Minimising the risk of administration of the wrong COVID-19 vaccine

David Erskine, Director, London Medicines Information Services, Specialist Pharmacy ServicePublished

A series of steps will help sites separate multiple vaccines as much as possible throughout the vaccination process, from receipt through to administration

Receiving the vaccine

Issue

Ensuring the correct vaccine has been received in the amounts expected and that cold chain is maintained as appropriate.

When receiving the vaccine, check:

  • The identity of the vaccine delivered against the delivery note and the order on your stock control system.
  • The identity of the vaccine, including the name of the manufacturer
  • The required storage conditions. Place the vaccine immediately into the correct storage location (fridge, freezer or ultra-low temperature freezer) following the relevant procedures.

Storing the vaccine

Issue

Maintaining separation of stock.

When storing or removing the vaccine:

  • Store in separate labelled containers within refrigerator; or
  • Store in separate fridges and have plan in place to maintain stock segregation in event of fridge failure
  • Put away in correct fridge/box
  • Read label on pack not label on fridge, shelf or storage container
  • Ensure correct handling of all vaccines, particularly those stored below freezing
  • Ensure where relevant expiry times are calculated, checked and recorded for vaccines after thawing
  • Ensure vaccines stocks are stored and rotated so that those with the earliest shortest expiry date/time are used first
  • Ensure unused vials are not returned to stock unless the maintenance of cold chain has been assured
  • Ensure consumables are stored in clearly labelled areas

Location of vaccine administration

Issue

Reducing likelihood of mix up by separation of processes.

When planning or designing vaccination services consider:

  • Planning vaccine-specific days, or if necessary sessions, in each vaccination site
  • Potential to run single vaccine centres where possible
  • Ideally maximise use of complex-to-handle vaccines (Pfizer/ Moderna) in hospital hubs and vaccination centres and less complex vaccines (AstraZeneca/Novavax) in non-hospital settings including roving model vaccination services
  • Ensuring adequate supply of appropriate of consumables is in place

Timing vaccine administration

Issue

Ensuring separation by time if separation by place is not possible.

When planning or designing vaccination services consider:

  • Clear break between vaccines – day, safety briefing, time, staff changes, judicious use of colours and posters on vaccine fridge and in treatment stations
  • Different vaccine sessions at different times (days / sessions)
  • Making break and safety briefing mandatory before next session
  • Potential to schedule sessions using complex vaccines (eg Pfizer) first so that supply of diluted vaccine is used up before having break, and then running remaining time with less complex vaccines
  • Ensuring adequate supply of appropriate consumables is in place

See also

Preparing and administering COVID-19 Vaccines

Guidance on preparing and administering common to all available COVID-19 vaccines, and specific to individual vaccines