{"id":7882,"date":"2021-02-11T15:22:24","date_gmt":"2021-02-11T04:22:24","guid":{"rendered":"https:\/\/mvec.mcri.edu.au\/?post_type=references&#038;p=7882"},"modified":"2022-11-29T16:43:14","modified_gmt":"2022-11-29T05:43:14","slug":"multi-dose-vials","status":"publish","type":"references","link":"https:\/\/mvec.mcri.edu.au\/hi\/references\/multi-dose-vials\/","title":{"rendered":"\u092c\u0939\u0941-\u0916\u0941\u0930\u093e\u0915 \u0915\u0940 \u0936\u0940\u0936\u093f\u092f\u093e\u0901"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div data-parent=\"true\" class=\"vc_row row-container\" id=\"row-unique-0\"><div class=\"row single-top-padding single-bottom-padding one-h-padding full-width row-parent\"><div class=\"wpb_row row-inner\"><div class=\"wpb_column pos-top pos-center align_left column_parent col-lg-12 single-internal-gutter\"><div class=\"uncol style-light\"  ><div class=\"uncoltable\"><div class=\"uncell no-block-padding\" ><div class=\"uncont\" ><div class=\"uncode_text_column\" ><\/p>\n<h2>What are they?<\/h2>\n<p>Multi-dose vials contain more than one dose of a medicine\/vaccine in a single vial. Whilst all vaccines on the National Immunisation Program are single-use preparations, BCG vaccines and COVID-19 vaccines are available in multi-dose vials in Australia. Multi-dose vials are more economical, take less time to manufacture and require less storage space than single-use preparations, however, there is an increased risk of infection control breaches associated with their use.<\/p>\n<h2>Infection control principles<\/h2>\n<p>There is an increased risk of blood-borne viruses or bacterial contamination with the use of multi-dose vials due to an increased risk of cross contamination. These risks can be mitigated by:<\/p>\n<ul>\n<li>Maintaining standard principles of infection control and strict aseptic technique when accessing multi-dose vials<\/li>\n<li>Preparing doses of vaccines from multi-dose vials in a clean, designated medication preparation area<\/li>\n<li>Cleaning the stopper with an alcohol swab and allowing to dry every time the vial is accessed<\/li>\n<li>Using a new, sterile syringe and needle each time the vial is accessed. Needles should never be left inside the vial<\/li>\n<li>Discarding a multi-dose vial if the vaccine\u2019s integrity or sterility is compromised<\/li>\n<\/ul>\n<h2>Storage and usage<\/h2>\n<ul>\n<li>Follow the manufacturer\u2019s recommendations for refrigeration, storage, usage timeframes and expiry dates. Protect from sunlight and freezing where required.<\/li>\n<li>Always label a multi-dose vial with the date and time of first access or reconstitution<\/li>\n<li>The <em>expiry date<\/em> is the date after which an unused multi-dose vial should be discarded<\/li>\n<li>The <em>use by date<\/em> is the date after which a multi-dose vial that has been accessed should no longer be used. A use by date supercedes the expiry date<\/li>\n<li>Check reconstituted vaccines for signs of deterioration, such as a change in colour or clarity. If there are signs of deterioration, refer to the vaccine product information. Do not use the vaccine<\/li>\n<\/ul>\n<h2>Multi-dose vials that require reconstitution<\/h2>\n<ul>\n<li>Only the recommended diluent should be used to reconstitute a multi-dose vial<\/li>\n<li>Introduce the diluent down the side of the vial to avoid foaming or potentially denaturing the vaccine.