Open Forum

Good afternoon,

One of our clinic sites is having some challenges with clearly recognizing "Best Use Date" (BUD) with COVID vaccine stock, thus patients have received COVID vaccines past the BUD date that was indicated. Our teams have worked diligently on processes and labeling to call attention to the BUD date. I am wondering if anyone else has challenges with this in their Primary Care Practices and if so, what are some measures you have taken to mitigate those errors?

Thank you,

Mallory 

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Mallory Leach BSN RN CPN
Nurse Manager
University of Kansas Health System
Kansas City KS
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Hi Mallory, 

COVID vaccines do have some unique challenges with BUD since it's not the same as the manufacturer expiration date. My background is in Primary Care and vaccine error prevention is something I've particularly focused on. Our most common error was wrong vaccine (Td vs Tdap, etc), but I believe the measures we implemented could be helpful to identifying vaccines past their BUD. These are some measures we use to help decrease risk of error. 

• Ensure there's a process for tracking and removing expired vaccines promptly on the BUD date. 
• Require independent verification of vaccine by a colleague who is also competent in administering vaccines. 
• Ensure staff are documenting NDC, lot, and expiration/BUD prior to administration. (We use EPIC and can choose "accept as incomplete" if needed.)

I unfortunately don't have robust data to provide as evidence of the measures' efficacy. Anecdotally, however, the rate of vaccine errors has diminished. The independent verification and documentation prior to administration have been critical. An additional consideration might be labelling each prefilled COVID syringe with a BUD sticker, though this might be a bit too laborious depending on your volume of vaccinations. 

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Victoria Roudabush RN
Nursing Professional Development Specialist
Lebanon NH
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