Anaphylaxis should be considered when signs or symptoms are generalized i. Symptoms of anaphylaxis often occur within minutes of vaccination, though it can sometimes take several hours for symptoms to appear. Early signs of anaphylaxis can resemble a mild allergic reaction, and it is often difficult to predict whether initial, mild symptoms will progress to become an anaphylactic reaction.
In addition, symptoms of anaphylaxis might be more difficult to recognize in people with communication difficulties, such as long-term care facility residents with cognitive impairment, those with neurologic disease, or those taking medications that can cause sedation.
Not all symptoms listed above are necessarily present during anaphylaxis, and not all patients have skin reactions. If anaphylaxis is suspected, administer epinephrine as soon as possible, contact emergency medical services, and transfer patients to a higher level of medical care.
In addition, instruct patients to seek immediate medical care if they develop signs or symptoms of an allergic reaction after their observation period ends and they have left the vaccination location. Symptoms of anaphylaxis in children are similar to those seen in adults. Pediatric autoinjectors are available in 0.
There are no contraindications to the administration of epinephrine for the treatment of anaphylaxis.
It is important that locations providing vaccination to older adults, including long-term care facility residents, have staff members available who are able to recognize the signs and symptoms of anaphylaxis.
This will help not only to ensure appropriate and prompt treatment for patients with anaphylaxis, but also to avoid unnecessary epinephrine administration to patients who do not have anaphylaxis. Pregnant people with anaphylaxis should be managed in the same manner as non-pregnant people. As with all patients with anaphylaxis, they should be transported to a medical facility where they and their fetus can be closely monitored to ensure adequate perfusion.
Homebound people who might be at increased risk for anaphylaxis following vaccination i. If home vaccination is the only option for these people and, through risk assessment , it is determined that the benefits of vaccination outweigh the potential risk for anaphylaxis, home vaccination providers should ensure they are able to manage anaphylaxis.
This includes appropriate screening; post-vaccination observation; medications and supplies; staff qualifications for recognition and treatment of anaphylaxis; ability to call for EMS; and location in an area where EMS is available. Patients who experience a severe allergic reaction e. In addition, patients may be referred to an allergist-immunologist for appropriate work-up and additional counseling.
Reporting is also encouraged for any other clinically significant adverse event, even if it is uncertain whether the vaccine caused the event. Lieberman P, et al. Shaker MS, et al. Epinephrine for First-aid Management of Anaphylaxis. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Section Navigation.
Where there are differences to the manufacturer guidance and UK policy, it is the Green Book guidance that takes precedence, as detailed as a basic vaccination principle. See: Immunisation procedures: the Green Book, chapter 4.
While there is other guidance which detail injection technique and procedures for other medicines and treatments, it is the Green book, Immunisation procedures: the Green Book, chapter 4 which should be followed for injection technique for vaccine administration. The green book provides detail of the procedure but in principle for giving vaccines.
The injection should be completed as quickly as possible to minimise pain and discomfort. It is not necessary to aspirate the syringe after the needle is introduced into the muscle. There is no requirement to hold the needle in place after giving the vaccine or to rub the area post vaccination.
Recommendations on reducing pain at the time of vaccination. Nurses and all health professionals are an important and trusted source of advice on vaccination. The discussion with parents and the public is time well spent and people value having the opportunity to ask questions. It is however, the approach you take during the conversation which is key:. It is good practice to support any advice you give with written information.
Check that the information printed from websites is up to date, evidence based and from a credible source. As a general guide when searching the web for information, ask yourself and encourage patients, parents and carers to ask the following questions:. In addition look for websites providing reliable and trustworthy health information which have the Health on the net HONcode. All staff administering vaccines need to be appropriately trained and competent.
See: Immunisation training section. Vaccines are Prescription Only Medicine POM this means they require authorisation to supply and or administer from an appropriately registered practitioner.
There are alternative authorisation processes identified by the legislation Human Medicines Regulations HMR relevant to vaccination which include:. For information on medicines administration in occupational health settings and the use of written instructions, see: Specialist Pharmacy Service Written instruction for the administration of seasonal flu vaccination. All staff involved in administering vaccines should be suitably trained and competent to fulfil the role and be able to answer questions with accuracy and confidence in line with nationally agreed standards.
It is recommended that immunisation training should be either through a face to face taught course or a blended approach of both e-learning and a face to face taught course. New immunisers should also have a period of supervised practice and support with a registered healthcare practitioner who is experienced, up to date and competent in immunisation. The programme is free to access, just register to use the e-lfh portal. The course is designed around the updated National Minimum standards and the competency assessment tool.
View the Immunisation e-learning programme. See the specific flu e-learning resource. The immunisation programme in the UK is constantly evolving to best protect the public by controlling vaccine preventable diseases. Health professionals must keep up to date with these changes. Email: Vaccine. Supply dh. This newsletter gives advice on current vaccine availability, any changes to the schedule and updates to the Green Book. However, for country specific information, see:.
There is a common misconception that individuals should wait 20 minutes after receiving a vaccine. The majority of reactions will occur within two minutes and some occur hours later. The advice from the RCN is that there is no need to keep patients waiting unless this is specifically indicated in the summary of product characteristics for a particular vaccine. Patients should be given advice on adverse reactions and possible sides effects either from the patient information leaflet included with the vaccine or by giving appropriate leaflets such as Public Health England's leaflet What to Expect after Vaccinations.
Practice nurses should also check that the patient is not being visited by the district nurses. It is inefficient for both district nurses and practice nurses to visit the same household.
There is no reason for a medical practitioner to be on site when vaccines are being administered. Nurses should only administer immunisation and vaccines if they are trained and competent and this includes being up to date with anaphylaxis management. In all cases of anaphylaxis, an ambulance should be called. It is good practice to have another person available who is also trained in managing anaphylaxis.
There were Take care of yourself. Stay safe. Make sure to follow safety precautions at the vaccination facility such as physical distancing while waiting and wearing a mask. Let the health care professional know if you have any medical conditions that could be considered precautions, such as pregnancy or a compromised immune system.
Keep your records. You should receive a vaccination card that tells you which COVID vaccine you received, when you received it and where you received it.
Make sure to hold on to this card in the event that you need it in the future. Stay for monitoring. However, it is extremely rare for severe health reactions. Be prepared for some side effects. Vaccines are designed to give you immunity without the dangers of getting the disease.
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