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How Long is a Reconstituted Vaccine Good for?

No matter how careful you are and with all of the planning in the world, eventually, you will be faced with the scenario that a child’s vaccines are drawn up, but for one reason or another, they can’t get them.

What do you do if you get a child's vaccines prepared, but then find that they can't get them at that visit?
What do you do if you get a child’s vaccines prepared, but then find that they can’t get them at that visit? Photo by Vincent Iannelli, MD

Maybe they already had them or the wrong vaccines were drawn up, but whatever the reason, you now have one or more vaccines that you have taken out of the refrigerator or freezer and you have to figure out what to do with them.

How Long is a Reconstituted Vaccine Good for?

Not surprisingly, there is no one size fits all answer when you are faced with this scenario.

What you can do with the unused vaccine and how long you have to do it depends on several factors, including the type of vaccine and the manufacturer.

Was the vaccine frozen?

Did you have to reconstitute it and mix it with a diluent?

Does the vaccine come in a multi-dose vial?

Was the vaccine in a single-dose, disposable, prefilled syringe?

And if your lucky, does the vaccine’s package insert mention how long it can be kept out after being reconstituted?

So the first thing you should do if you have a vaccine that you have prepared, no longer have a patient to give it to, and want to know what to do with it is to check the vaccine’s package insert! Also be sure to mark the vaccine with the date and time that it was reconstituted or removed from the refrigerator or freezer so that you don’t mistakenly use it after it has expired. And return it to the refrigerator!

While the time is quickly up on some vaccines, including Pentacel, Varivax, and ProQuad, which must be used within 30 minutes, others can be good for eight (MMR and Menveo) to 24 hours (ActHIB, Hiberix, and Rotarix).

Will another patient be in the office at that time that can use the vaccine? Can one be called so the vaccines don’t go to waste?

Many other vaccines that come in single-dose, disposable, pre-filled syringes (or manufacturer-filled syringe) can last much longer if they aren’t immediately used. In fact, if you noticed your error right away and didn’t take the tip cap off, you might be able to just return the vaccine to its refrigerator.

“A manufacturer-filled syringe (MFS) is prepared and sealed under sterile conditions by the manufacturer. Activate an MFS (i.e., remove the syringe cap or attach the needle) only when ready to use. An MFS does not contain a preservative to help prevent the growth of microorganisms. Once the sterile seal has been broken, the vaccine should be used or discarded by the end of the workday.”

Vaccine Storage and Handling Toolkit

In general though, once you take the tip cap off a pre-filled syringe, unless you get other instructions from the package insert or manufacturer, you can expect to have to use that vaccine within eight hours.

Gardasil won’t last 72 hours if you took the tip cap off and attached a needle to the pre-filled syringe, even if you didn’t use it.

If you aren’t sure, that brings us to the next step, call the vaccine manufacturer for further instructions.

And to avoid vaccine wastage and situations in which you are stuck with vaccines you can’t use, don’t prefill your own syringes and before drawing up any vaccines, review the 7 Rights of vaccine administration, including that you give the Right vaccine to the Right patient at the Right time by the Right route at the Right injection site and then follow it with the Right documentation.

Lastly, if the vaccines truly must be thrown away, be sure to document the loss and discard them as medical waste.

More on Storing Vaccines

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