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WILSON MEMORIAL GENERAL HOSPITAL
P.O.BAG “W”
MARATHON, ONTARIO
P0T 2E0
POLICY AND PROCEDURE MANUAL
DEPARTMENT
POLICY/PROCEDURE NO.
SUBJECT
DATE OF ISSUE
DISTRIBUTION
REVISION DATES
Nursing
Administration of Influenza Vaccine
October 29, 2007
Nursing
APPROVAL
October 30, 2008
PAGE
1 of 2
Administration of Influenza Vaccine by Nurses
Background: Administration of influenza vaccine by nurses will improve
influenza immunization rates in the community.
Implementing Persons:
Registered Nurses; Registered Practical Nurses.
Inclusion Criteria:
This policy applies to any patient who is 1 year or older.
Contraindications:
Any of the following timing-related contraindications:
1. Patient has already received influenza vaccine for the current influenza
season (unless < 9 years old, received 1 or 0 doses of vaccine last year, and
has never received 2 doses of vaccine within a single season).
2. Patient has already received 2 doses of influenza vaccine for the current
influenza season.
3. Patient presents less than 4 weeks since previous influenza vaccine dose.
4. Current acute febrile illness (defer until symptoms have abated).
5. Current active neurologic disorders (defer until the disease process has been
stabilized).
Any of the following medical contraindications:
6. Previous anaphylactic reaction to influenza vaccine.
7. History of anaphylactic-type allergy to eggs or egg products.
8. History of anaphylactic-type allergy to thimerosal, neomycin, or any other
component of the vaccine.
9. History of developing of Guillain-Barré Syndrome within 8 weeks of a
previous influenza immunization.
10. Immunization should be delayed in a patient with an active neurological
disorder, but should be considered when the disease process has been
stabilized.
Situational Conditions Required:
WMGH Influenza Vaccine Form
Emergency Treatment readily available – Inform ER nurse of flu clinic wheel
chair available.
Procedure:
 For patients 6-35 months, administer 2008-2009 influenza split-virus
vaccine 0.25 ml intramuscularly.
 For children 3-8 years, administer 2008-2009 influenza split-virus vaccine
0.5 ml intramuscularly.
 For children >9 years 0.5ml administer 2008-2009 influenza split-virus
vaccine 0.5ml intramuscularly.
 Previously unvaccinated children under the age of nine require two doses of
vaccine four weeks apart. If a child has only had one dose in any previous
year, only 1 dose is required.
 Preferred site of administration is the deltoid in adults and children ≥ 12
months.
25g 1 inch adult
25g 5/8 inch children
1. Pediatric vaccine is not to be pre-drawn.
2. Nurses to be aware of anaphylaxis policy and procedure and have easy
access to ER department.
3. Determine if the patient meets the criteria and if there are any
contraindications.
4. Give pamphlet about the vaccine and discuss possible side effects.
5. Examine each vial and do not use if any extraneous particulate of
discoloration is evident. Shake vial to uniformly distribute the suspension.
6. Determine the dose according to age as per the product monograph for the
specific drug used and WMGH medical directive.
7. The patient is encourage to wait for 20 minutes post injection in case of
possible anaphylaxis.
Documentation:
 Report of Adverse Reaction Form
 Vaccination Coverage Data Form
 Patients yellow immunization card or immunization card (WMGH)
initialed and dated.
Reference:
Product monograph supplied with the vaccine
Statement on Influenza Vaccine from the National Advisory Committee on
Immunization (NACI) – provided annually
Canadian Immunization Guide, Edition 2007