for non prescribers who are not authorised or
pharmacist vaccinators

Describe initial authorisation, re-authorisation as a vaccinator and the process for
pharmacists administering vaccines

Define the legal role and responsibilities of an authorised/approved vaccinator as covered in
the Medicines Regulation 1984

Practice according to the Immunisation Standards

Identify the acts and regulations which govern immunisation practice
Course content should include

The need to administer vaccines under prescription or standing orders if not
authorised/approved

Authorisation of vaccinators and criteria for pharmacist vaccinators administering vaccines
as per current Immunisation Handbook (MoH)

The process required at the local level to apply for authorisation, and re-authorisation

The current Immunisation Standards and their relevance to immunisation best practice for
vaccinators

Legislation relevant to vaccinators, including:
o Health (Immunisation) Regulations 1995
o Medicines Regulations 1984
o Health Act 1956
o Health and Disability Services Act 1993
o Health Practitioners Competency Assurance Act 2003
Resources
Refer to resource website list at beginning of document

Local process, and forms required for application as an authorised vaccinator

Contact details for Medical Officer of Health, and local immunisation coordinator/facilitator

Current Immunisation Handbook (MoH)

Ministry of Health requirements for standing orders
Page 9 of 17
Date revised: January 2015
Unit 3: The immune system
Purpose
To provide a review of the function of the immune system, and response to vaccines.
Learning outcomes
At the end of this session attendees will be able to:

Describe the structure of the immune system

Describe how the nonspecific responses prevent infection

Describe briefly the specific immune response to a vaccine antigen and the generation of
immune memory

Differentiate cellular and humoral immune response

Differentiate passive and active immunity

Relate the infant immune response to the timing of the vaccination schedule

Differentiate primary and secondary immune response

Describe herd immunity and explain its role for individuals and population health

List factors that affect the immune response to vaccines
Course content should include

Cell mediated and antibody mediated immunity, soluble mediators, antibodies and antigens

The immune response to a vaccine including primary and secondary antibody responses

The physiology of active immunity

The physiology of passive immunity

Rationale for the use of conjugated vaccines in infants

The concept of herd immunity for the community

Duration of immunity following disease and vaccination

Access to resources discuss the immune response with parents and care givers
Resources
Refer to resource website list at beginning of document

Current Immunisation Handbook (MoH)

The Body Story, cold war DVD
Page 10 of 17
Date revised: January 2015
Unit 4: The National Immunisation Schedule
Purpose
To provide an outline of the vaccines on the New Zealand National Immunisation Schedule and
immunisation of special groups.
Learning outcomes
At the end of this session attendees will be able to:

Outline the current National Immunisation Schedule

Identify the recommended timing/spacing of National Immunisation Schedule vaccines

Describe the length of immunity provided by different vaccines

Describe the immunisation of special groups and high risk populations

Differentiate between a standard and a catch-up when implementing the National
Immunisation Schedule
Course content should include

The current New Zealand National Immunisation Schedule and purpose

Spacing of vaccines

Strategies for control of each disease and the pattern of disease

Effectiveness of vaccines at different ages

How to modify or adapt the schedule to encompass variations e.g. child, adolescent, or adult
immigrants, parents selectively vaccinating

Publicly funded and privately funded vaccines

Duration of immunity

Use of the current Immunisation Handbook (MoH)

Resources available locally and nationally to consult about immunisation issues
Resources
Refer to resource website list at beginning of document

New Zealand National Immunisation Schedule poster MoH code HE1221

Hepatitis B Information For Health Professionals MoH code HE1401

IMAC National Immunisation Schedule card

IMAC Guidelines for Tetanus Prone Wounds current flow chart

Current Immunisation Handbook (MoH)
Page 11 of 17
Date revised: January 2015
Unit 5: Composition of vaccines
Purpose
To provide an outline of the types of vaccines on the New Zealand National Immunisation Schedule
including composition and regulation for vaccine safety.
Learning outcomes
At the end of this session attendees will be able to:

Describe the process of vaccine regulation and the role of Medsafe

Outline the types and classification of vaccines on the NZ National Immunisation Schedule

