| Technically Speaking |
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| Monthly Column by Deborah Wexler, MD |
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| 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. |
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| 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. |
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| TECHNICALLY SPEAKING |
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| Guidance for Busy Clinics on Prefilling Your Own Syringes |
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| Published September 2011 |
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| 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. |
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| 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 |
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| 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. |
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| 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. |
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| 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. |
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| 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. |
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ACIP Recommendations
Vaccine Information Statements 
