﻿Welcome back, everyone, to part two of our episode eight of our series on multiple-dose vials.
We are now going to talk about some basic steps that you can take
to protect the vaccine in the vial for your patients, and to use these multiple-dose vials safely.
To do that, we have some props from my kitchen.
We've got a mason jar here to represent our multiple dose vial.
This is our top, the shiny metal lid.
We have a meat injector to represent our needle and our syringe.
Okay.
So, we can't cover every safety issue in today's video.
But we wanted to walk through some of the most important and basic safety steps for using these multiple-dose vials.
First, you should not bring one of these vials into a place where patients are.
By that, we mean the vaccination station where they're going to get their shot.
A vaccine cart, a clinic room, anywhere where the patient might be, the vial should not be.
This might seem like a lot to do for this, but it's really important.
One, so you have a nice, clean, organized space to work,
and can follow, you know, your needle, your syringe, what you're doing with the vial,
but also so that you decrease the risk of using a dirty needle or a dirty syringe on the vial.
You decrease the chance that the vial is going to get contaminated with blood,
with body fluids, with dirt in the environment, even.
So, having a nice, separate area that you clearly label as your clean area
to put together the vaccine and draw it up for patients,
is what you should do for these multiple-dose vials.
That's different than the single-dose vials, and it's a big practice change, but it's very important.
Okay.
Second thing you want to do, before you even touch this vial,
is you want to clean your hands.
You can use alcohol based hand sanitizer, you can also use soap and water,
but your hands should be cleaned before you touch this vial.
That's to keep the germs on your hands from off of this vial,
and particularly off of this top area where you're going to be putting your needle.
Okay.
You also want to make sure when you get the vial that you check the dates on the vial,
so there should be an expiration date.
There should also be a beyond-use date if the vial has already been opened.
that tells you how long you can use the vaccine inside.
If you are beyond those dates, if the dates say the vaccine inside has expired,
you need to not use the vaccine, and throw it away.
You don't want to give vaccine that's expired because it could be weaker than non-expired vaccine.
And you don't want to give a dose of vaccine to patients that may not protect them as well
as a good, not expired vaccine dose, okay?
It should be very clearly labelled as well that this is a multiple-dose vial and not a single-dose vial.
So make sure that you check that there are many doses, multiple doses, inside this.
Alright.
Second thing--next thing to do, is to look at the vaccine, make sure it's not dirty.
So it might sound simple, but sometimes you can see stuff inside that's not supposed to be there.
If you're not sure, check with the vaccine maker's instructions.
They tell you how this vaccine should look at each step of the way.
And so you know, you'll be able to see if anything has gotten in there
and made it kind of obviously dirty.
Again, if you're not sure, don't use it.
Now, as in terms of your needle and your syringe,
always use a brand new needle and a brand new sterile syringe for every dose.
Never use a dirty needle or a not-sterile needle and a dirty syringe or not-sterile syringe
to do your vaccination and to draw a vaccine from the vial.
Just using a new needle isn't enough. The syringe also has to be new.
We have definitely seen people get in trouble by using new needles but having dirty syringes.
Okay, if you're not sure whether the needle or the syringe is dirty, don't use it.
Now. At the top of the vial is the area where you're going to be sticking that needle.
Before any needle goes into that, you need to take an alcohol prep pad and you need to clean it off.
You're going to rub the top of this vial with the little alcohol prep pad.
Usually we say for at least 15 seconds, okay?
Rub it, make sure it's nice and clean around that entire space where the needle could be stuck
and then let it dry. That's an important step.
Don't stick it in without letting it dry to make sure that everything on this gets killed.
And so what are we trying to do? We're trying to kill the germs, the bacteria,
any fungus that might have landed here, any virus that might be here.
It may seem like, "Why would there be stuff in there?"
I promise you, there's stuff on the top of this, and we need to clean it off to make sure that it's gone.
Alright.
When the vial is stuck with your needle, we call this accessing the vial,
and it's just basically opening the vial.
So you've put your needle in that first time, you've opened up the vial,
you have to make sure that you put the date and the time that that happened on the label,
there will be a space for you to do that.
That's because once that vaccine is opened, the clock starts running
and you only have a certain amount of time to use that vaccine.
Every vaccine is different that way.
You have to make sure you know what the vaccine maker says about how long you can use the vaccine
before it is no longer able to be used on patients.
So check with the vaccine maker and follow their instructions for how long you can continue to use it.
Now, we know some people have found that there are extra doses in their vaccine, okay?
So you get done with the number of doses that you think are in the vial,
but you've still got something left.
If you have a full dose of vaccine in that vial, you can use it.
So if the vaccine is there and you can get a full dose from this one vial,
then you can go ahead and use that full dose on another patient.
But--if you don't have a full dose-- if you have half a dose, or a third of a dose,
and you want to mix it with a little bit left over in another vial--not okay. We can't do that.
We definitely have seen that people will contaminate the vaccine,
and then those pooled vaccines come together.
We call it pooling or marrying doses.
And people can, can get sick from that, so...
be sure not to mix doses from different vaccines.
A full dose has to come out of one vial and one vial only.
Alright, and then finally, make sure you follow the vaccine maker's instructions for storing the vaccine,
for when the vaccine can no longer be used, so that doesn't spoil or weaken,
because again, we don't want to put weak vaccine into patients that's not going to completely protect them.
We've covered a lot in a short amount of time.
Like we said in part one of this series, we have a lot of resources on the Web.
You should definitely check out the CDC's One And Only campaign.
That's our injection safety campaign.
They have a lot of information, a lot of posters and FAQs that you can look at to answer some of your questions.
And we will also be posting some of our stuff as it gets produced and made for you, on Facebook, on our website.
So don't hesitate to follow up with us. Continue to check us out.
We'll be here with new tools to help you along the way.
In the meantime, always check Facebook and Twitter for us to follow up on the latest episodes,
and see us at our website, CDC.gov/ProjectFirstline
We will see you at the next episode.