Which vaccines should not be given together?
Nonsimultaneous Administration of Live Vaccines If any combination of live, injected vaccines (MMR-II, ProQuad, Varivax) or live, attenuated influenza vaccine (LAIV [FluMist]) is not administered simultaneously, the vaccine doses should be separated by at least 4 weeks.
Can Tdap and influenza be given together?
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) and inactivated influenza vaccine (IIV) can be administered simultaneously (21).
What is the preferred injection location for most in immunizations?
For infants and younger children receiving more than two injections in a single limb, the thigh is the preferred site because of the greater muscle mass. For older children and adults, the deltoid muscle can be used for more than one intramuscular injection.
What is the route of administration of BCG vaccine?
BCG Vaccine AJV should be administered by personnel trained in the intradermal technique. The vaccine should be injected strictly intradermally in the arm, over the distal insertion of the deltoid muscle onto the humerus (approx.
Can Tdap and varicella be given together?
Conclusions: The varicella vaccine given simultaneously with DTaP produced strong B- and T-cell responses alike. This is the first report to show that CMI to VZV is conferred to young children by vaccination with a temperature stable VZV vaccine.
Can DPT and MMR be given together?
Thus, DTP, Hib, IPV, hepatitis B, pneumococcal conjugate vaccine, MMR, varicella, and rotavirus vaccines can be administered simultaneously.
Why is Z track method not recommended?
However, due to the potential for injury to the sciatic nerve, the ventrogluteal muscle is most often used instead. This site in the dorsogluteal muscle is difficult to use for self-injection and is not recommended. You should not use an injection site that has evidence of infection or injury.
Where does Covid vaccine go in arm?
Administering Vaccine The injection site is approximately 2 inches below the acromion process and above the axillary fold/armpit.
Is the Z track method still used?
YOU SHOULD USE the Z-track method for all I.M. injections in adults. By leaving a zigzag path that seals the needle track, this technique prevents drug leakage into the subcutaneous tissue, helps seal the drug in the muscle, and minimizes skin irritation.
Why is BCG intradermal?
Why do we give 0.05 mL dose of BCG to newborns (below 1 month of age)? This is because the skin of newborns is thin and an intradermal injection of 0.1 mL may break the skin and penetrate into the deeper tissue and this may cause local abscess and enlarged axillary lymph nodes. Which strain is used?
Why is BCG given in deltoid?
Adverse effects BCG immunization generally causes some pain and scarring at the site of injection. The main adverse effects are keloids—large, raised scars. The insertion to the deltoid muscle is most frequently used because the local complication rate is smallest when that site is used.
Where is DPT administered?
Administer all diphtheria, tetanus, and pertussis vaccines (DT, DTaP, Td, and Tdap) by the intramuscular route. The preferred injection site in infants and young children is the vastus lateralis muscle of the thigh. The preferred injection site in older children and adults is the deltoid muscle in the upper arm.
Covid-19 Vaccine and Coadministration with Other Vaccines
- CDC and the Advisory Committee on Immunization Practices (ACIP) guidance states COVID-19 vaccines can be given during the same visitwith other vaccines, including flu vaccine, if the recipient is eligible for the vaccines. Considerations for Coadministration of COVID-19 Vaccines …
Procedural Pain Management
- Vaccine injections are often cited as a common source of procedural pain in children. The pain associated with injections is a source of distress for children and their parents and/or guardians. Although pain from injections is, to some extent, unavoidable, there are some things that parents and health care providers can do to help prevent distress and decrease fear. Evidence-based str…
Managing Acute Vaccine Reactions
- Severe, life-threatening reactions following vaccinations are rare. However, all vaccination providers should be familiar with the office emergency plan and currently certified in cardiopulmonary resuscitation. All health care professionals who administer vaccines to older children, adolescents, and adults should be aware of the potential for syncope after vaccination …
Infection Control and Sterile Technique
- General Precautions
Persons administering vaccinations should follow appropriate precautions to minimize risk for disease exposure and spread. Hands should be cleansed with an alcohol-based waterless antiseptic hand rub or washed with soap and water before preparing vaccines for administratio… - Vaccine Administration: Preparation and Timely Disposal
Vaccines should be drawn up in a designated clean medication area that is not adjacent to areas where potentially contaminated items are placed. Multi-dose vials to be used for more than one patient should not be kept or accessed in the immediate patient treatment area. This is to preve…
Route of Administration
- Injectable Route
Routes of administration are recommended by the manufacturer for each immunobiologic (Table 6-1). With the exceptions of bacille Calmette-Guérin (BCG) vaccine and smallpox vaccine (administered intraepidermally), injectable vaccines are administered by the intramuscular or su… - Oral Route
Rotavirus, adenovirus, cholera vaccine, and oral typhoid vaccines are the only vaccines administered orally in the United States. Oral typhoid capsules should be administered as directed by the manufacturer. The capsules should not be opened or mixed with any other substance. Ro…
Multiple Injections
- If multiple vaccines are administered at a single visit, administer each preparation at a different anatomic site (28). The location of all injection sites with the corresponding vaccine injected should be documented in each patient’s medical record. Health-care practices should consider using a vaccination site map so that all persons administering vaccines routinely use a particula…
Jet Injections
- Jet injectors are needle-free devices that pressurize liquid medication, forcing it through a nozzle orifice into a narrow stream capable of penetrating skin to deliver a drug or vaccine into intradermal, subcutaneous, or intramuscular tissues (32-33). Immune responses generated by jet injectors against both attenuated and inactivated viral and bacterial antigens are usually equival…
Methods For Alleviating Discomfort and Pain Associated with Vaccination
- Comfort measures, such as distraction (e.g., playing music or pretending to blow away the pain), cooling of the injection site(s), topical analgesia, ingestion of sweet liquids, breastfeeding, swaddling, and slow, lateral swaying can help infants or children cope with the discomfort associated with vaccination (40-42). Pretreatment (30-60 minutes before injection) with a 5% to…
Clinical Implications of Nonstandard Vaccination Practices
- Best practice guidance for route, site, and dosage of immunobiologics is derived from data from clinical trials, practical experience, normal intervals of health care visits, and theoretical considerations. ACIP discourages variations from the recommended route, site, volume, or number of doses of any vaccine. Variation from the recommended route and site can result in in…
References
- Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene T...
- Occupational Health and Safety Administration. Occupational exposure to bloodborne pathogens; needlesticks and other sharps injuries; Final Rule (29 CFR Part 1910). Fed Regist. …
- Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene T...
- Occupational Health and Safety Administration. Occupational exposure to bloodborne pathogens; needlesticks and other sharps injuries; Final Rule (29 CFR Part 1910). Fed Regist. 2001;66(12):5318-5325.
- Siegel J, Rhinehart E, Jackson M, Chiarello L, the Healthcare Infection Control Practices Advisory Committee. 2007 guideline for isolation precautions: preventing transmission of infectious agents...
- Centers for Disease Control and Prevention. General recommendations on immunization. Re…
