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...such as prepping supplies and paperwork, drawing up doses, and administering immunizations. Discuss how to involve students and interns.

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

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

Resist the urge to skip breaks...running on empty can increase the risk of burnout and mistakes. If needed, remind patients and colleagues that the priority is always safety.

To limit product mix-ups, separate vaccines using labeled containers or shelves...or even different fridges or freezers.

Don’t rely on cap color alone to differentiate unused vials. Read labels closely...scan barcodes...and consider using colored stickers.

For example, Pfizer-BioNTech COVID-19 vials for age 12 and up have gray caps and labels for the primary series AND bivalent booster.

And the Moderna bivalent booster has a dark blue cap...just like monovalent Moderna vials for ages 6 months to 5 years and 6 to 11 years.

Plus the Moderna product for the primary series in kids 6 to 11 and previously for monovalent boosters in adults may say “booster doses only.” Mark these “kids 6 to 11”...so they’re not used for adult boosters.

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

If you’re a trained immunizer, take only the vaccines you need to the administration area...for 1 patient at a time.

Ask open-ended questions to confirm that you have the right patient (name, birth date, etc)...and right vaccine (product, dose, etc).

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

Find more strategies to help prevent vaccine errors in our resource, The Basics of Immunization and Vaccines...and look into our PTU Elite: Immunizations program for training on administration.

Key References

  • https://www.ismp.org/alerts/age-related-covid-19-vaccine-mix-ups (9-22-22)
  • https://www.ismp.org/alerts/mix-ups-between-influenza-flu-vaccine-and-covid-19-vaccines (9-22-22)
  • https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html#appendix-d (9-22-22)
  • https://www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration-preventing-errors.pdf (9-22-22)
Pharmacy Technician's Letter. October 2022, No. 381002



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