Preparing and administering the AstraZeneca COVID-19 Vaccine

Anna Bischler, Lead Medicines Information Pharmacist, Midlands and East Medicines Advice Service (East Anglia site)Published Last updated See all updates

Preparing vaccine using our SOPs, plus additional advice on batch numbers, withdrawing additional doses and post-vaccination observation

Additional clarifications

In addition to our SOPs, further points of clarification related to preparation and administration are as follows.

Withdrawing an additional dose from a vial

The Patient Group Direction (PGD) and the National Protocol allows for the withdrawal of an additional dose from a vaccine vial. The PGD and MHRA Information for Healthcare Professionals outlines that each vial contains at least the number of doses stated. When low dead volume syringes and/or needles are used, the amount remaining in the vial may be sufficient for an additional dose. Care should be taken to ensure a full 0.5ml dose is administered. Where a full 0.5ml dose cannot be extracted, the remaining volume should be discarded.  It is important to remember that vials must not be pooled, a full dose must be extractable from the volume in a single vial and that staff are assured that each extraction from the vial has been for correct full dose(s).

Observation post vaccination

There is no requirement for routine post-administration observation of AstraZeneca COVID-19 vaccine recipients in any delivery setting.

Monitoring for adverse effects

Supervision should always be readily available in case of an anaphylactic event following the administration of any vaccine.

Public Health England’s Immunisation Against Infections Disease (the Green book) states that the British Society for Allergy and Clinical Immunology (BSACI) advises that individuals with a localised urticarial (itchy) skin reaction (without systemic symptoms) to the first dose of any COVID-19 vaccine should receive the second dose of vaccine with prolonged observation (30 minutes) in a setting with full resuscitation facilities (e.g. a hospital).

Change history

  1. Information related to batch numbers removed. Information now on the generic all vaccine administration and preparation page

  2. Monitoring for adverse effects added

  3. Observation post vaccination added

  4. Specific reference to the 9th and 11th additional doses removed. Additional guidance added.

  5. Page title changed from "Administering the AstraZeneca COVID-19 Vaccine"

  6. Published