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Guidelines for Administering Vaccinations

• Set up before the child comes back. Complete as much of the work as possible before the child comes back. Prepare the area: open alcohol preps; have Band-Aids ready to be used; set up chairs set up; have all supplies and papers ready
• Determine if (1) past complications (convulsions within 3 days after past immunizations, fever >105 within 48 hours, collapse or shock, inconsolable crying for 3 hours); (2) acutely ill with high fever (URIs, OM, mild diarrhea are not reasons to delay immunization); (3) altered immune response (child or adult in close contact). Check with Mr. Kemp or physician if any + responses.
• Check the shot record to determine needed vaccines. Many patients are off schedule, hence it is sometimes difficult to determine what vaccinations are needed. Verify with Mr. Kemp.
• Explain to the parent that the child may have pain at the site(s), be fussy, or run fever. Administer liquid acetaminophen or Pediacare (ibuprofen) for fever and pain after (1) determining that there are not any medication allergies or contraindications and (2) consulting Mr. Kemp.
• Give acetaminophen or Pediacare to administer at home and explain how much to give. The following are not normal and medical attention should be sought if they occur: convulsions within 3 days after past immunizations, fever >105 within 48 hours, collapse or shock, inconsolable crying for 3 hours.
• Have the parent fill out and sign the (colored) paper for each vaccine to be given (found in the cabinet under the baby weight scale). Note on this paper what number this is (#1, #2, etc.) in the series of the particular immunization (DtaP, MMR, etc.). Examples are attached.
• Draw up medication (3 cc syringe) - 0.5 cc of vaccine
• Discard needle used to draw up vaccine and put on a new needle
• Use 25- 5/8 inch needle for small children and SQs; and 1 inch needle for larger or heavier children.
• MMR and varicella are given SQ (arm) and the others are given IM in VL site in small children (with small muscle mass) and deltoid site in larger children.

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