Use These Resources to Help you Avoid Vaccine Administration Errors in Your Practice

May 2014

Technically Speaking
Monthly Column by Deborah Wexler, MD
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.
Use These Resources to Help you Avoid Vaccine Administration Errors in Your Practice
Published May 2014
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
Unfortunately, vaccine administration errors happen all too often. To avoid this situation, it is essential that all clinic staff members be well trained in proper vaccine administration technique. Avoiding vaccine administration errors will save your clinic time and money, as well as potential embarrassment. Most importantly, it can prevent your practice from having unprotected patients who must be recalled to have doses repeated.
The Immunization Action Coalition (IAC) receives frequent inquiries from healthcare professionals regarding vaccine administration errors and what to do about them. Some of the most common errors are:
Administering the wrong vaccine (e.g., DTaP vs. Tdap; PPSV vs. PCV; varicella vs. zoster)
Administering the wrong dose of vaccine for the patient’s age (e.g., pediatric HepB to an adult)
Administering vaccine by the wrong route (intramuscularly vs. subcutaneously)
Administering expired vaccine
Using the wrong diluent when mixing a vaccine or administering diluent alone
Administering a dose of vaccine to the wrong patient
To prevent these errors from happening, make sure that everyone who administers vaccines is properly trained and that you use standardized protocols for vaccine administration. The following resources can help with training for new staff, as well as for providing periodic refreshers for all staff members.
Immunization Techniques: Best Practices with Infants, Children and Adults. This 25-minute DVD was developed by the Immunization Branch, California Department of Public Health, and is available for a nominal charge from the Immunization Action Coalition (IAC). It provides excellent training for new staff members and is a first-rate refresher for experienced staff.
Print resources for administering vaccines from IAC
Several free print materials are available for downloading from IAC’s Administering Vaccines Web section. Some of the most utilized materials are:
How to Administer Intramuscular (IM) and Subcutaneous (SC) Injections
How to Administer Intradermal, Intranasal, and Oral Vaccinations
How to Administer Intramuscular, Intradermal, and Intranasal Influenza Vaccines
Administering Vaccines: Dose, Route, Site, and Needle Size
Vaccines with Diluents: How to Use Them
Summary of Recommendations for Child/Teen Immunization
Summary of Recommendations for Adult Immunization
Skills Checklist for Immunization
Related resources from IAC and other organizations
Clinic Resources: Administering Vaccines Web section on
“Vaccine Administration” appendix, from CDC’s Pink Book
Vaccine administration tools from the California VFC Program
Vaccine Error Reporting Program (VERP) at the Institute for Safe Medication Practices (ISMP) provides an online system to report vaccine errors. VERP was created to allow healthcare professionals and patients to report vaccine errors confidentially. By collecting and quantifying information about these errors, ISMP will be better able to advocate for changes in vaccine names, labeling, or other appropriate modifications that could reduce the likelihood of vaccine errors in the future.
Vaccine Adverse Event Reporting System (VAERS). If an adverse event occurs following vaccine administration, a report should be submitted to VAERS, regardless of whether or not a healthcare professional thinks the event was related to the vaccine.
Do you have a question about vaccine administration errors? Check out IAC’s “Ask the Experts” archive for Q&As answered by CDC experts. If you are unable to find answers to your specific vaccine administration questions, e-mail CDC at or IAC at for answers.


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