- The patient is 7 year or older
- Holds an active CPR certification with hands-on training component, and is valid for a maximum of three years.
- Following Oregon Health Authority Protocol (OHA)
- There is a current copy of the CDC “Epidemiology and Prevention of Vaccine-Preventable Diseases”
- Report adverse events
- VIS is given to patient or patient representative and all questions answered.
- “The pharmacist must report adverse events as required by the Vaccine Adverse Events Reporting System (VAERS) and to the primary care provider as identified by the patient.”
- Storage temperature: Refrigerator storage should be at 2 to 8°C (35 to 46°F); frozen products between -25 to -10 °C (-13 to 14 °F)
- Must be stored in a temperature stable section of the refrigerator (NOT the door).
- Use a centrally placed and accurate buffered probe thermometer (e.g. glycol or glass beads), calibrated within +/- 0.5 °C variance
- Comply with continuous temperature monitoring requirements, with quarterly validations of vaccine storage units and their monitoring equipment.
- Adhere to monitoring plan with elements listed in OAR 855-041-1036
- Adhere to written quality assurance process to avoid temperature excursions.
Laws & Rules
During the period from July 1 through June 30 of each biennial license renewal cycle, each pharmacist must have satisfactorily completed three (3) continuing pharmacy education units (CEU's) in an approved continuing pharmacy education program prior to submission of the license renewal. Ten contact hours equals 1 CEU. Fifty minutes equals 1 contact hour.
The patient did not receive the full volume of their dose, what do I do?
Any vaccination using less than the standard dose should not be counted, and the person should be revaccinated according to age unless serologic testing indicates that an adequate response has developed. However, if 2 half-volume formulations of vaccine have already been administered on the same clinic day to a patient recommended for the full volume formulation, these 2 doses can count as one full dose.
Examples: inappropriately divided doses, syringe, applicator, or needle leakage.
What are typical needle specifications?
- Gauge: 22-25
- 1-inch needle or larger is required to ensure intramuscular administration, If the subcutaneous and muscle tissue are bunched to minimize the chance of striking bone.
- Administer at a 90-degree angle
- Age specifics visit ACIP
- Gauge: 23-25
- Administer at a 45-degree angle
Other routes of administration: Visit ACIP
Do immunizations administered by the wrong route need to be repeated?
Vaccines should always be given by the route recommended by the manufacturer because data regarding safety and efficacy of alternative routes is limited.
However, ACIP recommends that vaccines given by the wrong route be counted as valid with two exceptions; Hepatitis B and Rabies vaccine must be given IM and in adults, in the deltoid or anterolateral thigh muscle in order to be counted as valid. If either is given in the gluteal site the immunization must be repeated.
Can I administer multiple vaccinations in one visit?
For older children and adults, the deltoid muscle can be used for more than one intramuscular injection. If a vaccine and an immune globulin preparation are administered simultaneously (e.g.,Td/Tdap and tetanus immune globulin [TIG], hepatitis B and hepatitis B immunoglobulin [HBIG]), separate anatomic sites (i.e., different limbs) should be used for each injection.
Visit ACIP for more information
A vaccination was not refrigerated, can it still be administered?
As a general rule, vaccines that have been stored at inappropriate temperatures should not be administered unless public health authorities or the manufacturer determine it is safe and effective to do so. If such vaccines already have been administered, vaccine exposed to inappropriate temperatures that is inadvertently administered should generally be repeated. Clinicians should consult promptly with state or local health departments in these situations.
More information: Storage and Handling of Immunobiologics
Does a dose of expired vaccine have to be repeated?
If a dose of expired inactivated vaccine is given by accident to a patient, the dose should be repeated with viable vaccine. The repeat dose can be given on the same day or at any time after the date of the expired dose. If a dose of expired live virus is given, you must wait at least 28 days after the expired dose was administered before repeating it.
Is an active CPR certification required to administer vaccinations?
The pharmacist must hold an active CPR certification issued by the American Heart Association or the American Red Cross or any other equivalent program intended for a healthcare provider that contains a hands-on training component and is valid for not more than three years, and documentation of the certification is placed on file in the pharmacy. OAR 855-019-0270