Technically Speaking: Resources to Help You Avoid Vaccine Administration Errors

Unfortunately, vaccine administration errors happen all too often. To avoid this situation, it is essential that all clinic staff members be well trained in proper vaccine administration technique. Avoiding vaccine administration errors will save your clinic time and money, as well as potential embarrassment. Most importantly, it can prevent your practice from having unprotected patients who must be recalled to have doses repeated.

The Immunization Action Coalition (IAC) receives frequent inquiries from healthcare professionals regarding vaccine administration errors and what to do about them. Some of the most common errors are:

• Administering the wrong vaccine (e.g., DTaP vs. Tdap; PPSV vs. PCV; varicella vs. zoster)
• Administering the wrong dose of vaccine for the patient’s age (e.g., pediatric HepB to an adult)
• Administering vaccine by the wrong route (intramuscularly vs. subcutaneously)
• Administering expired vaccine
• Using the wrong diluent when mixing a vaccine or administering diluent alone
• Administering a dose of vaccine to the wrong patient

To prevent these errors from happening, make sure that everyone who administers vaccines is properly trained and that you use standardized protocols for vaccine administration. The following resources can help with training for new staff, as well as for providing periodic refreshers for all staff members.

Video

Immunization Techniques: Best Practices with Infants, Children and Adults. This 25-minute DVD was developed by the Immunization Branch, California Department of Public Health, and is available for a nominal charge from the Immunization Action Coalition (IAC). It provides excellent training for new staff members and is a first-rate refresher for experienced staff.

Print resources for administering vaccines from IAC

Several free print materials are available for downloading from IAC’s Administering Vaccines Web section. Some of the most utilized materials are:

• How to Administer Intramuscular (IM) and Subcutaneous (SC) Injections(PDF)
• How to Administer Intradermal, Intranasal, and Oral Vaccinations(PDF)
• How to Administer Intramuscular, Intradermal, and Intranasal Influenza Vaccines(PDF)
• Administering Vaccines: Dose, Route, Site, and Needle Size(PDF)
• Vaccines with Diluents: How to Use Them(PDF)
• Summary of Recommendations for Child/Teen Immunization(PDF)
• Summary of Recommendations for Adult Immunization(PDF)
• Skills Checklist for Immunization(PDF)

Related resources from IAC and other organizations

• Clinic Resources: Administering Vaccines Web section on immunize.org
• “Vaccine Administration” appendix(PDF), from CDC’s Pink Book
• Vaccine administration tools from the California VFC Program
• Vaccine Error Reporting Program (VERP) at the Institute for Safe Medication Practices (ISMP) provides an online system to report vaccine errors. VERP was created to allow healthcare professionals and patients to report vaccine errors confidentially. By collecting and quantifying information about these errors, ISMP will be better able to advocate for changes in vaccine names, labeling, or other appropriate modifications that could reduce the likelihood of vaccine errors in the future.
• Vaccine Adverse Event Reporting System (VAERS). If an adverse event occurs following vaccine administration, a report should be submitted to VAERS, regardless of whether or not a healthcare professional thinks the event was related to the vaccine.

Do you have a question about vaccine administration errors? Check out IAC's "Ask the Experts" archive for Q&As answered by CDC experts. If you are unable to find answers to your specific vaccine administration questions, e-mail CDC at nipinfo@cdc.gov or IAC at admin@immunize.org for answers.