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10 Ways to Promote Patient Safety When Using Multi-Dose Vaccine Vials

It is important to protect yourself, your colleagues, and your patients from SARS-CoV-2 and other infectious diseases. The CDC formed Project Firstline, a national infection control training collaborative, to provide all health care professionals with foundational knowledge so that you can be ready to implement infection control protocols and procedures during patient care activity and health care interactions. The American Medical Association is one of many health care and public health collaborators of Project Firstline.

The CDC created the Inside Infection Control vlog series to share some basic ideas behind infection control, how they apply to COVID-19 and how these ideas can help yourself and others.

A multi-dose vial is a vial of liquid medication intended for injection or infusion that contains more than one dose of medication. Currently authorized COVID-19 vaccines are distributed in multi-dose vials.

  1. Do not bring multi-dose vaccine vials into any place where there are patients.

    Draw vaccine from vials in a designated 'clean area' to reduce potential contamination from multiple use.

  2. Clean your hands before touching the vial.

    Use an alcohol-based hand sanitizer or soap and water.

  3. Check the vial's label, expiration and beyond use dates.

    If a vial is expired, throw it away immediately as the vaccine may have a weaker efficacy and not provide sufficient protection. In addition, the vial should be clearly labeled for multiple doses and contain the correct dosage.

  4. Visually inspect the vial to make sure it is not dirty.

    If you see anything inside the vial that should not be there do not use the vaccine. The vaccine manufacturer's instructions tell you how the vaccine should look.

  5. Check and adhere to the vaccine manufacturer's instructions on storage and use.

    Minimize the risk of using a less potent vaccine on patients by understanding how to store the vial and how long the vaccine can be used once opened.

  6. Always use a brand-new, sterile needle and a brand-new sterile syringe for every dose.

    Do not use a needle or syringe if you are unsure whether or not they are sterile.

  7. Use an alcohol prep pad and clean off the top of the vial for at least 15 seconds.

    Allow the alcohol to dry to kill any germs, bacteria and fungus.

  8. Access the vial.

    Open the vial by sticking it with the needle. In the designated label space, write the date and time first opened, as the vial can only be used for a limited time as outlined in the manufacturer's instructions.

  9. A full vaccine dose for a patient must come out of one vial.

    Due to cross-contamination risk, do not use multiple vials to fill one dose.

  10. If the vaccine vial gets dirty or spoiled, it must be thrown away and all patients who received a contaminated vaccine need to be contacted and monitored.

    Strict infection control practices prevent this from happening; however, should it occur, exposed patients must be tested to ensure no infection spread, and periodic follow-up may be recommended.

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