Red Book 28e

Vaccine Administration

General Instructions For Vaccine Administration

Personnel administering vaccines should take appropriate precautions to minimize risk of spread of disease to or from patients. Hand hygiene should be used before and after each new patient contact. Gloves are not required when administering vaccines unless the health care professional has open hand lesions or will come into contact with potentially infectious body fluids. Syringes and needles must be sterile and disposable. To prevent inadvertent needlesticks or reuse, a needle should not be recapped after use, and disposable needles and syringes should be discarded promptly in puncture-proof, labeled containers placed in the room where the vaccine is administered. Changing needles between drawing a vaccine into a syringe and injecting it into the child is not necessary. A patient should be restrained adequately if indicated before any injection. Different vaccines should not be mixed in the same syringe unless specifically licensed and labeled for such use.

Because of the rare possibility of a severe allergic reaction to a vaccine component, people administering vaccines or other biological products should be prepared to recognize and treat allergic reactions, including anaphylaxis (see Hypersensitivity Reactions After Immunization). Facilities and personnel should be available for treating immediate allergic reactions. This recommendation does not preclude administration of vaccines in school-based or other nonclinic settings.

Syncope may occur following immunization, particularly in adolescents and young adults. Personnel should be aware of presyncopal manifestations and take appropriate measures to prevent injuries if weakness, dizziness, or loss of consciousness occurs. The relatively rapid onset of syncope in most cases suggests that health care professionals should consider observing adolescents for 15 minutes after they are immunized. Having vaccine recipients sit or lie down for 15 minutes after immunization could avert many syncopal episodes and secondary injuries. If syncope develops, patients should be observed until symptoms resolve.1 Syncope following receipt of a vaccine is not a contraindication to subsequent doses.

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