Preventing vaccine administration errors (VAEs)

January 2025 – Updated schedule & 6 Rights

Updated QLD Immunisation Schedule

Due to the addition of the RSV vaccine (Abrysvo) for pregnant women to the QLD Immunisation Program, the Immunisation Schedule Queensland was updated in December 2024. Please ensure you have the most up-to-date schedule at your practice.

Preventing vaccine administration errors (VAEs)

The Gold Coast Public Health Unit has received several recent enquiries regarding Vaccine Administration Errors (VAE’s). These include, but are not limited to, vaccines given at an incorrect site or age and administration of expired vaccines.

When administering any vaccine, please remember to check the 6 Rights:

1. Right patient
   • Check 3 forms of identity e.g. patients name, D.O.B, gender.
   • If more than 1 person is being vaccinated at the same time, prepare 1 vaccine at a time to avoid a potential error.
2. Right time
   • Check the patient’s AIR record to ensure the vaccine is due.
   • Check the NIP schedule to ensure the dose is given at the appropriate age.
   • Check the minimum interval between doses including catch up schedules.
3. Right drug
   • Check the vaccine against the National Immunisation Program (NIP) schedule.
   • Does the vaccine need reconstitution?
   • Does the patient have any risk factors for needing additional vaccines?
   • Is the vaccine within expiry date? If expired QHIP stock, complete the discard form and send to QHIP-Admin@health.qld.gov.au.
4. Right dose
   • Is the vaccine type correct for the patient’s age?
   • If using a multidose vial (COVID-19 vaccines), ensure the correct dose is withdrawn.
5. Right route
   • Check if the vaccine is to be given intramuscular, subcutaneously or orally.
   • Is the appropriate needle on the vaccine syringe and securely attached?
   • The recommended injection site depends on the patient’s age – anterolateral thigh for <12 months old or deltoid for ≥ 12 months old.
6. Right documentation
   • Ensure you have a doctor’s order to administer the vaccines. Note: Immunisation Program Nurses (IPN’s) can vaccinate under the Extended Practice Authority (EPA) ‘Registered Nurses’, Part D without a doctor’s order.
   • Ensure informed consent (preferably written) from the patient or caregiver including why you are giving the vaccine and the possible side effects.
   • Document the 5 rights above in the patient notes.

Double check with another nurse or doctor to help pick up a potential error before administration.

For more information, refer to Vaccination procedures in The Australian Immunisation Handbook.

If you experience a VAE, complete the Adverse Event Following Immunisation Reporting Form (tick the ‘Vaccine Administration Error’ box if there has been no adverse event. Please contact GCPHU for advice and support on 5667 3200 or GCPHU-CDC@health.qld.gov.au.