The PDL Professional Officers have noted a recent reduction in the number of calls about the COVID-19 vaccination service. This is pleasing and a likely indication of reduced demands on pharmacists and a greater familiarity with the vaccination process.
However, this phase of the pharmacy vaccination service brings other challenges. With the inclusion of the Pfizer Comirnaty vaccine into the pharmacy vaccination program, there are increased risks that need to be identified and managed by pharmacists and pharmacy owners.
Managing three brands of vaccine
Handling three different vaccines increases the risk of error in several areas. Actions pharmacists can take to reduce the risks include:
- Ensure staff involved in relevant aspects of vaccine management have completed the associated Department of Health training module.
- Separate all handling and storage of brands – and use colour coding or other means to separate brands at every phase of the process.
- Consider setting specific days or times for particular vaccines.
- Avoid preparation errors by clearly flagging storage limitations for all stocked vaccines and dilution volume for Pfizer Comirnaty.
- Ensure vaccination schedules are clearly documented for all vaccines, especially given the approval for Pfizer Comirnaty as a booster vaccine as well as its availability for first and second doses.
Expiry of Multi Dose Vials (MDV)
PDL has noticed an increase in reports regarding expired vaccinations being administered. Given the reduction in demand and the addition of a third brand, there is a greater chance of an expiry incident. To ensure expired vaccines are not administered, the following expiry dates should be clearly identified by a reminder or calendar system:
- The manufacturer’s expiry date of the MDV
- The thawed expiry date for each MDV
- The individual syringe expiry date (based on the time of drawing up).
Dealing with patients in this phase
Since a high proportion of the public has willingly been vaccinated, pharmacists are now more likely to encounter people who are hesitant about or averse to vaccination, often attending only because of employment obligations.
- Pharmacists need to be empathic with these patients and be prepared to handle discussions or discontent regarding vaccination.
- Discontent may be understandable given an individual’s anxieties or frustration. We hope pharmacists remain professional and offer support and advice in a non-judgemental manner.
- While rare, pharmacists should be alert to a very small number of people seeking to manipulate a pharmacist to achieve a vaccination record without vaccination, through means such as a bribe or manipulating vaccines when a pharmacist is distracted. Such events need to be reported to the appropriate authorities.
The AIR is the source of truth
A review of the AIR before every vaccination event is vital. It can prevent the following issues:
- Patients seeking vaccination outside approved schedules and protocols. PDL continues to receive reports of people lying or being confused about past vaccine numbers or brands. There may be some public perception that Moderna Spikevax may be a more effective vaccine leading patients to seek another brand of vaccine or an extra dose of a particular brand of vaccine. Checking the AIR can prevent this occurrence.
- Vaccination of children under 12 years of age. A very small number of parents are reportedly seeking to have children under 12 vaccinated by falsifying consent or booking form details.
- Provision of a booster dose in situations that are not approved. At the time of publication, Pfizer Comirnaty is approved as a single booster dose, irrespective of the brand of vaccine used for the primary course. Continue to check the latest guidance from ATAGI on the interval for a booster or any other changes to the booster program.
- AstraZeneca Vaxzevria can be used as a booster dose in certain circumstances as per ATAGI guidance.
The PPA has recently released a useful table summarising important aspects of the three vaccines currently approved in Australia.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7, Australia-wide.