COVID-19 vaccination: risk assessment and mitigation


Be aware and prepare for expansion of vaccination services, warns PDL

In its latest practice alert, PDL has offered advice on Ivermectin and on providing vaccination against COVID-19.

Pharmacist vaccination services are continuing to expand and PDL urges all pharmacists to consider the risk assessment and risk mitigation strategies needed to prevent errors or incidents.

Below are some of the most common areas of risk identified by the PDL Professional Officers.

Check the patient’s age The inclusion of Moderna’s Spikevax vaccine in the community pharmacy setting requires even more vigilance to ensure compliance with the minimum age limit. PDL advises pharmacists to consider the following:

  • Awareness that TGA approval for Moderna Spikevax is 12 years and AstraZeneca’s Vaxzevria is 18 years.
  • State or Territory regulations may dictate a higher minimum age so please check your jurisdiction’s requirements.
  • Some consent and booking forms may request a patient’s date of birth but not seek or translate this data into age in years. Confirm age in years to avoid errors.
  • Use a reminder in the vaccination area or beside the computer booking system to confirm the current date and the patient’s date of birth to assure the minimum ages. For example, on 16.9.2021 a patient 12 years or older would have a DOB no later than 16.9.2009 and 18 years and over would be no later than 16.9.2003.
  • PDL stresses the importance of checking the Australian Immunisation Register (AIR) before every vaccination.

Check the brand

Many patients are attending for the second dose of a COVID-19 vaccine. The patient’s expectation of the brand to be administered should be confirmed using open questions.

  • For example, a question such as “Can you please confirm the vaccine you expect to receive today?”
  • Do not use closed questions such as “So you’re here for a Vaxzevria today, is that right?” or “So you’ve had your first COVID-19 vaccine without any problems?”

Check the interval

  • Given the three vaccines currently available have a range of dosing intervals dependent on the vaccine and the outbreak setting status, there is potential for patient and pharmacist confusion.
  • Review the AIR before every vaccination and ensure any second dose is in line with the approval interval for the brand and the setting. See previous vaccination alerts from PDL by visiting the website.

Separate and differentiate vaccine services

  • Separate Spikevax and Vaxzevria regarding storage, preparation, labelling, bookings and administration whenever possible.
  • Colour coding of the vaccines across all areas of handling can minimise risk of incident.
  • Be aware of the different expiry considerations for the vaccines.

Ivermectin

The recent uptick in ivermectin prescribing has prompted the TGA to apply further restrictions on the prescribing of ivermectin.

PDL reminds all pharmacists to always assess each prescription on an individual basis and ensure that there is sufficient information to support the supply of a medicine in an off-label manner.

 Please note that according to new TGA directives, General Practitioners can only prescribe ivermectin for indicated conditions of scabies treatment and some parasitic conditions.

Some specialists (listed below) can prescribe for unapproved indications if deemed appropriate.

  • Infectious disease specialists
  • Dermatologists
  • Gastroenterologists
  • Hepatologists (liver disease specialists)

For immediate advice and incident support, members can call PDL on 1300 854 838 to speak with one of its Professional Officers. PDL is there to support its pharmacist members 24/7, Australia-wide.

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