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Guidance for Busy Clinics on Prefilling Your Own Syringes
September 2011
Technically Speaking
Monthly Column by Deborah Wexler, MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
TECHNICALLY SPEAKING
Guidance for Busy Clinics on Prefilling Your Own Syringes
Published September 2011
Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit www.immunize.org/acip/acip_vax.asp.
The Immunization Action Coalition (IAC) frequently receives email inquiries from immunization staff asking if they can draw up vaccine into syringes ahead of time, especially before busy influenza or back-to-school vaccination clinics. The Centers for Disease Control and Prevention (CDC) discourages the practice of prefilling syringes because it can result in these undesirable outcomes:
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Increased possibility of administration and dosing errors
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Increased risk of maintaining vaccine under inappropriate storage conditions (i.e., temperature or light)
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Possibility of bacterial contamination
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Possibility of reducing a vaccine’s potency over time because of its interaction with the plastic syringe components
Prefilling syringes might also violate basic medication administration guidelines, which state that an individual should administer only those medications he or she has prepared and drawn up him or herself.
Although pre-drawing vaccine is discouraged, immunization staff may pre-draw a limited amount of vaccine in a mass-immunization clinic setting if the following conditions apply:
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Only a single type of vaccine (e.g., influenza) is administered at the mass-immunization clinic setting
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Vaccine is not drawn up in advance of its arrival at the mass-vaccination clinic location
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Prefilled syringe doses are stored at temperatures appropriate for the vaccine they hold
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No more than one vial or 10 doses (whichever is greater) is drawn into syringes
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Clinic staff monitor patient flow carefully, avoid drawing up unnecessary doses, and promptly administer pre-drawn doses.
At the end of the clinic day, discard any remaining syringes prefilled by staff. Never save these syringes for another day, and never attempt to put the vaccine dose back into a vial.
As an alternative to personally prefilling syringes, CDC recommends using manufacturer-supplied prefilled syringes, which are designed both for storage and administration. However, keep in mind that once you remove the syringe cap or attach a needle, the sterile seal is broken. You should either use the syringe or discard it at the end of the clinic day.
