Health professionals are trusted sources of information and their recommendations for vaccination go a long way in motivating clients to get vaccinated. Based on age and risk factors, health professionals should consider which vaccines are required for an individual and a family. To obtain informed consent for vaccination, the individual should know about the disease that the vaccine will prevent and the side effects, benefits, and risks of vaccinating. The health professional should notify the patient before the vaccination visit and share materials about vaccine-preventable diseases (VPD) wherever possible. For example, expecting parents can start the conversation about a vaccination series for their infant in the pre-natal period.
On the Day of Vaccination
Begin the visit asking if the client has any questions about the vaccine. Use a presumptive statement, meaning assume the client is ready to vaccinate. This approach is recommended because it normalizes vaccines as an everyday occurrence that is recommended by the healthcare provider rather than an uncommon, fearful event. For example, “Today you will get your vaccine to protect against tetanus.” Clients may respond with hesitancy if they sense the health professional is unsure or not confident about immunization. The best way to convey confidence is by being a knowledgeable provider.
See Table 3.1 about steps and considerations involved in the pre-vaccination checklist. For further information about effective communication strategies, visit Chapter 5 on Vaccine Hesitancy.
Table 3.1: Pre-Immunization Checklist
| Steps | Considerations |
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Assess the client’s current health status.
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Discuss benefits and risks of receiving or not receiving the vaccine.
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Assess for contraindications and precautions.
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Note: Health professionals need to inform themselves of contraindications for each vaccine respectively. Also assess for client’s health status including age, comorbid conditions, risk factors and travel plans . |
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Evaluate reactions to previous vaccines.
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Discuss frequently occurring minor adverse events and potential rare severe adverse events.
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Points of Consideration
A common misconception among health professionals is that vaccination should be postponed in the event of minor or moderate acute illness such as upper respiratory tract infections, otitis media, and mild gastrointestinal illness, or in persons on antibiotic therapy. Generally, clients experiencing mild to moderate acute illness (even with fever) can be vaccinated. The health professional should use their clinical judgment to assess the risk, benefits, and health profile of the client when making a decision to delay vaccination.
Informed Consent
Health professionals should obtain consent from the client or the Substitute Decision Maker (SDM) prior to vaccinating. Consent must be informed, voluntary, related to the treatment being proposed, and not obtained through misrepresentation or fraud (College of Nurses of Ontario, 2017). Health professionals should consult their respective regulatory association for further information and guidelines on obtaining consent.
Preparation
Health professionals should ensure the client has met the criteria to vaccinate and screen for any contraindications, potential drug interactions, or precautions (see Chapter 4 on Vaccine Safety). Table 3.2 details criteria the health professional should actively verify prior to immunization. Remind the client that they will need to remain at the healthcare facility for a minimum of 15 minutes after receiving the vaccine in order for potential side effects to be monitored.
Table 3.2: Health Professional Criteria Before Vaccine Administration
| Criteria | Ask yourself |
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The right client, informed consent, and contraindications
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The right age
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The right vaccine or diluent
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If reconstituting:
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The right dose
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The right interval
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The right route, needle length, and technique
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The right site
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The right time
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The right storage
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The right comfort
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The right documentation
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