Appendix 10: Summary table – procedures for a vaccination encounter

Please note: due to continuous updates being made to the Immunisation Handbook, the page number on the electronic version will not always match the hard copy version.


PDF printable version of Appendix 10: Summary table – procedures for a vaccination encounter (PDF 90 KB)

This table summarises the information provided in Chapters 1.3–1.5 and provides an overview of the requirements before, during and after a vaccination encounter. This table can also be photocopied and used as an audit tool, if required.

Pre-vaccination procedures (Chapter 1.3)

Prepare anaphylaxis response kit: check availability of the protocols, equipment and drugs necessary for the management of anaphylaxis, before each vaccination session. (1.3.1) Only vaccine that has been transported and stored at the correct cold chain temperature of between +2°C to +8°C should be administered. Follow the National Vaccine Storage Guidelines: Strive for 5. (1.3.2) Perform pre-vaccination screening to determine the person’s medical fitness for vaccination, and possible need for additional vaccines. Any concern about the person’s eligibility for vaccination must be discussed with a medical practitioner, paediatrician or public health physician with expertise in vaccination (see Appendix 1 for phone numbers for State/Territory health authorities.) If a person’s health status or suitability for vaccination cannot be determined, defer vaccination and seek advice. (1.3.4) Review the individual’s vaccination history and, based on documented evidence, decide on the appropriate vaccine(s) to be administered. If the recommended vaccination schedule for age has not been completed, plan and document a ‘catch-up’ schedule and discuss this with the person or parent/carer. (1.3.5) Obtain valid consent from the person to be vaccinated, or that person’s parent/carer: this includes providing the appropriate information about the risks and benefits of vaccination and the risks of vaccine-preventable diseases. (Written vaccination information can be provided to parents as early as the last trimester of pregnancy or at the well-baby check.) Advise the person to be vaccinated, or the parent/carer of a child, of the incidence of common adverse events that may occur following vaccination. This advice and the parent’s consent should be documented. It is important that the parent be given a contact phone number in case a significant adverse event occurs within 24 to 48 hours of the vaccination. (1.3.3)

Administration of vaccines (Chapter 1.4)

Follow standard occupational health and safety guidelines to minimise the risk of needle-stick injury. (1.4.1) Depending on the vaccine(s) that are to be administered, and the age and size of the person to be vaccinated, decide on the appropriate injection site and route, and the injection equipment required (ie. syringe size, needle length and gauge) as recommended in the current NHMRC immunisation guidelines. Use a new, sterile, disposable syringe and needle for each injection. (1.4.2–1.4.6) Prepare the vaccine (check whether the vaccine is injectable or oral): Check each individual dose (ie. ampoule, pre-filled syringe or vial) to see that the expiry date has not lapsed, and that there is no particulate matter or colour change in the vaccine. Reconstitute the vaccine as needed immediately before administration, preferably using a separate needle to draw up the diluent or as recommended by the manufacturer. Use only the diluent supplied with the vaccine. Mix fully, and draw up the vaccine. Locate the injection site by fully uncovering the appropriate limb(s) and visualising the correct anatomical markers. Position the limb for vaccination so that the muscles are relaxed (usually a flexed position). Keep the limb as immobile as possible without using excessive restraint. Ensure that the skin is visibly clean. (1.4.7–1.4.8) Administer the vaccine(s) using the recommended technique (IM, SC or Oral). For injectable vaccines, follow the recommendations for administering more than 1 vaccine into a limb during the encounter. Do not inject oral vaccines. Remove the needle briskly after IM injection. (1.4.5, 1.4.9)

Post-vaccination procedures (Chapter 1.5)

Immediate after-care Dispose of used needles, syringes and vaccine vials/ampoules in accordance with standard infection control guidelines. Cover the puncture wound quickly with a dry cotton wool ball and hypoallergenic tape as needed. Apply gentle pressure for 1–2 minutes but do not massage. Remove the cotton wool and tape after a few minutes. Continue using comfort and distraction techniques to alleviate any distress and pain. Note: paracetamol is not used routinely at the time of vaccination but may be recommended as required for fever or pain. (1.5.1) Managing adverse reactions, documentation and follow-up Remind the vaccinated person, or the parent/carer of a child, about the possible common adverse events following immunisation and how to manage them. It is preferable to provide this as written information (see inside back cover of this Handbook). Before departure, inform the person or the parent/carer, preferably in writing, of the date of the next scheduled vaccination. The vaccinated person and/or parent/carer should be advised to remain in a nearby area for a minimum of 15 minutes after the vaccination. The area should be close enough to the vaccinator, so that the child/person can be observed and medical treatment can be readily obtained if needed. Take the opportunity to check the vaccination status of other family members (as appropriate) and provide (or refer) for catch-up vaccination. Document the details of vaccination: (i) on a record to be retained by the person, or the parent/carer of a child, (ii) on the relevant clinical record (electronic or hard-copy), and (iii) on an ACIR (or equivalent) encounter form, for children <7 years of age. Remind the vaccinated person, or the parent/carer of a child, to promptly report any significant adverse event following immunisation to the vaccinator, so that it can be reported to either the Adverse Drug Reactions Advisory Committee (TAS) or to the relevant State/Territory health authorities (ACT, NSW, NT, QLD, SA, VIC and WA). (1.5.2–1.5.4)