Vaccine Dispensing

Vaccines require a ________ to be dispensed

Prescription

What temperature must refrigerators that keep vaccines be kept at? What about freezers?

Refrigerator: 2 - 8 °C or 36 - 46 °F

Freezer: -50 - 15 °C or -58 - 5 °F

If a vaccines expiration date is a month and year, until when may it be used?

Up to and including the last day of stated month

If a vaccines expiration date is dd/mm/yyyy, until when may it be used?

Up to the end of that day

Multidose vials expire when?

Certain time frame for use once a needle has entered, ex. 28 days after piercing

According to the National Childhood Vaccine Injury Act, what must be dispensed with most vaccines?

VIS, vaccine info statement

What info does a VIS contain?

Similar to MedGuides, explains the risks and benefits of the vaccine and what to do if patients experience an adverse effect

When must VIS be given to patients?

Prior to the vaccination and prior to each dose of a multi dose series, regardless of age

What must we also do after giving a patient a VIS?

It must be documented, along with the edition and date of the VIS and the date

With COVID19 vaccines, what must be dispensed instead of a VIS?

A fact sheet that is authorized under an Emergency Use Authorization (EUA)

EUA fact sheets are…

Specific to each authorized COVID19 vaccine, developed by the manufacturer of vaccine, authorized by FDA

When selecting needles, what is the best size for SubQ vaccines/IM vaccines?

SubQ: 5/8 inch

IM: 1 - 1.5 inch

What would happen if we picked a needle too short for a vaccine injection?

Decreases vaccine efficacy, since it is delivered to wrong tissue layer, and increases risk of injection site reactions

What would happen if we picked a needle too long for a vaccine injection?

May hit bone, nerve or blood vessel, resulting in pain or injury

What needle gauge is good for vaccines?

22 - 25

All needles used for administering vaccines must have a…

Safety device, as required by OSHA

What is SIRVA?

Shoulder injury related to vaccine admistration. Caused by injury to tendons, ligaments, or other muskuloskeletal structures of shoulder

How is SIRVA recognized?

Shoulder pain or limited range of motion after getting an IM vaccine

What causes SIRVA?

Thought to be caused by trauma from needlde going into and around the underlying fluid sac of the shoulder, resulting in a inflammatory reaction

Proper technique of giving SubQ injection

45 degree angle, into anterolateral thigh for infants, and into fatty tissue overlying triceps for patients 1 and older

Proper technique of giving IM injection

90 degree angle, into anterolateral thigh any age, or deltoid 3 and older

What are the three categories of adverse effects after vaccine administration?

Local, systemic, and allergic

What are local reactions?

Reaction is local, or confined to injection site, such as soreness, redness, itchinh, or swelling

Local reactions are _______ with injectable vaccines

Expected

How long do local reactions last?

temporary and go away after a few days

What are systemic reactions?

Fever, malaise, muscle pain, headache, and loss of appetite

When do systemic reactions appear?

3 to 21 days after the vaccine is given

What is a systemic reaction that occurs immediately?

Syncope, or fainting (not serious and patient recover quick)

What can cause allergic reactions with a vaccine?

Can be caused by antigen in the vaccine or any of the components of the vaccine

What is the most severe type of allergic reaction to a vaccine?

Anaphylactic shock. Ocurrs shortly after and is life-threatning

In the US, any significant adverse event after vaccine administration should be…

reported to VAERS within 7 days

What is VAERS?

Vaccine Adverse Event Reporting System. Nationwide reporting system

Where must preventable vaccine errors be reported?

To VERP, or National Vaccine Errors Reporting Program

What is found in VERP?

Gathers data of current vaccine errors, and offers advice for manufacturers and pharmacies to help prevent errors in future

According to US federal law, what 8 things must be documented?

Patients name, DOB, address

Date of administration

Vaccine administered

Manufacturer, lot number of vaccine

Dose and route of injection

Location of injection

Date on VIS and date VIS was given

Signature and title of person administering

What is the IIS?

State’s Immunization Information Systems, a computerized database to consolidate a person’s immunization history for both access and reporting