Train the Trainer
Steps to Administering Influenza Vaccine
Why people get vaccinated?
Influenza (“flu”) is a contagious disease that spreads around the United States every year, usually
between October and May. Flu is caused by influenza viruses, and is spread mainly by coughing,
sneezing, and close contact. The flu can be spread to anyone and lasts serval days to weeks.
The flu is more serious for infants and young children, people 65 years of age and older,
pregnant women, and people with a weakened immune system.
The flu vaccine has multiple functions including:
Preventing the flu,
Dampens the effects of the flu virus
Prevents spread of the flu virus
Inactivated and recombinant flu vaccines
A dose of flu vaccine is recommended every flu season. Children 6 months through 8 years of
age may need two doses during the same flu season.
There is no live flu virus in flu shots, this means they cannot cause the flu.
There are various flu virus strains each flu season. Each year a new flu vaccine is made to
protect against the projected strains for the upcoming season. But even when the vaccine doesn’t
exactly match the strains, it may still provide some protection. It takes about 2 weeks for
protection to develop after vaccination, and protection lasts through the flu season.
Risks of a vaccine reaction
With any vaccine there is a chance of adverse reaction. These are usually mild, but serious
reactions are also possible. The majority of vaccinated individuals have no reaction.
Minor problems following a flu shot include:
Soreness, redness, or swelling at the injection site
Hoarseness or cough
Sore, red or itchy eyes
Fever, aches, headache, itching, and fatigue.
If these problems occur, they usually begin soon after the shot and last 1 or 2 days.
Problems that could happen after any injected vaccine:
People can faint after any medical procedure, including vaccination. Sitting or lying down for
about 15 minutes can help prevent fainting, and injuries caused by a fall.
What if there is a serious reaction?
Look for signs of a severe allergic reaction, including:
Swelling of the face and throat, difficulty breathing
Dizziness or weakness
These usually appear within a few minutes to a few hours after the vaccination.
What should I do?
If you think it is a severe allergic reaction or other emergency that can’t wait, call 911.
If you believe a reaction is occurring that requires medical attention ask for faculty assistance
immediately, get the person to a safe area, and call 911.
Do not administer vaccine to children less than 6 months of age.
When recording information, use months instead of years for children under age of 3
years old (36 months).
If asked why intranasal vaccine is not being offered, refer to CDC website that only
injectable flu vaccines are recommended for the 2016-2017 flu season.
The colored card and pre-screening questionnaire should stay together at all times.
o A green dot on the color card indicates a previous reaction or problem with the
Injection Safety Guidelines from the CDC
o Never administer medications from the same syringe to more than one patient, even if
the needle is changed.
o Never enter a vial with a used syringe or needle.
o Never use medications packaged as single-dose vials for more than one patient.
o Follow proper infection control practices during the preparation and administration of
Administering the Vaccine
Scanning & clerical work
Take client’s temperature
o Temperature above 100.4⁰F gets referred to TAMP RN or faculty for vaccination
Review Pre-screening questionnaire
o If patient answered yes to any of the Pre-screening questionnaire refer to faculty or
Determine age of patient for location of injection
o If Patient is under 3 years old (36 months), the injection should be administered in the
Vastus Lateralis muscle (anterolateral thigh)
o Depiction of this placement below
Make decision of gauge of needle to be used
o In general, pediatric patients under 18 years of age will need a 25 gauge needle
o In general, adult patients over 18 years of age will need a 23 gauge needle.
o Up to discretion of student which gauge needle to be used.
Remember 25 gauge is smaller than the 23 gauge
All needles used will be 1 inch in length
Be certain you have right vaccine for right person
o Verify name and date of birth with the colored card to the pre-screening questionnaire
Red card= egg allergy
Blue card= pediatric (36 months)
Yellow card= senior over 65
White card= regular
Green dot on card= previous adverse reaction
Be certain consent form is signed
Ensure consent form is signed, vaccine classification card and sticker match, and patient
understands what vaccine they are receiving.
There will be one student to one vaccine/client.
If at any time you feel uncomfortable giving the vaccine (anxious person, upset child,
having to restrain a child, etc.) request faculty assistance.
o Syringe with the drug to be administered (without air), needle (Gauge 23 or 25, 1 inch
in length), alcohol swab, gauze, and adhesive tape.
o Wash hands or use hand sanitizer and don clean gloves
o Reassure the patient and explain the procedure.
o Ask for patient allergies and confirm patient name and
date of birth (with second student)
o Uncover the area to be injected (deltoid muscle or
vastus lateralis ).
o Disinfect the skin with alcohol swab.
o Tell the patient to relax the muscle.
o Insert the needle swiftly at an angle of 90 degrees.
o Push down on the plunger and slowly inject the entire
contents of the syringe. There is no need to aspirate.
o Withdraw needle swiftly.
o Press gauze onto the opening. Fix with
adhesive tape. This step may not be necessary.
o Check the patient's reaction and give additional
reassurance, if necessary.
o Clean up; dispose of waste safely (in sharps container);
wash your hands or use hand sanitizer.
For anxious children attempt to use distraction techniques and let parent hold the child,
only use restraining techniques as last resort.
Take vaccine classification card from the patient
Sign and fill out the bottom portion of the consent form and keep the form
o Sign as first name last name SN
Fill out the vaccine verification card and this remains with the patient
If client is 8 years of age or younger they need a 30 day reminder card
o This is a reminder for the parent to get the child re-vaccinated again in 30 days.
Post Injection Table
For the Drive-thru clinic this is a mandatory 5 minute waiting area
For all other clinics this in an optional waiting area.
Have client fill out survey if they are willing.
If they have a 30 day reminder card educate the parent that the pediatric client needs to be
vaccinated again to ensure proper immunity from the flu virus.
o A localized reaction at the injection site with redness, swelling, and mild pain is
normal and they can use ice and Ibuprofen (if not allergic) to help mitigate the
o If the patient experiences more severe symptoms they should seek further medical
This will be the table all green dot patients are referred to.