Prevent Errors With COVID-19 Boosters and Flu Vaccinations

You can be ready to manage competing demands and prevent errors as COVID-19 boosters and flu vaccines overlap this fall.

Continue to work as a team to organize and delegate tasks.

For example, lean on techs and students to prep supplies and paperwork, draw up doses, and administer immunizations if possible.

Train your staff to use checklists, charts, etc...not memory. Date these materials...and have a point person keep them current.

Promote online appointments...to limit the load of walk-ins.

Prevent product and dosing mix-ups. Separate vaccines using labelled containers or shelves...or even different fridges or freezers.

Don’t rely on cap colour alone to differentiate unused vials. Read labels closely...scan barcodes if applicable...and consider using coloured stickers.

For example, Moderna’s Spikevax bivalent booster has a royal blue cap...just like monovalent Spikevax for 6 months to 5 years.

Plus monovalent Spikevax with a royal blue cap can also be used for the primary series for kids 6 to 11 or for adult boosters.

Follow a standard process when drawing up doses...since they vary by age and product. Ask for a second set of eyes whenever possible.

As a best practice, label syringes as each dose is drawn up.

Take only the vaccines needed to the administration area...for 1 patient at a time. Ask open-ended questions to confirm the right patient (name, birth date, etc)...and right vaccine (product, dose, etc).

Also ask the patient to read the syringe label if practical.

Follow your policy for internal reporting if an error occurs...and also report it to the Canadian Adverse Events Following Immunization Surveillance System (CAEFISS).

Use our resource, Vaccine Administration Strategies, for ways to limit risk of injury, injection pain, and patient anxiety.

Key References

  • https://www.ismp.org/alerts/age-related-covid-19-vaccine-mix-ups (10-24-22)
  • https://www.ismp.org/alerts/mix-ups-between-influenza-flu-vaccine-and-covid-19-vaccines (10-24-22)
  • https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-1-key-immunization-information/page-8-vaccine-administration-practices.html (10-24-22)
Pharmacist's Letter Canada. November 2022, No. 381115



Get concise advice on drug therapy, plus unlimited access to CE

Pharmacist's Letter Canada includes:

  • 12 issues every year, with brief articles about new meds and hot topics
  • 200+ CE courses, including the popular CE-in-the-Letter
  • Quick reference drug comparison charts
  • Access to the entire archive

Already a subscriber? Log in

Volume pricing available. Get quote