Background

The NHS in England uses several COVID-19 vaccines, each with unique handling conditions relating to their storage, reconstitution where necessary, and dose.

Requirement

Several different vaccines may be stored and used within a single vaccination site. It is vital that all vaccines are stored, selected, handled and administered correctly, and that staff are trained in and practise safe preparation and administration of the vaccine, to ensure that every patient receives the right dose of the right product at the right time.

Principles

To support this requirement, the following principles should be assessed and implemented locally.

Physically segregate different vaccines during storage

When storing or handling the vaccine:

• Store in separate fridges if possible and have plan in place to maintain stock segregation in event of fridge failure
• Where separate fridges are not possible, store in separate labelled containers or on separate, labelled shelves within refrigerator. If possible try not to store more than one vaccine on a single shelf.
• Ensure packs are positioned so that the label and identity of the vaccine is clearly visible on every pack when the fridge door is opened
• Read label on pack not label on fridge, shelf or storage container
• Ensure correct handling of all vaccines, particularly those stored below freezing
• Where relevant, ensure expiry times are calculated, checked and recorded for vaccines after thawing
• Ensure vaccines stocks are stored and rotated so that those with the earliest shortest expiry date/time are used first
• Ensure unused vials are not returned to stock unless the maintenance of cold chain has been assured
• If returning unused vials, ensure vaccines put away in correct fridge/box
• Ensure consumables are stored in clearly labelled areas

Administer one vaccine at a time

Only a single type of vaccine should be administered in any vaccination administration station during a single vaccine administration session.

When planning or designing vaccination services consider:

• Running single vaccine centres where possible
• Planning vaccine-specific sessions in each vaccination site where more than one vaccine is in use
• Ensuring clear break between vaccination sessions including the use of staff briefings and/or staff changes.
• Ensuring adequate supply of vaccine and appropriate of consumables is in place

Additional support checklists are available below to minimise the risk of administration of the wrong COVID-19 Vaccine

Establish sessional all staff safety briefings

Where there is a team involved in vaccine administration, all members of that team should be involved in a safety briefing before participating in each vaccination session. This will clarify roles and responsibilities, and will ensure everyone involved knows which vaccine and the characteristics of the vaccine being used, the dose to be administered and how that vaccine is handled.

Take a break between vaccines

When a different vaccine is to be administered, schedule a break between vaccination sessions. Nominate a staff member to be responsible for ensuring that the work area is cleared completely of the first vaccine and all associated consumables and documentation before the new vaccine and relevant consumables and documentation are brought into the work area.

Ensure vaccine-specific competence

Staff must be trained and assessed as being competent to undertake their role using a particular type of vaccine before being involved in a vaccination session.

Segregate vaccine-specific consumables

Only the vaccine, syringes, documentation and consumables needed for the specific vaccine to be administered should be available in the designated work area during a vaccination session.

Report and learn from incidents

Notify all errors and near misses to the designated clinical lead and report to the SVOC and RVOC using local governance processes. This will ensure that learning can be shared more widely and the content of national SOPs adjusted if appropriate. A standard operating procedure is available.

Use in conjunction with 

Additional resources

The UK Health Security Agency (UKHSA) have produced a series of posters which provide information on the presentation, doses and storage of Covid-19 vaccines.

Additional support materials

The attached checklists should be used in conjunction with the “Good governance guidance when handling multiple COVID-19 vaccines” article and after making yourself familiar with the policy and governance material.

• Checklist-for-pharmaceutical-oversight-multiple vaccines - v3-22.8.22 · PDF · 558 KB
• Checklist-for-safety-briefing-v3.0-22.8.22 · PDF · 464 KB
• Checklist-for-clear-down-of-vaccine-v3-22.8.22 · PDF · 589 KB
• Checklist-for-set-up-of-new-vaccine-V3 22.8.22 · PDF · 589 KB

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