7.5.4  How to avoid AEFIs

In order to avoid AEFIs as much as possible, you should follow these guidelines:

• Fulfil the five requirements for using opened multi-dose vials (see Box 7.1).
• Do not vaccinate clients with absolute contraindications to immunization (see Box 7.2).
• Always reconstitute vaccines with the diluent supplied by the manufacturer. Never use another diluent.
• Discard reconstituted vaccines and PCV10 six hours after reconstitution, or at the end of the immunization session, whichever comes first.
• Do not keep other drugs in vaccine refrigerators if at all possible. If you have to keep other injectable drugs in the same refrigerator, put them on a separate shelf. AEFIs are likely to occur if you give an injection of a drug instead of the vaccine by mistake, or use a drug instead of the correct diluent.
• Prepare immunizations in a clean area where contact with blood and body fluids is unlikely.
• Use a sterile needle and syringe to prepare every injection dose immediately before administering it. Do not prepare several syringes in advance and do not re-use injection equipment.
• Do not touch the needle and never leave it in the top of the vaccine vial.
• If you use auto-disable (AD) syringes, AEFIs due to contamination should not occur.
• The child should be held firmly, so that there cannot be a sudden movement during the injection.

Do not leave the needle in the vial!