This will reduce errors. Often, more than one vaccine is needed during the same doctor’s visit, requiring more than one shot. 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). The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The preferred site for infants and young children is the vastus lateralis muscle in the anterolateral thigh. If you accidently administered varicella vaccine to an adult when Shingrix was indicated, no specific safety concerns exist, but the dose should not be considered valid. Best practices for multiple injections include: 1. Dowash hands between patient encounters and before preparing vaccines. Dos 1. 4. Shingrix should be injected intramuscularly in the deltoid region of the upper arm. Doensure that the person who drew up the vaccine administers it.
Subcutaneous injection is a vaccine administration error and should be avoided. Each person administering vaccines should draw up no more than one multidose vial, or 10 doses, at one time. CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines. Dowear gloves to administer a vaccine if there is a risk coming into contact with body fluids or if the administrator has open sores or cuts on the hands. Administration of Shingrix to a child who was supposed to be vaccinated with varicella vaccine is a vaccine administration error, and the event should be documented and procedures put in place to prevent this from happening again. Shingrix and pneumococcal vaccine may be administered at the same visit if the person is eligible for both. Otherwise, discard it. For older children and adults, the deltoid muscle can be used for more than one intramuscular injection.
If the error is not immediately detected, you may initiate the Shingrix series no less than eight weeks later. 2. Administer pneumococcal conjugate vaccine (PCV13) intramuscularly. Drawing up doses days or even hours before a clinic is not acceptable. Persons administering vaccinations should follow appropriate precautions to minimize risk for disease exposure and spread. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. 3. Intramuscular (IM) injection Intranasal (NAS) administration of Flumist (LAIV) vaccine 90° angle muscle skin subcutaneous tissue Subcutaneous (Subcut) injection 45° angle skin subcutaneous tissue Administering Vaccines: Dose, Route, Site, and N eedle Size Vaccine Dose Route Diphtheria, Tetanus, Pertussis (DTaP, DT, Tdap, Td) 0.5 mL.
Do not draw up vaccines before arriving at the clinic site.
IM .. Document the Vaccination(s) Health care providers are required by law to record certain information in a patient’s medical record. If a subcutaneous vaccine administration error occurs on the first dose of Shingrix, a second dose is still required after 2 – 6 months. This will help with documenting which vaccines were given in which site. The gluteal area should never be used for rabies vaccine injections because observations suggest administration in this area results in lower neutralizing antibody titers. Each vaccine has a recommended administration route and site, which are based on clinical trials, practical experience, and theoretical considerations. Prepare Shingrix by reconstituting the antigen component with the adjuvant suspension component.
Administer pneumococcal polysaccharide vaccine (PPSV23) intramuscularly or subcutaneously. Lab… Shingrix should not be used for children, and should not be used in place of varicella vaccine. This event should be reported to the Vaccine Adverse Event Reporting System (VAERS) by phone 1-800-822-7967 or through the websiteexternal icon. For infants and younger children receiving more than two injections in a single limb, the thigh is the preferred site because of the greater muscle mass.
For children, the anterolateral aspect of the thigh is also acceptable. For adults, the vaccination should always be administered intramuscularly in the deltoid area (arm). CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. However, if you inadvertently administer Shingrix subcutaneously, that dose is considered valid and does not need to be repeated. These events should be documented and procedures put in place to prevent this from happening again. However, you do not need to restart the vaccine series. You will be subject to the destination website's privacy policy when you follow the link. If the second dose is given less than 4 weeks after the first dose, the second dose should be considered invalid. Do not use if exposed to temperatures below 36⁰F. VAERS is maintained jointly by CDC and the U.S. Food and Drug Administration. Either administer it immediately, or store it in the refrigerator and use it within 6 hours of reconstitution. When both pneumococcal conjugate vaccine PCV13 and PPSV23 are recommended for an adult, PCV13 should always be administered first and may be administered concomitantly with Shingrix. Saving Lives, Protecting People, You Call The Shots – Intramuscular Shingrix vaccination (recombinant zoster vaccine), National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. 5. Concomitant administration of Shingrix with Fluarix Quadrivalent (influenza vaccine) (QIV) has been studied, and there was no evidence for interference in the immune response to either vaccine or safety concerns. CDC general recommendations advise that recombinant and adjuvanted vaccines, such as Shingrix, can be administered concomitantly, at different anatomic sites, with other adult vaccines. If more than 6 months have elapsed since the first dose of Shingrix, you should administer the second dose as soon as possible.
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