Immunization Administration Procedures

Compliance and Preparation

• Comply with OSHA's blood-borne pathogens standard.
• Required supplies:
  • Vaccine for injection
  • Alcohol swabs
  • Cotton swabs or gauze
  • Adhesive bandages
  • Syringe and needle of appropriate size
  • Synthetic gloves
  • Sharps container
  • Absorbent pad
  • Emergency kit with epinephrine
• Set up supplies in a private/semi-private area with a chair and workspace.
• Arrange space to allow for fainting and access to a hard surface for CPR.
• Provide the patient with a Vaccine Information Sheet (VIS).
• Review screening questions and updated information with the patient.
• Answer any patient questions.

Syringe Preparation

• Review contents of each vial (e.g., antigen, diluent/adjuvant).
• Remove plastic cap from the vial and swab the top with alcohol.
• Fill the syringe with air equivalent to the vaccine volume needed.
• Insert the needle into the vial, inject air, invert, and withdraw the required vaccine amount.
• Remove any large air bubbles.
• Options after filling syringe:
  • Recap for later use (if the needle has not entered a patient).
  • Directly inject into the patient.

Intramuscular Injection Procedure

• Gloves are optional but recommended.
• Ensure both you and the patient are seated.
• Identify and expose the injection site (middle of the upper arm, deltoid muscle).
• Swab the injection site with alcohol and let it dry.
• Ensure sharps container is accessible.
• Hold syringe near the hub, insert needle at a 90-degree angle to the hub.
• Maintain patient contact, depress plunger smoothly, and activate safety device.
• Dispose of syringe and needle into sharps container.
• Cover the injection site with cotton/gauze and secure with adhesive bandage.
• Remove gloves and wash hands.
• Change gloves between patients.
• Provide post-injection counseling and follow-up instructions.
• Document the injection while complying with legal requirements.

Subcutaneous Injection Procedure

• Ensure both you and the patient are seated.
• Expose the injection site (posterior lateral aspect of the upper arm).
• Swab the site with alcohol and let it dry.
• Ensure sharps container is accessible.
• Hold the syringe near the hub, pinch a fold of skin, and insert the needle at a 45-degree angle to the hub.
• Maintain patient contact, depress plunger smoothly, withdraw needle quickly, and activate safety device.
• Dispose of syringe and needle into sharps container.
• Cover the site with cotton/gauze and secure with adhesive bandage.
• Remove gloves and wash hands.
• Change gloves between patients.
• Provide post-injection counseling and follow-up instructions.
• Document the injection while complying with legal requirements.
• For multiple vaccinations, use separate arms or inject at least one inch apart in the same arm.

Intranasal Vaccine Delivery Procedure

• Ensure the patient is sitting and provide a tissue.
• Remove the rubber tip protector from the syringe.
• The patient should be upright with a slightly tilted head.
• Place the tip inside one nostril and depress the plunger rapidly until the dose divider stops further motion.
• Remove the tip, take off the dose divider clip, and administer the remaining dose in the other nostril.
• Discard the syringe into a biohazard container.
• Provide post-delivery instructions and follow-up.
• Document the immunization while complying with legal requirements.

Additional Information

• For more information or questions, contact the American Pharmacists Association Education Department.