Describe the manufacture process of vaccines

Discuss the function of vaccines components

Identify current resources on vaccine ingredients
Course content should include

Vaccine types and classifications

Vaccine manufacture; including the cell lines used, recombinant, polysaccharide, and
conjugate vaccines

Use of, and rationale for vaccine components

Current resources on efficacy, reactogenicity, specific contraindications, presentations and
dosage of vaccines

Resources to assist discussions with parents/patients/caregivers
Resources
Refer to resource website list at beginning of document

IMAC Vaccine ingredients factsheet

Vaccine data sheets from the Medsafe website

IMAC vaccine composition game (optional)

Expired/compromised vaccine samples

Current Immunisation Handbook (MoH)
Page 12 of 17
Date revised: January 2015
Unit 6: Vaccine safety
Purpose
To provide an overview of prevention strategies, management of an adverse event following
immunisation (AEFI), and reporting for global vaccine pharmacovigilance.
Learning outcomes
At the end of this session attendees will be able to:

Minimise the risks of adverse reaction due to vaccination by assessing for true
contraindications

Describe common expected responses to National Immunisation Schedule vaccines

Differentiate between adverse event and adverse reaction

Differentiate between anaphylaxis, faint, hypotonic-hyporesponsive episode (HHE), and
other hypersensitivities

Identify, manage and report an AEFI

Describe the emergency management of anaphylaxis

Outline the equipment required for emergency response

Discuss how vaccine safety can be misconstrued and appropriate responses to address this

Discuss the contribution to global vaccine pharmacovigilance of reporting to the Centre for
Adverse Reactions Monitoring (CARM)
Course content should include

2012 WHO classification of AEFIs

Essential components of a pre vaccination check to reduce the risk of an AEFI

Contraindications to specific vaccines

Differentiation between anaphylaxis, HHE, faint and other hypersensitivities

The equipment required in managing a serious event and regular checking of this

The process to manage a serious event

The process for documenting and reporting AEFIs to CARM

The Brighton Collaboration’s role in global vaccine pharmacovigilance

The role of active and passive surveillance in vaccine safety
Resources
Refer to resource website list at beginning of document

IMAC Vaccine safety factsheet

CARM reporting form

Current Immunisation Handbook (MoH)
Page 13 of 17
Date revised: January 2015
Unit 7: Storage and handling of vaccines
Purpose
To outline the standards for the correct storage and transport of vaccines, along with provider
evidence demonstrating this.
Learning outcomes
At the end of this session attendees will be able to:

Describe the key elements of the cold chain

Describe and assess the requirements for the correct storage of vaccines in any vaccination
site

Assess that vaccine storage/transportation meets cold chain accreditation standards at their
site

Discuss vaccines vulnerable to light, hot or cold thermal insult

Identify an appropriate process for vaccines when cold chain breaches occur

Describe the essential role of electronic loggers

Outline the correct procedure for receiving and accepting a vaccine supply

Outline the process for management of National Cold Chain Accreditation monitors received
by a provider

Outline monthly, six monthly, and annual refrigerator maintenance
Course content should include

Medicines Regulations 1984

‘Vaccine Storage and Distribution National Standards 2012’(MoH)

Cold chain information in the current Immunisation Handbook (MoH)

Actions required when vaccines have been compromised

Cold chain accreditation process and the requirements for providers of immunisations

National cold chain audit and the process required when a card is received

Correct process for transporting vaccines in a chilly bin
Resources
Refer to resource website list at beginning of document

National Guidelines Vaccine Storage and Distribution 2012(MoH)

Annual Cold Chain Management Guide (MoH)

Practical guide and equipment for packing a chilly bin

Current Immunisation Handbook (MoH)
Page 14 of 17
Date revised: January 2015
Unit 8: Informed consent and immunisation conversations
Purpose
To outline the process for informed consent and introduce strategies to enhance immunisation
conversations.
Learning outcomes
At the end of this session attendees will be able to:

Describe the informed consent process

Identify barriers to informed consent and immunisation and discuss strategies to address
these

