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Education
and Training
The Immunization Encounter: Critical Issues
Broadcast June 27, 2002
Updates
and Clarifications
- ActHIB
reconstitution. In the Immunization Encounter broadcast
we stated that ActHIB must be used within 30 minutes of reconstitution.
Actually, it is when ActHIB is reconstituted with Tripedia to
form TriHIBit that it must be used within 30 minutes. ActHIB alone
should be used within 24 hours of reconstitution. (7/5/02)
- PedvaxHIB
reconstitution. We stated that PedvaxHIB should be used within
24 hours of reconstitution. This was once true. Now, however,
PedvaxHIB is a liquid and does not require reconstitution. (7/5/02)
- Repeating
dose when vaccine has expired. On the air we stated that if
a dose of expired vaccine is inadvertently given it should be
repeated immediately. After consulting with other vaccine experts,
we agreed that the interval between a dose of expired vaccine
and the repeat dose should be 28 days. This more conservative
approach is consistent with ACIP recommendations on repeating
doses that are invalid for other reasons (e.g., too close together),
and it also reduces the possibility of interference when the vaccine
in question is live. (7/5/02)
- Aspiration.
Yet another issue regarding the practice of aspirating when giving
an intramuscular vaccination arose after the broadcast . . . namely,
should the syringe be reused or discarded if blood is aspirated.
As with aspiration itself, there are virtually no data on the
topic. The prudent approach is that if you do choose to aspirate,
and if blood is aspirated, remove and discard the syringe. Then
start the procedure again. If no blood is aspirated, inject the
vaccine. (7/5/02)
- Menomune
Reconstitution. On the air we stated that multi-dose vials
of vaccine contain a bacteriostatic agent, usually thimerosal,
and that once they are opened the vaccine can be used until the
date of expiration unless it becomes visibly contaminated. This
guideline does not apply to Menomune (meningococcal polysaccharide
vaccine), which must be reconstituted. Unused vaccine from a multi-dose
vial of Menomune should be refrigerated at 2°- 8° C (35°-
46° F) and discarded 35 (previously 10) days after reconstitution
if not used. Use single dose vials within 30 minutes of reconstitution.
(4/17/03)
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