In this video,
I will demonstrate how to prepare vaccine
from a multidose vial.
A multidose vial or MDV contains more than one dose of vaccine.
CDC recommends that providers prepare and draw up vaccines
just prior to administration.
Vaccines should be prepared in a designated area
that is not adjacent to any area
where potentially contaminated items are placed.
Before preparing or administering any vaccine,
always start with proper hand hygiene.
CDC has hand hygiene guidelines and resources
for health care personnel available online.
begin by removing the vaccine from the storage unit.
Verify the box contains the correct vaccine.
Check the vial for an expiration or beyond use date,
if applicable.
Additional information about the beyond use date can be found
in the manufacturer´s product information
and on the CDC Vaccines and Immunizations website.
Next, gather the appropriate supplies.
This includes a syringe and needle...
...prepackaged sterile alcohol wipes...
and bandages.
Needles and syringes may be packaged together or separately.
Next, verify the vaccine you are preparing
matches the standing order or the provider´s order.
Then, check the expiration or beyond use date on the vial.
Never administer vaccine after the expiration
or beyond use date.
Now, mix the vaccine by shaking the vial.
Check the vaccine to make sure it is thoroughly mixed.
Make sure there is no discoloration or precipitate.
The vaccine should not be administered
if it is discolored, contains particulate matter,
or is not thoroughly mixed.
Remove the protective cap from the vial if present.
Use a new sterile alcohol wipe
to clean the stopper on top of the vial.
Do not rub the stopper vigorously
as this can move bacteria from the uncovered rim
of the vial to the stopper.
While the alcohol is drying,
check the expiration date on the needle and syringe if present.
Never use expired equipment.
Next, carefully open the needle and syringe.
Be careful not to touch the inside of the packaging
or where the needle attaches to the syringe.
Place the packaging inside up on the counter
with the needle and syringe resting
on the inside of the packaging.
Carefully, remove the protective cover from the needle.
Being careful not to touch the open end,
place the needle cover back on the packaging.
Hold the vaccine vial on the counter
with your non-dominant hand.
Holding the syringe with your dominant hand,
insert the needle straight into the center of the stopper.
Pick up the vial and syringe together, then invert them.
Hold the vial and syringe at eye level
and carefully pull the needle back
so the tip is in the liquid.
Withdraw the vaccine by pulling on the plunger of the syringe.
Fill to the dosage mark on the barrel of the syringe.
Now, remove the vial from the needle
and return the vial to the counter.
To release any air bubbles,
tap gently on the barrel of the syringe
and then push up on the plunger,
being careful not to expel the vaccine.
Now, recap the needle by replacing
the protective cover on the needle.
Recheck the multidose vial against the provider´s order
and recheck the expiration or beyond use date if present.
If vaccine remains in the multidose vial,
write down any relevant information needed
for documentation such as the manufacturer and lot number.
Once in the syringe, many vaccines look alike.
Label the syringe with the vaccine name or abbreviation.
Put the multidose vial back into the box
and return the vaccine to the storage unit.
A multidose vial should not be kept or accessed
in the immediate patient treatment area.
The vaccine is now ready to administer.
To follow medication administration best practice,
healthcare personnel should only administer vaccines
they have prepared themselves.
There is no need to change needle between preparing
and administering the vaccine,
as long as the needle has not been damaged or contaminated.
If the sterility of a vial, needle, or syringe
is compromised or questionable,
appropriately discard the contaminated equipment.
This video is part of a series designed to demonstrate
vaccine administration skills and best practices.
The video series is available
on the Vaccine Administration Web page
on the CDC Vaccines and Immunizations website
at www.cdc.gov/vaccines.