Vaccines with Diluents

Many vaccines come either in prefilled syringes or ready to use multi-dose vials.

The MMR vaccine is mixed with a diluent (sterile water) before it is administered.
The MMR vaccine is mixed with a diluent (sterile water) before it is administered.

Others are freeze dried and need to reconstituted or mixed with a specific diluent, such as sterile water.

Vaccines with Diluents

Those that use a diluent include:

  • MMR II
  • ProQuad
  • Varivax (chickenpox)
  • Zostavax (shingles)
  • ActHib and TriHIBit (Hib)
  • Hiberix
  • Menveo and Menomune (Meningococcal)
  • Pentacel
  • Rotarix
  • Imovax and RabAvert (rabies)
  • YF-VAX (yellow fever)

In addition to sterile water, vaccine diluents can include sodium chloride, distilled water, and vaccine antigens.

Unfortunately, the use of diluents can lead to errors when administering vaccines, from using the wrong diluent, using a drug instead of a diluent, to giving a diluent instead of a vaccine.

That’s what happened when 15 children in Syria died after being vaccinated with MMR. The drug Atracurium was used instead of the diluent for the MMR vaccine.

It is also what happened to the children in Samoa.

And that’s why people who give vaccines are taught to “Check the vial label three times to be sure you have chosen the correct vaccine product (and diluent, when applicable). Check the expiration date of the vaccine (and diluent) before using to be sure they are not out of date.”

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