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Appropriately trained staff is key to ensuring the safety of vaccine recipients and builds trust among the public. Before licensed/certified vaccinators administer vaccines, they should:
- Receive competency-based training.
- Assess readiness to vaccinate by utilizing the Immunization Action Coalition’s (IAC) “Skills Checklist for Vaccine Administration.”
- Know the rights of medication administration:
- Right patient
- Right vaccine and diluent (when applicable)
- Right time (including the correct age and interval, as well as before the product expiration time/date)
- Right dosage
- Right route (including the correct needle gauge and length and technique)
- Right site
- Right documentation
Considerations when Administering COVID-19 Vaccine
General Considerations
- Ensure proper intramuscular (IM) injection technique:
- Spread the skin of the site taut between the thumb and forefinger, isolating the muscle.
- Another technique acceptable for geriatric patients is to grasp the tissue and “bunch up” the muscle.
- Insert the needle fully into the muscle at a 90° angle and inject.
- Withdraw the needle and immediately dispose.
- If applicable, ensure needle and syringe are tightly luer-locked together.
- Use the smallest syringe appropriate for the vaccine dose to improve dose accuracy.
- If you are short on syringes, 1 mL insulin syringes can be used for vaccine administration as long as they are used with the correct needle length and gauge for an IM injection.
- Exercise care to avoid contaminating or bending the needle if being used for both withdrawal and administration. The same needle should be used for withdrawal and administration.
- Inserting the needle in various locations of the vial septum can reduce leaking of vaccine and maximize doses withdrawn.
- Refrain from using transfer devices, mini spikes, or one needle to prepare multiple syringes due to potential loss of medicine in dead space.
- Use the same technique every time withdrawing vaccine.
- Maximize doses withdrawn from vials utilizing low dead-volume syringes and needles, whenever possible. A low dead-volume syringe is designed with less space between the syringe hub and needle. A low dead-volume needle is designed with less space between the needle and the plunger.
- If a vaccination site has inadequate quantities of low dead-volume syringes, to more consistently achieve the maximum doses withdrawn, a combination of low dead-volume syringes and non-low dead-volume syringes could also maximize doses withdrawn.
Pfizer Considerations
The following steps can help maximize the number of Pfizer-BioNTech COVID-19 vaccine doses per vial.
To reconstitute the Pfizer-BioNTech COVID-19 vaccine:
- Inject 1.8 mL of sodium chloride, preservative free, diluent into the vaccine vial.
- Draw out 2.1 mL of air before removing the needle from the vial.
When drawing up each dose of the Pfizer-BioNTech COVID-19 vaccine:
- Inject 0.2 mL of air into the vial of reconstituted vaccine.
- Draw up 0.3 mL of vaccine into the administration syringe. Do not change the needle unless the patient meets weight requirements.
- Rotate where you insert the needle in various locations of the vial septum for each withdrawal to reduce leaking of vaccine.
If receiving the vaccine through the hub and spoke model, supplies will be prorated based on the number of doses.
Pfizer-BioNTech COVID-19 Vaccine
- 1,000 needles (22-25G X 1”)
- 240 needles (22-25G X 1.5”)
- 205 mixing needles (21-25G X1.5”)
- 1,240 syringes (1 mL)
- 205 syringes (3 mL or 5 mL)
- 2,900 alcohol pads
- 1,200 vaccination record cards
- 10 needle gauge and length charts
- 25 face shields
- 50 surgical masks
- 200 diluent vials
Moderna COVID-19 Vaccine
- 85 needles (22-25G x 1”)
- 20 needles (22-25G x 1.5”)
- 105 syringes (1 mL or 3mL)
- 210 alcohol pads
- 100 vaccination record cards
- 1 needle gauge and length chart
- 2 face shields
- 4 surgical masks
Please direct any issues regarding the ancillary kits to support the Pfizer COVID-19 vaccine to McKesson Customer Service at:
McKesson Customer Service
Phone Number: 833-272-6634
Email: SNSSupport@McKesson.com
Concerns related to needle/syringe quality and performance should be directed to the WI COVID-19 Vaccine Program at: DHSCOVIDVACCINATOR@wi.gov. If possible, please include brand, lot number, and a picture of the quality issue.
Vaccination providers should contact the manufacturer with questions related to proper product use:
- Becton Dickinson (BD) - website or 844-823-5433
- Cardinal Health - website or 1-800-964-5227
- HTL Strefa- website or 877-660-1900
- Duopross Meditech Corp- website or 1-800-844-1350
- Retractable Technologies Inc. (RTI)- website or 888-703-1010
It’s possible that due to unforeseen circumstances, deliveries of supplies may be delayed or not be sufficient to administer all doses. To make sure this does not hold up the process of vaccination, vaccination sites should try to have backup ancillary supplies on-hand to administer the vaccine.
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