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Storage & Handling - Vaccine Handling
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Vaccine Prep and disposal

Questions
Answers
  1. Can vaccines be pre-filled prior to an event?
    Vaccine doses should not be drawn into a syringe until immediately before administration. When the syringes are filled, the type of vaccine, lot number, and date of filling must be labeled on each syringe, and the doses should be administered as soon as possible after filling. ACIP discourages the routine practice of pre-filling syringes due to the potential for administration errors, because a majority of vaccines have a similar appearance. In addition, the FDA does not license administration syringes for vaccine storage due to the lack of data concerning the stability and sterility of vaccine stored in end user filled (i.e., not filled by the manufacturer) syringes. Unused syringes filled by the end user should be discarded at the end of the clinic day. This does not apply to manufacturer-supplied prefilled glass syringes.

  2. Can you pre-fill syringes prior to mass influenza vaccination clinic?
    In certain circumstances in which a single vaccine type is being used (e.g., in advance of a community influenza vaccination campaign), filling a small number of syringes (10 at a time) can be considered. When conducting an influenza clinic certain procedures should be followed: only one vaccine type may be administered at the clinic, vaccine should not be drawn up in advance of arriving at the clinic site, vaccine should be transported in the manufacturer supplied packaging, patient flow should be monitored to avoid drawing up unnecessary doses and any remaining vaccine drawn up in syringes and not administered, must be discarded at the end of the clinic day.  

  3. How long can a multi-dose vial be used once it is opened and a dose is withdrawn?
    Doses from a partially used multi-dose vial can be administered until the expiration date printed on the vial or vaccine packaging, provided that the vial has been stored correctly and that the vaccine is not visibly contaminated. The expiration date for reconstituted multi-dose vials varies from product to product and the new expiration date and time will differ from that printed on the vial. For example, after reconstitution, MMR vaccine must be administered within 8 hours and must be kept at refrigerator temperature during this time. Consult the package insert for the most up-to-date information about expiration dates and times following reconstitution. Unused reconstituted vaccines kept beyond these limits should not be administered.

  4. What information should be marked on the multi-dose vaccine bottle once it has been opened?
    Mark multi-dose vials with the date it was first opened and mark reconstituted vaccine with the date and time it was reconstituted. This is important for two reasons: some vaccines expire within a certain time after opening or after reconstitution. This may not be the same as the expiration date; and dating opened or reconstituted vials helps manage vaccine inventory by identifying which vials should be used first.

  5. How long can manufacturer-filled syringes be stored once the rubber tip is removed and the needle is added?
    When manufacturer-filled glass syringes are not supplied with needles, the needles should be attached just before administration. If a needle is attached to a sealed manufacturer prefilled syringe, the syringe should be used or discarded at the end of the clinic day because the sterile seal has been broken.

  6. Are vaccine diluents interchangeable?
    Diluents are not interchangeable, even diluents from the same manufacturer. Therefore, use only the specific diluent provided by the manufacturer for each type of vaccine to ensure adequate potency and safety of the resulting mixture.