It’s that time of the year again for flu vaccines.

‘The annual National Seasonal Influenza Vaccination Program will commence in April 2017.’

(NSW Health 2017)

This article is a quick brush up on injection technique and a reminder about what the ‘flu vacc.’ is. Obviously, you will need to be familiar with, and work according to, your workplace organisational policies, procedures and protocols, as well as professional and ethical standards. Below we will examine information put forward by the New South Wales State and Australian Governments as well as the World Health Organisation (WHO).

What is ‘the Flu’ and Why are Vaccinations Offered?

‘The flu’ or influenza is very contagious and spreadable by close contact, contact with infected hands, contact with infected hard surfaces, sneezing, or coughing.

Signs such as: headache, runny nose, decreased appetite, chills, tiredness, sore muscles, fever, and sore throat can occur (usually around 3 days post-infection); and serious (potentially fatal) complications of the flu can involve sinus infections, bronchitis, pneumonia and even complications of the heart, liver and blood (Department of Health, 2017).

There are three different types of influenza viruses that infect humans. They are influenza A, B and C. ‘Only influenza A and B cause major outbreaks and severe disease, and these types are included in seasonal influenza vaccines’ (Department of Health, 2017).

Who Should Receive the Flu Vaccination?

From your experience working in healthcare or your health studies, you are probably aware that the groups most at risk of the dangers or complications of the flu are: older adults, pregnant women, Aboriginal and Torres Strait Islander people, very young children, and people with medical conditions (Department of Health, 2017).

NSW Health Information Sheet: 2017 Influenza vaccine presentations and eligibility under the National Immunisation Program

It is important to note also that ‘Immunisation providers should report influenza vaccines given to all people to the Australian Immunisation Register (taking care to note the correct vaccine brand name).’; and, that ‘Immunisation providers should report any suspected adverse events following immunisation (AEFI) directly to their local Public Health Unit on 1300 066 055.’ (NSW Health 2017).

Child receiving vaccination | Image

Prevention of the Flu:

This year, the flu shot will be available throughout April from GP surgeries and other providers. It is available free under the Nationa Immunisation Program for people who face a ‘high risk’ from influenza, though is recommended for all people over six months old (Department of Health 2017).

Fact sheets for yourself or your workplace regarding the flu: Immunise Australia Publications and Resources
You can also get information for immunisation providers at: Australian Technical Advisory Group on Immunisation (ATAGI) advice for immunisation providers

In 2017, four age-specific vaccines will be available under the National Immunisation program. Visit the Australian Government Department of Health website for more information and the names of each vaccine (‘parents should make sure vaccination providers know the age of their child so they can receive the correct vaccine’) (2017).

Other points to be aware of:

There is no live virus in the flu shot
The composition of the vaccine changes every year
The flu shot is safe for pregnant women at all stages

(Department of Health 2017)

Resources on Injection Skills for Giving Vaccinations:

WHO (2017) have an e-learning course on Vaccine Safety Basics available at the following link: Vaccine Safety Basics, or you can learn offline at: http://vaccine-safety-training.org/tl_files/vs/pdf/vsb-manual.zip
The Australian Immunisation Handbook (Department of Health, page updated 6th March 2017) is available here: The Australian Immunisation Handbook. (This handbook highlights that ‘All immunisation service providers must be familiar with, and adhere to, the National Health and Medical Research Council’s Australian guidelines for the prevention and control of infection in healthcare‘)(National Health and Medical Research Council 2016).

Important Points from the Australian Immunisation Handbook

OHS must be considered (e.g. routine hand hygiene, use of PPE, correct disposal of sharps, cleaning of the workplace environment, keep sharps containers out of reach of children at all times, and adherence to post-exposure prophylaxis guidelines as exposure to blood or body fluids occurs)
Selection of appropriate injection site and injection equipment (e.g. gauge of needle) based on the individual client
You may wish to consider appropriate and respectful diversional therapy activity for the client to minimise discomfort during vaccination process (e.g. children may enjoy focusing on a rattle)
Ensure that the vaccine has been stored at the correct temperature in the refrigerator (+2°C to +8°C) and that it has not been damaged or tampered with, and has not expired
Complete the five moments of hand hygiene
Vastus lateralis or deltoid are the preferred IM sites but refer to the government link for more details for making an informed decision about the injection site when administering vaccinations to clients
‘Provided the skin is visibly clean, there is no need to wipe it with an antiseptic (e.g. alcohol wipe). If the immunisation service provider decides to clean the skin, or if the skin is visibly not clean, alcohol and other disinfecting agents must be allowed to dry before vaccine injection (to prevent inactivation of live vaccines and to reduce the likelihood of irritation at the injection site)’
‘If using a safety needle system, once the vaccine has been drawn up, draw back on the syringe to ensure as much vaccine as possible is removed from the tip of the needle, and then eliminate any air to the tip of the syringe without re-priming the needle.’
For all injectable vaccines:
- ‘Do not extrude small air bubbles through the needle for injection. However, in the rare instance of a large air bubble in a pre-filled syringe, first draw back on the needle to ensure no vaccine is expelled along with the air, and then expel the air through the needle, taking care not to prime the needle with any of the vaccine, as this can lead to increased local reaction.’
- ‘Never mix other vaccines together in the one syringe (unless that is the manufacturer’s registered recommendation, e.g. Infanrix hexa).’
- ‘Never mix a local anaesthetic with a vaccine’.

(Department of Health, page updated 6th March 2017).

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References:

Department of Health 2017, Australian Technical Advisory Group on Immunisation (ATAGI) advice for immunisation providers regarding the administration of seasonal influenza vaccine in 2017, Australian Government, Canberra, ACT, viewed 20 April 2017, http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/ATAGI-advice-influenza-vaccines-providers
Department of Health 2017, Immunise Australia Publications & Resources, Australian Government, Canberra, ACT, viewed 20 April 2017, http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/resources-menu
Department of Health 2017, Influenza (Flu), viewed 13 April 2017, http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-influenza
Department of Health 2017, The Australian Immunisation Handbook, 10th Edition, Australian Government, Canberra, ACT.
National Health and Medical Research Council 2016, Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010), NHMRC, Australian Government, Canberra, ACT, viewed 20 April 2017, https://www.nhmrc.gov.au/guidelines-publications/cd33
NSW Health 2017, 2017 influenza vaccine presentations and eligibility under the National Immunisation Program, NSW Government, viewed 20 April 2017, http://www.health.nsw.gov.au/immunisation/Documents/influenza-information-sheet.pdf
NSW Health 2017, Seasonal Influenza Vaccination 2017, NSW Government, viewed 20 April 2017, http://www.health.nsw.gov.au/immunisation/Pages/seasonal_flu_vaccination.aspx
World Health Organisation 2017, ‘Welcome to the WHO Course on Vaccine Safety Basics’, Vaccine Safety Basics: e-learning course, WHO, Geneva, viewed 20 April 2017, http://vaccine-safety-training.org/route-of-administration.html

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