Demonstrate acknowledgement of concerns about immunisation respectfully

Provide adequate communication for parents/caregivers/vaccinees in regard to the benefits
and risks of vaccination appropriate to their individual need

Evaluate own skills to further develop communication competence

Prepare for questions about common immunisation concerns by extending own knowledge

Identify resources to support effective communication conversations

Document the informed choice and consent process
Course content should include

Barriers to consent

Myths and misconceptions to immunisation

Legal requirements for consent

Care of the Children Act 2004

Resources for facts about common immunisation concerns: vaccine safety, multiple
injections, how vaccines work, vaccine misconceptions, natural immunity versus vaccine
immunity, why vaccines are necessary

Strategies to address immunisation issues and support immunisation decision- making
respectfully and appropriately
Resources
Refer to resource website list at beginning of document

Childhood Immunisation MoH code HE1323

After your child is vaccinated MoH code HE1504

Immunisation certificate MoH code HE7013

Health and Disability Commissioner website resources

Immunisation audience research

Current Immunisation Handbook (MoH)

Myths and realities: responding to arguments against vaccination. A guide for providers.
Australian Government
Page 15 of 17
Date revised: January 2015
Unit 9: Vaccine administration
Purpose
To promote administration of vaccinations on the NZ National Immunisation Schedule according to
best practice standards.
Learning outcomes
At the end of this session attendees will be able to:

Describe the provision of a suitable environment for vaccination

Demonstrate appropriate pre-vaccination clinical assessment

List true contraindication for all vaccines and specific contraindications

Demonstrate evidence based medication checking procedure

Identify the correct route, site, and positioning of limbs for all vaccines for different age
groups

Ensure that vaccines, resources and emergency equipment are accessible and checked

Correct disposal of vaccines and associated equipment

Documentation
Course content should include

Preparation for administering vaccinations

Assessment of a potential vaccinee prior to vaccination

Location and rationale of injection site(s) and choice of needle gauge(s) and length(s)

Factors that contribute to optimal vaccine delivery

Safe and appropriate restraint and distraction techniques for children of various ages

Safe and appropriate disposal of vaccines and associated equipment

Post vaccination information

Documentation of vaccination event
Resources
Refer to resource website list at beginning of document

The National Immunisation Schedule card MoH code HE1308

Appropriate post-immunisation advice leaflets

Immunisation certificate code HE7013

Immunisation Record MoH code HE1309

Expired/compromised vaccine samples, needles and syringes

Infant doll for demonstration/practical session

Current Immunisation Handbook (MoH)

IMAC Best practice strategies factsheet

Guidelines for nurses on administration of medicines
Page 16 of 17
Date revised: January 2015
Unit 10: Improving immunisation coverage
Purpose
To outline a range of strategies to achieve and maintain immunisation targets to prevent vaccine
preventable disease.
Learning outcomes
At the end of this session attendees will be able to:

Obtain and utilise resources to confidently and appropriately communicate with parents and
caregivers about immunisation

Utilise the newborn enrolment tool to ensure on time 6 week immunisations

Utilise the National Immunisation Register (NIR) and the provider’s patient management
system (PMS) to assist in improving immunisation coverage within their practice

Describe the importance of the national target for immunisation

Discuss how to optimise opportunistic immunisation in their practice

Adhere to only using true contraindications to immunisation

Outline the principles for planning catch-up schedules

Describe the local referral process and role of Outreach Immunisation Service (OIS)

Describe quality data entry for their PMS, and subsequent transfer to NIR, to ensure
accurate immunisation coverage figures
Course content should include

Presentation of immunisation resources and how to obtain them. Include Health and
Disability Code of Rights.

The National Immunisation Register (preferably by local NIR administrator) - basic rules on
PMS data entry and referral processes and how to contact NIR administrator

How to plan and manage catch-up schedules
Resources
Refer to resource website list at beginning of document

Local NIR PMS troubleshooting guide if available

Local NIR and Datamart coverage reports if available

Current Immunisation Handbook (MoH)
Page 17 of 17
Date revised: January 2015