In this section
Definition of Terms
The aims of this guideline are;
Immunisation – The process of inducing immunity to an infectious agent by administering a vaccine Immunity – the ability of the body to fight off certain infections; immunity can result from natural (wild) infection or from vaccinationVaccination – the administration of a vaccine; if vaccination is successful, it results in immunityAdverse event following immunisation (AEFI) – any untoward medical occurrence that follows immunisation and does not necessarily have a causal relationship with the usage of the vaccine.Cold chain – is the system of transporting and storing vaccines within the temperature range of +2ºC to +8 ºC from the place of manufacture to the point of administration. Maintenance of cold chain is essential for maintaining vaccine potency and in turn, vaccine effectiveness.Contraindications - Only 2 absolute contraindications apply to all vaccines:
2 further contraindications apply to live vaccines (both parenteral and oral):
Inactivated vaccines - Prevenar 13®, Infanrix-Hexa®, Infanrix-IPV®, Nimenrix®. Boostrix®, Adacel®, Gardasil 9®, Act Hib®, Hiberix®, Infanrix®, Quadracel®, Tripacel®.Live vaccines – Priorix®, Priorix Tetra®, Proquad®, MMRII®, Varilrix®, Varivax®Valid consent – the voluntary agreement by an individual to a proposed procedure, given after sufficient, appropriate and reliable information about the procedure, including the potential risks and benefits, has been conveyed to that individualNIP – National Immunisation Program
admission assessment should be completed by the nurse with a parent or care giver, upon arrival to the ward. Every encounter with a health care professional is an opportunity to review immunisation status. If you have identified that the patient requires immunisation, providers should;
1. Occupational health and safety issues
occupational health and safety guidelines should always be followed during vaccination.
2. Equipment for vaccination
The equipment chosen will vary depending on whether the vaccine is a reconstituted vaccine or a vaccine in a pre-filled syringe. Equipment may include;
3. Preparing the vaccine
Injectable vaccines that do not require reconstitution
Injectable vaccines that require reconstitution
For all injectable vaccines
4. Administering the vaccine
Photo courtesy Lloyd Ellis, The Royal Children’s Hospital, Victoria (pg 80 of Australian Immunisation handbook, 10th ed. 2013)
Children aged 12 months or older
Photo courtesy Jane Jelfs NCIRS (pg 82 of Australian Immunisation handbook, 10th ed. 2013)
6. Positioning for vaccination
It is important that movement of infants and children is minimised during injection of vaccines. The following positions may be used for vaccinating.
Infants less than 12 months of age
Position the infant in a semi-recumbent position on the lap of the parent/carer (see figure below). It can also be used for young children.
Photo courtesy of Dr Joanne Molloy, Victoria (pg 75 of Australian Immunisation handbook, 10th ed. 2013)
Photo courtesy CHW Photography (pg 77 of Australian Immunisation Handbook, 10th ed. 2013)
Adolescents and adults
7. Distraction techniques
Immunisations can result in distress and anxiety for infants, children and their parents. It is important that effective pain management strategies are used during immunisation. Some
strategies that are recommended during administration of the vaccine include;
Topical anaesthetic agents, such as AnGel cream or EMLA can also be used. Routine use of paracetamol at the time of, or immediately after, vaccination is not recommended, unless Bexsero® is being administered (see
The Evidence Table for this guideline can be viewed here.
Remember to read the
The development of this nursing guideline was coordinated by Sonja Elia, NUM, Immunisation Service, and approved by the Nursing Clinical Effectiveness Committee. Updated February 2021.