Preparing and administering the COVID-19 Vaccine AstraZeneca

Tim Meadows, Medicines Information Pharmacist, Midlands and East Medicines Advice Service (East site)Published Last updated See all updates

Preparing COVID-19 Vaccine AstraZeneca using our SOPs, plus additional advice withdrawing additional doses and post-vaccination observation

Guidance on handling and Standard Operating Procedures (SOPs)

Our guidance and standard operating procedures specific to handling and preparation cover many points and can be found below.

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).

Monitoring for adverse effects

The MHRA Summary of Product Characteristics states that hypersensitivity reactions including anaphylaxis and angioedema have occurred following administration of the AstraZeneca COVID-19 vaccine. Appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event following the administration of the vaccine.

Observation post vaccination

UK Health Security Agency (UKHSA – formerly known as PHE) Immunisation Against Infectious Disease (the Green Book) states that there is no routine requirement for observation following administration of the AstraZeneca COVID-19 vaccine.

Advising individuals with allergies on their suitability for COVID-19 Vaccine AstraZeneca provides guidance on the monitoring requirements for those with a history of allergic reactions.

UK Health Security Agency (UKHSA – formerly known as PHE) Immunisation Against Infectious Disease (the Green Book) states that a 15-minute observation period is recommended for those individuals who had non-allergic reactions such as vasovagal episodes, non-urticarial skin reaction or non-specific symptoms following previous vaccine doses.

Driving advice

UK Health Security Agency (UKHSA – formerly known as PHE) Immunisation Against Infectious Disease (the Green Book) states that as fainting can occur following vaccination, all those vaccinated with any of the COVID-19 vaccines should not drive for 15 minutes after vaccination.

Administering to patients with a previous allergy status

Advising individuals with allergies on their suitability for COVID-19 Vaccine AstraZeneca

Advice on whether people with a previous allergic reaction can have the COVID-19 Vaccine AstraZeneca.

Change history

  1. All information resources checked and information up to date.
  1. Information on observation recommendations for individuals that experienced non-allergic reactions to a previous dose added. Advice for individuals driving after vaccination added.
  1. Reference to hypersensitivity reactions following administration of the AstraZeneca COVID-19 vaccine added to monitoring for adverse effects section.
  1. Statement from British Society for Allergy and Clinical Immunology (BSACI) removed as link available to 'administering to patients with a previous allergy status' page with associated tool.
  1. Administering to patients with a previous allergy status section with link added
  1. Information related to batch numbers removed. Information now on the generic all vaccine administration and preparation page
  1. Monitoring for adverse effects added
  2. Observation post vaccination added
  3. Page title changed from "Administering the AstraZeneca COVID-19 Vaccine"
  4. Specific reference to the 9th and 11th additional doses removed. Additional guidance added.
  1. Published