- A St John WA team member who requires immunisation against seasonal Influenza (recommended annually).
- Past history of Guillain-Barré syndrome
- FLUARIX TETRA should not be administered to individuals with known hypersensitivity after previous administration of FLUARIX TETRA or influenza vaccines or to any component of the vaccine.
- Patients must be well on the day of vaccination and provide voluntary consent prior to receiving the vaccination.
- FLUARIX TETRA should under no circumstances be administered intravascularly.
- As with other vaccines, vaccination with FLUARIX TETRA should be postponed in individuals suffering from an acute severe febrile illness.
- Adverse event following immunisation (AEFI) may occur. These AEFI must be reported to WA Department of Health through the Western Australian Vaccine Safety Surveillance (WAVSS) reporting system.
Equipment
- Pre-filled FLUARIX TETRA syringe and needles (ensure cold chain has been maintained)
- Sharps container
- Latex-free adhesive dressing / clean cotton wool and tape
- Anaphylaxis kit
- Alcohol based hand rub
- Personal protective equipment - gloves and protective eyewear are not routinely recommended unless there is a risk of exposure to blood and body fluids or if the immunisation provider has open lesions on their hands.
1. Pre-vaccination screening
- Pre-screening checklist to be completed by person receiving the vaccine.
- Establish there are no medical condition/s that contraindicate vaccination. Consider actions for any conditions identified and refer person to a medical practitioner if needed.
2. Obtain valid consent (also refer to Patient Capacity & Consent)
The person receiving the vaccine should be given sufficient information and the risks and benefits of the vaccine, including:
- possible adverse events
- how common they are
- what they should do about them
For consent to be legally valid, the following criteria must be present:
- It must be given by a person with legal capacity, and of sufficient intellectual capacity to understand the implications of receiving a vaccine.
- It must be given voluntarily in the absence of undue pressure, coercion or manipulation.
- It must cover the specific procedure that is to be performed.
- It can only be given after the potential risks and benefits of the relevant vaccine, the risks of not having it, and any alternative options have been explained to the person.
3. Procedure
Prepare the person receiving the vaccine. Skin decontamination is not required if skin is visibly clean. If alcohol or other disinfecting agents are used, the skin must be allowed to fully dry to reduce likelihood of irritation at injection site.
Check expiry date of pre-filed syringe and attach needle. For intramuscular injection, use a 22-35 gauge needle 25mm long in most cases.
Check that there is no foreign material or contaminant/precipitate present in the syringe prior to administration.
The preferred injection site is the deltoid or anterolateral thigh. Position the limb to relax the muscle.
Pierce the skin at a 90o angle. It is not necessary to draw back on syringe plunger before injecting. However, if you have done this and a flash of blood appears in the needle hub, withdraw the needle and select a new site for injection.
Dispose of the used syringe in sharps box, and cover injection site with adhesive dressing/cottonwool ball.
Record the relevant details:
- the person’s full name and date of birth
- Medicare number (if applicable)
- details of the vaccine given, including the brand name, batch number and dose number
- date and time of vaccination
- site of administration
- name of the person providing the vaccination
- date the next vaccination is due
Keep the person under observation for 15 minutes to ensure they do not experience an immediate adverse event.
Management of Adverse Event Following Injection
- In the event of an anaphylactic reactions, refer to the Clinical Practice Guidelines for Anaphylaxis.
- Report AEFI to Western Australian Vaccine Safety Surveillance.
Cold chain
- It is essential to maintain cold chain while storing and transporting flu vaccines. Vaccines must be kept between +2°C and +8°C as they could otherwise become breached and not suitable for use.
- The cold chain begins from the time the vaccine is manufactured, continues through to state or territory vaccine distribution centres and immunisation service providers, and ends when the vaccine is administered.
- Purpose built vaccine refrigerators are specifically designed to store and transport vaccines safely.
- Vaccine refrigerators should include a data logger to monitor the temperature in 5-minute intervals. Twice daily minimum and maximum temperatures must still be manually recorded as a timely alert to any breach in cold chain.
Cold Chain Breach
- A cold chain breach occurs when vaccine storage temperatures deviate outside the recommended range of +2°C to +8°C. The optimal storage temperature for vaccines is +5°C.
- All vaccine temperatures recorded below +2°C or above +8°C must be reported to WA Department of Health.
- This does not include temperature deviations or excursions in which the temperature reaches a maximum of up to +12°C for 15 minutes or less.
- Any deviation below +2°C must be reported.
What to do if there is a Cold Chain Breach
- Immediately stop the clinic and isolate the breached vaccines in temporary vaccine storage and label them ‘Do Not Use’.
- Refer to WPI Managing a cold chain storage breach
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ATAGI Clinical Advice STATEMENT ON THE ADMINISTRATION OF SEASONAL INFLUENZA VACCINES IN 2023 https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf
Australian Immunisation Handbook https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu
Facts about the influenza (flu) vaccine Pre and post vaccination information for WA Health Staff https://www.health.wa.gov.au/~/media/Corp/Documents/Health-for/Infectious-disease/Influenza/Facts-about-the-influenza-vaccine-2022.pdf
NCIRS https://ncirs.org.au/ncirs-fact-sheets-faqs-and-other-resources/influenza
St John WA Paramedic Vaccinator resources https://stjohnwa.sharepoint.com/sites/Connect-Vaccination/SitePages/Paramedic-Vaccinators.aspx
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