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or state registries. Create easy-to-read office forms for documenting administration.
• Screen patients for contraindications and pre- cautions to administering any vaccine to prevent adverse events following vaccinations. Reference the CDC guidelines for various vaccines and specific CDC guidance for COVID-19 vaccine administration.
• Educate patients and parents regarding vaccina- tion schedules.
• Designate a licensed staff member to monitor
for revisions/new recommendations of FDA/CDC vaccination schedules. Ensure that new vaccina- tion schedules are incorporated with office procedures and are included on office vaccination forms.
• Provide accurate information to patients. Con- duct and document a thorough informed consent discussion; use Vaccine Information Statements prior to vaccine administration. Include informa- tion on the consequence of diseases contracted as a result of non-vaccination. Since parental immunization attitudes vary, be knowledgeable and prepared to address concerns utilizing appropriate communication methods. Use this resource from the American Academy of Pediat- rics to assist with addressing vaccine-hesitant parents.
• Obtain patient or parent signatures on an informed consent form that includes potential side effects and complications. In the case of parents who have disagreed previously on vaccination, consider requesting both signatures on a vaccination consent. In the case of pediatric patients of divorce where sole physical custody is involved, the custodial parent or guardian should provide documentation to show authorization to sign a consent. Document the discussion in the progress notes when the immunization is refused. Consider using the Refusal to Vaccinate form from the American Academy of Pediatrics or The Doctors Company’s sample informed refusal form.
• Check the EEOC and state laws regarding exemp- tions, and educate patients. Be aware that in some circumstances, Title VII and the ADA require an employer to provide reasonable accommoda- tions for certain employees.
• Monitor patients closely post-administration for anaphylaxis, vasovagal response, and reaction at the injection site. Document any reactions,
suspected side effects, and complications in the medical record.
• Educate staff and conduct skills verification on accepted procedures, new standards, and risk prevention methods. Document these efforts in administrative training files.
• Store and handle vaccinations in accordance with Vaccines for Children/CDC guidelines. Monitor these practices with staff—don’t just assume they are being followed correctly.
• Follow basic medication administration safety protocols for vaccine administration. Be aware of the most common vaccine-related errors by reviewing “Confusion Abounds! 2-Year Summary of the ISMP National Vaccine Errors Reporting Program” Part I and Part II and the article ISMP Analyzes First Few Months of COVID-19 Vaccine Errors.
• Should an error in vaccine administration occur, conduct a disclosure discussion with the patient/ parent utilizing The Doctors Company’s Disclo- sure Resources. Conduct a root cause analysis with your staff to determine why an error occurred and to prevent reoccurrence in the future by adjusting office procedures and provid- ing staff training, as needed.
• Be responsive to patients who express concerns about reactions from their vaccines. Document these discussions in the medical record.
• Report errors to the Vaccine Adverse Event Reporting System. .
Healthcare providers can help raise awareness of the benefits of immunizations.Use CDC materials to:
• Encourage parents of children 5-18 to get the COVID-19 vaccination following CDC recommendations.
• For other routine vaccines, encourage parents of young children to follow recommended vaccina- tion schedules from birth-6 years.
• Help parents make sure older children have received vaccinations by the time they return to school.
• Remind college students to get required vaccina- tions before moving into dormitories.
• Educate adults, including healthcare workers, about vaccines and boosters they may need.
• Inform pregnant women about getting vaccinated to protect newborns from disease such as whooping cough.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.
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DECEMBER 2021/JANUARY 2022 | WWW.OCMS-MI.ORG