Prevent Errors With COVID-19 Boosters and Flu Vaccinations

You can be ready to manage competing demands and prevent errors as COVID-19 boosters and flu vaccines overlap this fall.

Continue to work as a team to organize and delegate tasks.

For example, lean on techs and students to prep supplies and paperwork, draw up doses, and administer immunizations if possible.

Train your staff to use checklists, charts, etc...not memory. Date these materials...and have a point person keep them current.

Promote online appointments...to limit the load of walk-ins.

Prevent product and dosing mix-ups. Separate vaccines using labeled containers or shelves...or even different fridges or freezers.

Don’t rely on cap color alone to differentiate unused vials. Read labels closely...scan barcodes...and consider using colored stickers.

For example, Pfizer-BioNTech COVID-19 vials for age 12 and up have gray caps and labels for the primary series AND bivalent booster.

And the Moderna bivalent booster has a dark blue cap...just like monovalent Moderna vials for 6 months to 5 years and 6 to 11 years.

Plus vials of Moderna’s primary series for kids 6 to 11 may say “booster doses only”...since they used to be monovalent adult boosters. Mark these “kids 6 to 11” until products with correct labels arrive.

Follow a standard process when drawing up doses...since they vary by age and product. Ask for a second set of eyes whenever possible.

As a best practice, label syringes as each dose is drawn up.

Take only the vaccines needed to the administration area...for 1 patient at a time. Ask open-ended questions to confirm the right patient (name, birth date, etc)...and right vaccine (product, dose, etc).

Also ask the patient to read the syringe label if practical.

Follow your policy for internal reporting if an error occurs...and also report to VAERS (Vaccine Adverse Event Reporting System).

Use our resource, Vaccine Administration Strategies, for ways to limit risk of injury, injection pain, and patient anxiety.

And see our training program, Pharmacy Technicians University’s PTU Elite: Immunizations...to help techs meet requirements to vaccinate.

Key References

  • https://www.ismp.org/alerts/age-related-covid-19-vaccine-mix-ups (9-21-22)
  • https://www.ismp.org/alerts/mix-ups-between-influenza-flu-vaccine-and-covid-19-vaccines (9-21-22)
  • https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html#appendix-d (9-21-22)
  • https://www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration-preventing-errors.pdf (9-21-22)
Pharmacist's Letter. October 2022, No. 381002



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