Reactions may occur at the injection site with influenza vaccine and other vaccines (eg, pain, redness). Best practices for multiple injections include labeling each syringe, separating injection sites by at least 1 inch (to reduce the chance of local reactions overlapping), and if possible, administering vaccines that may be more likely to cause a reaction in separate limbs. See here for more information on proper vaccine administration and visit the CDC Resource Library for vaccine administration job aids.
When co-administering vaccines, precautions and safety strategies should be implemented to avoid errors, particularly mix-ups between the COVID-19 vaccine and influenza vaccine.
The Institute for Safe Medication Practices offers a set of safe practice recommendations, summarized below:
- Provide staffing support. Schedule vaccines for a dedicated block of time each day and ensure adequate staffing.
- Separate vaccination areas. Provide vaccinations in an area away from distractions and interruptions.
- Label the syringes. Clearly label all individual syringes containing vaccines.
- Separate the vaccines. Bring only the intended vaccine(s) for each individual patient to the vaccination area.
- Identify the patient and requested vaccine. Verify with the patient and/or parent/caregiver the vaccine(s) that will be administered.
- Involve the patient/parent in the checking process. Ask the patient and/or parent/caregiver to read the syringe label to confirm the correct vaccine will be administered. At minimum, the vaccine provider should tell the patient and parent/caregiver which vaccine is being given before administration.
- Document lot number and expiration date. Document vaccine lot number and expiration date prior to administration. Make sure to document vaccine administration afterward in patient’s medical record.
- Scan the barcode. Scan the vaccine barcode to verify the correct product is being administered, to confirm the correct vaccine has been retrieved and prepared.
- Provide the intended vaccine. If a mix-up occurs, ensure it is addressed with the patient and/or parent/caregiver right away and that the intended vaccine is provided.
- Report vaccine errors. Report all vaccine errors internally as well as to the FDA Vaccine Adverse Event Reporting System (VAERS), which is mandatory for errors with the COVID-19 vaccines available under an EUA.