Vaccine administration is the process of delivering a vaccine into the body to stimulate the immune system and provide protection against specific infectious diseases. It involves selecting the correct vaccine, preparing it properly, choosing the appropriate route (e.g., intramuscular, subcutaneous, oral, or intranasal), and administering it safely and accurately.
Administering vaccines in paediatrics requires precision, safety, and child-friendly communication.
General Principles in Vaccination
- Any number of vaccines can be given on the same day (live/inactivated). However, there should be 5-cm gap between different vaccines site (except BCG and measles/ MMR).
- Inactivated vaccines can be given any time in relation to any other live/inactivated vaccines.
- If missed on a single day, gap between any two live vaccines should be at least 4 weeks.
Routes of Vaccine Administration
| Route | Common Vaccines | Site (by age) |
|---|---|---|
| Intramuscular (IM) | DTaP, Hep B, Hib, PCV, Influenza | <12 mo: Anterolateral thigh; ≥12 mo: Deltoid |
| Subcutaneous (Subcut) | MMR, Varicella | Outer upper arm (triceps) |
| Oral (PO) | Rotavirus | Administered via dropper into mouth |
| Intranasal (NAS) | Live attenuated influenza (FluMist) | One spray per nostril |
7 Rights of Vaccine Administration
- Right patient – Confirm identity and screen for contraindications.
- Right vaccine – Verify name, expiration, and lot number.
- Right dose – Use age-appropriate volume and formulation.
- Right route – IM, Subcut, Oral, or Intranasal as indicated.
- Right site – Based on age and vaccine type.
- Right time – Follow immunization schedule and intervals.
- Right documentation – Record vaccine, site, lot, manufacturer, and VIS date.
Role of Nurse in Immunization Procedure
- General guidelines for storing vaccines in domestic refrigerator:
- Maintain the temperature of vaccines; check the log temperature twice a day.
- Do not keep any other items in the refrigerator other than vaccines.
- Never leave the vaccine vials outside after use.
- Stocking of vaccine vials: follow the rule of first in is the first used. Keep the supply for only 1 month as it is a temporary storage.
- Do not keep vaccines on the door shelves.
- Open the refrigerator only when necessary.
- Administration of vaccines:
- Be alert about the type of vaccine to be given, its dosage, and route of administration.
- Ensure that the vaccine is administered immediately or within the prescribed period of use after reconstitution.
- Educate the parents about possible side effects and home care management.
Home Management of Common Side Effects
- Pain: Keep wet cloth over the injection site.
- Immobilize the vaccinated limb by keeping soft rolled towels on either side.
- Give paracetamol if prescribed.
- Fainting: Make the child to lie down until he/she is feeling better.
- Fever: Administer paracetamol.
- Ensure adequate fluid intake.
- Put loose cotton cloth.
- Monitor the temperature regularly.
- Seizure: Child should be immediately brought to the hospital.
Special Considerations
- Perform hand hygiene before and after administration.
- Use separate sites for multiple injections.
- Apply comfort measures (e.g., distraction, sucrose for infants).
- Observe for 15 minutes post-vaccination for adverse reactions.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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