For administration of routinely recommended vaccines, there is no evidence of risk of exposure of vaccine components to the health care provider, so conditions in the provider labeled as contraindications and precautions to a vaccine components are not a reason to withdraw from this function of administering the vaccine to someone else. Providers are sometimes concerned when they have the same contraindications or precautions as their patients from whom they withhold or defer vaccine. Health Care Provider Exposure to Vaccine Components This can lead to violation of expiration dates and product contamination ( 6,7). Vaccine from two or more vials should never be combined to make one or more doses. Unused syringes that are prefilled by the manufacturer and activated (i.e., syringe cap removed or needle attached) should be discarded at the end of the clinic day. The doses should be administered as soon as possible after filling, by the same person who filled the syringes. In certain circumstances in which a single vaccine type is being used (e.g., in preparation for a community influenza vaccination campaign), filling a small number (10 or fewer) of syringes may be considered (5). The FDA does not license administration syringes for vaccine storage. Because unused prefilled syringes also typically must be discarded if not used within the same day that they are filled, vaccine wastage might occur. Because the majority of vaccines have a similar appearance after being drawn into a syringe, prefilling might result in administration errors. When in doubt about the appropriate handling of a vaccine, vaccination providers should contact that vaccine’s manufacturer.ĪCIP discourages the routine practice of providers’ prefilling syringes for several reasons. For example, varicella vaccine should be discarded if not used within 30 minutes after reconstitution, whereas MMR vaccine, once reconstituted, must be kept in a dark place at 36☏ to 46☏ (2☌ to 8☌) and should be discarded within 8 hours if not used. For live vaccines that require reconstitution, manufacturers typically recommend the vaccine be used as soon as possible after reconstitution and be discarded if not used within 30 minutes after reconstitution. For non-live vaccines, manufacturers typically recommend use within the same day that a vaccine is withdrawn or reconstituted. Syringes that are prefilled by the manufacturer and activated (i.e., syringe cap removed or needle attached) but unused should be discarded at the end of the clinic day. Single-dose vials and manufacturer-filled syringes are designed for single-dose administration and should be discarded if vaccine has been withdrawn or reconstituted and subsequently not used within the time frame specified by the manufacturer. To prevent contamination of the vial, make sure the patient area is clean and free of potentially contaminated equipment.ĭifferent single-components of combination vaccines should never be mixed in the same syringe by an end-user unless specifically licensed for such use ( 4). The vial must be accessed in the immediate patient area to reduce environmental contamination by vaccine virus. The vaccine adheres to the sides of the bifurcated needle, and is administered via skin puncture. Smallpox vaccine is accessed by dipping a bifurcated needle directly into the vaccine vial. This is to prevent inadvertent contamination of the vial through direct or indirect contact with potentially contaminated surfaces or equipment that could then lead to infections in subsequent patients ( 3). Multi-dose vials to be used for more than one patient should not be kept or accessed in the immediate patient treatment area. Vaccines should be drawn up in a designated clean medication area that is not adjacent to areas where potentially contaminated items are placed. Vaccine Administration: Preparation and Timely Disposal If worn, gloves should be changed between patients. Occupational Safety and Health Administration (OSHA) regulations do not require gloves to be worn when administering vaccinations, unless persons administering vaccinations have open lesions on their hands or are likely to come into contact with a patient’s body fluids ( 2). Hands should be cleansed with an alcohol-based waterless antiseptic hand rub or washed with soap and water before preparing vaccines for administration and between each patient contact ( 1). Persons administering vaccinations should follow appropriate precautions to minimize risk for disease exposure and spread. Printer friendly version Infection Control and Sterile Technique General Precautions
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