\u00a0Mix gently with a careful swirling motion. Do not shake<\/li>\n<li>Give reconstituted vaccines as soon as practicable after reconstituting. This is because reconstituted vaccines may deteriorate rapidly<\/li>\n<li>Once accessed, label the multi-dose vial with the date and time of reconstitution<\/li>\n<\/ul>\n<h2>Pre-filling syringes<\/h2>\n<p>Pre-preparing\u00a0syringes with vaccines\u00a0is not recommended for several reasons:<\/p>\n<ul>\n<li>The uncertainty of vaccine stability<\/li>\n<li>The risk of contamination<\/li>\n<li>Increased risk of potential errors in administration<\/li>\n<li>Potential vaccine wastage<\/li>\n<\/ul>\n<p>If you are in a setting where pre-preparing multiple\u00a0doses is required,\u00a0then only draw up the number of doses necessary to keep the immunisation session running efficiently. These doses must be labelled with the\u00a0date and time the vial was accessed and should be\u00a0used as soon as possible, ensuring that the cold chain is maintained.<\/p>\n<h2>Principles of administration<\/h2>\n<ul>\n<li>Attach a new, sterile, disposable injecting needle of appropriate size and length to administer the vaccine<\/li>\n<li>Be careful not to prime the needle with any of the vaccine as this can increase the risk of injection site reactions<\/li>\n<li>Administer the vaccine as soon as practicable after drawing it up<\/li>\n<li>Discard multi-dose vials at the end of an Immunisation session\/6 hours after accessing (whichever is sooner) or according to manufacturer\u2019s guidelines<\/li>\n<li>Refer to the product information to determine the specified timeframe the vaccine must be used by once the vial has been accessed<\/li>\n<\/ul>\n<h2>\u0938\u0902\u0938\u093e\u0927\u0928<\/h2>\n<ul>\n<li><a href=\"https:\/\/education-mvec.mcri.edu.au\/courses\/use-of-multi-dose-vials\/\" target=\"_blank\" rel=\"noopener\">MVEC: Use of Multi-dose Vials eLearning package<\/a><\/li>\n<li><a href=\"https:\/\/www.health.gov.au\/resources\/publications\/atagi-guidance-on-the-use-of-multi-dose-vials-for-covid-19-vaccination\" target=\"_blank\" rel=\"noopener\">ATAGI guidance on the use of multi-dose vials for COVID-19 vaccination<\/a><\/li>\n<li><a href=\"https:\/\/mvec.mcri.edu.au\/wp-content\/uploads\/2021\/02\/Aseptic-Technique-Clinician-Cheat-Sheet-1.pdf\" target=\"_blank\" rel=\"noopener\">ACIPC: Aseptic Technique Clinician Cheat Sheet<\/a><\/li>\n<li><a href=\"https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/healthy-living\/canadian-immunization-guide-part-1-key-immunization-information\/page-8-vaccine-administration-practices.html\" target=\"_blank\" rel=\"noopener\">Canadian Immunization Guide: Vaccine administration practices<\/a><\/li>\n<li><a href=\"https:\/\/www.cdc.gov\/injectionsafety\/providers\/provider_faqs_multivials.html\" target=\"_blank\" rel=\"noopener\">Center for Disease Control Injection Safety: Questions about multi-dose vials<\/a><\/li>\n<li><a href=\"https:\/\/www.mja.com.au\/journal\/2011\/194\/8\/vaccination-consent-and-multidose-vials\" target=\"_blank\" rel=\"noopener\">Medical Journal of Australia: Vaccination, consent and multi-dose vials<\/a><\/li>\n<li><a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/135972\" target=\"_blank\" rel=\"noopener\">WHO policy statement: Multi-dose Vial Policy (MDVP)<\/a><\/li>\n<\/ul>\n<div class=\"reviewedSection\">\n<p><strong>\u0932\u0947\u0916\u0915:\u00a0<\/strong>\u092b\u094d\u0930\u093e\u0902\u0938\u0947\u0938\u094d\u0915\u093e \u092e\u091a\u093f\u0902\u0917\u093e\u0907\u092b\u093e (\u090f\u092e\u0935\u0940\u0908\u0938\u0940 \u090f\u091c\u0941\u0915\u0947\u0936\u0928 \u0928\u0930\u094d\u0938 \u0915\u094b\u0911\u0930\u094d\u0921\u093f\u0928\u0947\u091f\u0930) \u0914\u0930 \u0930\u093e\u091a\u0947\u0932 \u092e\u0948\u0915\u0917\u093e\u092f\u0930 (\u090f\u092e\u0935\u0940\u0908\u0938\u0940 \u090f\u091c\u0941\u0915\u0947\u0936\u0928 \u0928\u0930\u094d\u0938 \u0915\u094b\u0911\u0930\u094d\u0921\u093f\u0928\u0947\u091f\u0930)<\/p>\n<p><strong>\u0926\u094d\u0935\u093e\u0930\u093e \u0938\u092e\u0940\u0915\u094d\u0937\u093f\u0924<\/strong>: Francesca Machingaifa (MVEC Education Nurse Coordinator)<\/p>\n<p><strong>\u0924\u093e\u0930\u0940\u0916:<\/strong> March 2022<\/p>\n<p>\u0928\u0908 \u091c\u093e\u0928\u0915\u093e\u0930\u0940 \u0914\u0930 \u091f\u0940\u0915\u0947 \u0909\u092a\u0932\u092c\u094d\u0927 \u0939\u094b\u0924\u0947 \u0939\u0940 \u0907\u0938 \u0905\u0928\u0941\u092d\u093e\u0917 \u0915\u0940 \u0938\u093e\u092e\u0917\u094d\u0930\u093f\u092f\u094b\u0902 \u0915\u094b \u0905\u0926\u094d\u092f\u0924\u0928 \u0915\u093f\u092f\u093e \u091c\u093e\u0924\u093e \u0939\u0948\u0964 \u092e\u0947\u0932\u092c\u0930\u094d\u0928 \u0935\u0948\u0915\u094d\u0938\u0940\u0928 \u090f\u091c\u0941\u0915\u0947\u0936\u0928 \u0938\u0947\u0902\u091f\u0930 (MVEC) \u0915\u0930\u094d\u092e\u091a\u093e\u0930\u0940 \u0938\u091f\u0940\u0915\u0924\u093e \u0915\u0947 \u0932\u093f\u090f \u0928\u093f\u092f\u092e\u093f\u0924 \u0930\u0942\u092a \u0938\u0947 \u0938\u093e\u092e\u0917\u094d\u0930\u093f\u092f\u094b\u0902 \u0915\u0940 \u0938\u092e\u0940\u0915\u094d\u0937\u093e \u0915\u0930\u0924\u0947 \u0939\u0948\u0902\u0964<\/p>\n<p>\u0906\u092a\u0915\u094b \u0907\u0938 \u0938\u093e\u0907\u091f \u0915\u0940 \u091c\u093e\u0928\u0915\u093e\u0930\u0940 \u0915\u094b \u0905\u092a\u0928\u0947 \u0935\u094d\u092f\u0915\u094d\u0924\u093f\u0917\u0924 \u0938\u094d\u0935\u093e\u0938\u094d\u0925\u094d\u092f \u092f\u093e \u0905\u092a\u0928\u0947 \u092a\u0930\u093f\u0935\u093e\u0930 \u0915\u0947 \u0935\u094d\u092f\u0915\u094d\u0924\u093f\u0917\u0924 \u0938\u094d\u0935\u093e\u0938\u094d\u0925\u094d\u092f \u0915\u0947 \u0932\u093f\u090f \u0935\u093f\u0936\u093f\u0937\u094d\u091f, \u092a\u0947\u0936\u0947\u0935\u0930 \u091a\u093f\u0915\u093f\u0924\u094d\u0938\u093e \u0938\u0932\u093e\u0939 \u0928\u0939\u0940\u0902 \u092e\u093e\u0928\u0928\u093e \u091a\u093e\u0939\u093f\u090f\u0964 \u091f\u0940\u0915\u093e\u0915\u0930\u0923, \u0926\u0935\u093e\u0913\u0902 \u0914\u0930 \u0905\u0928\u094d\u092f \u0909\u092a\u091a\u093e\u0930\u094b\u0902 \u0915\u0947 \u092c\u093e\u0930\u0947 \u092e\u0947\u0902 \u0928\u093f\u0930\u094d\u0923\u092f \u0938\u0939\u093f\u0924 \u091a\u093f\u0915\u093f\u0924\u094d\u0938\u093e \u0938\u0902\u092c\u0902\u0927\u0940 \u091a\u093f\u0902\u0924\u093e\u0913\u0902 \u0915\u0947 \u0932\u093f\u090f, \u0906\u092a\u0915\u094b \u0939\u092e\u0947\u0936\u093e \u090f\u0915 \u0938\u094d\u0935\u093e\u0938\u094d\u0925\u094d\u092f \u0926\u0947\u0916\u092d\u093e\u0932 \u092a\u0947\u0936\u0947\u0935\u0930 \u0938\u0947 \u092a\u0930\u093e\u092e\u0930\u094d\u0936 \u0932\u0947\u0928\u093e \u091a\u093e\u0939\u093f\u090f\u0964<\/p>\n<\/div>\n<p>\n<\/div><\/div><\/div><\/div><\/div><\/div><script id=\"script-row-unique-0\" data-row=\"script-row-unique-0\" type=\"text\/javascript\" class=\"vc_controls\">UNCODE.initRow(document.getElementById(\"row-unique-0\"));<\/script><\/div><\/div><\/div>\n<\/div>","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":"","_wp_rev_ctl_limit":""},"first_letter":[21],"class_list":["post-7882","references","type-references","status-publish","hentry","first_letter-m"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Multi-dose vials - The Melbourne Vaccine Education Centre (MVEC)<\/title>\n<meta name=\"description\" content=\"Multi-dose vials contain more than one dose of a medicine\/vaccine in a single vial, are more economical, take less time to manufacture and 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