5 Recommendations for Safer Vaccine Administration

Introduction

Like compliance packaging and opioid agonist therapy, vaccine administration is a high-risk process. The rapid introduction of COVID-19 vaccines has introduced new risks. ISMP Canada reported a spike in vaccine medication incidents from across the country. COVID-19 vaccine incidents related to children were also reported in Canada and the U.S. Pharmacy professionals should understand the contributing factors and prevention strategies. The storage, preparation, and administration requirements of COVID-19 vaccines were unfamiliar to pharmacy teams. The complexity of administering COVID-19 vaccines increases the chance of a medication incident.

Incident Example from a Manitoba Community Pharmacy

A COVID-19 vaccine was prepared and administered to a patient without the necessary dilution step. The error was recognized soon after when another pharmacist asked if the vaccine had been diluted. The patient, physician, and manufacturer were contacted accordingly.

5 Key Recommendations for Vaccine Administration Safety

1. Develop a standardized checklist for counselling patients. Your checklist should cover points before and after you give the vaccine. For example, vaccine indication, expected side effects, etc. before you give the vaccine. Monitoring, follow-up, etc. after you give the vaccine.
2. Post specific preparation instructions for each vaccine in the vaccine preparation area.
3. Print out and post current COVID-19 and other immunization schedules for children and adults.
4. Arrange the work environment to support safe vaccine dose preparation and verification. Use the following guidelines:
   • • Reduce distractions as much as possible.
     • Ensure proper lighting.
     • Design a clean, uncluttered workspace.
5. Sort and store vaccines by age range. For example, separate the various doses on labelled shelves or in plastic bins: 2 – 5 years, 5 – 11 years, and 12 years and older.

Please see the resources related to COVID-19 vaccine administration below for additional safety recommendations: 

• COVID-19 vaccine guide for youth and adults (12 years and over): Managing COVID-19 vaccine administration errors or deviations. 

• Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers (appendix D).  
• CPhM (College of Pharmacists of Manitoba) Resources Relevant to the Administration of Injections to Young Children (Ages 2-5). 
• Manitoba Module: Administration of Injections (for reference without post-test). 
• Shoulder Injury Related to Vaccine Administration: Causes, Response, and Prevention.