Pandemic Immunizer Education

Informed consent is an essential pre-condition to providing immunization. It is the professional and legal responsibility of the provider to obtain informed consent prior to immunization. The intent of the informed consent standard of practice is to achieve a more client-centered [and] consistent... approach.

The following list has been developed to help ensure that immunizers achieve informed consent with each client:

For Use by Immunizers to Guide Informed Consent

1. Determine who will give informed consent – Self, Parents/Guardians, Substitute Decision Maker
2. Provide standard information, such as, risks, benefits, side effects, eligibility, common and expected adverse events, possible serious side effects and adverse events, contraindications, disease(s) being prevented, management of anaphylaxis
3. Confirm understanding of standard information
4. Confirm consent with client and/or parent/guardian
5. Provide opportunity for questions
6. Confirm consent
7. Document consent or refusal

For additional information regarding determining capacity to provide consent and requirements of informed consent please visit the Canadian Nurses Protective Society resource page.

Please review the following links:

As Nova Scotia rolls out the COVID-19 immunization program, we want to ensure that all citizens have access to immunization. Being able to report immunization progress based on race and indigenous subgroups allows us to monitor and ensure equity in access and distribution of immunizations. If gaps exist, it allows public health to make changes to the immunization program. All consent forms contain specific questions related to race-based data that immunizers will ask during the consent process. Persons have a right to refuse to answer these questions, and refusal will not impact their ability to receive the COVID-19 vaccine, nor are they related to the informed consent process.

Introducing the Collection of Race, Ethnicity and Indigeneity Data for COVID-19 Objectives 

This course is offered via the Nova Scotia Health Provincial Learning Management System. It will take approximately 30 minutes to complete.

If you do not have access to the Provincial Learning Management System (LMS), please review the following:

Health equity is a foundational standard of Public Health, as such it must be considered in every aspect of our work. The mass immunization program has health equity built in and we must all commit to equitable access to immunizations. This presentation is a refresher in relevant health equity topics.

Health Equity for COVID Mass Immunizations Duration

This course is offered via the Nova Scotia Health Provincial Learning Management System. It will take approximately 20 minutes to complete. 

Vaccine providers contribute to vaccine safety by reporting AEFI which allows further investigation of adverse events, but does not mean that an observed event was caused by either vaccine or immunization. It is important that all serious AEFI are reported without delay. It is also important to report unexpected AEFI. Expected common events such as vaccination site reactions or fever do not need to be reported.

Please review the following in regards to AEFI reporting:

Successful immunization programs for COVID-19 vaccine products are dependent upon proper handling, storage and rigorous cold chain management of the COVID-19 vaccine. Vaccines are sensitive biological products that may be less effective when exposed to temperatures outside of the recommended cold chain storage requirements.

Every cold chain excursion involving COVID-19 vaccine product must be investigated in order to obtain sufficient information about the circumstances under which the temperature excursion occurred by assessing the duration and temperature of the excursion. The provincial bio-depot Pharmacy Practicing Assistant and/or the biological depot Immunization Coordinator will follow up with the manufacturer’s Medical Information Specialist and/or Quality Assurance to determine vaccine stability, viable or non-usable.

The immunizer:

• Reviews appropriate medical directives, policies & procedures prior to clinic opening
• Sets up immunizing workstation and receives and stores vaccine according to vaccine storage and handling requirements
• Attends huddles prior to start of mass immunization clinic
• Reviews informed consent checklist with client
• Administers COVID-19 vaccine
• Ensures documentation is completed immediately following administration of vaccine in CANImmunize at point of care
• Follows policies and procedures for the management of faints or any adverse events related to COVID-19 vaccine
• Advises client to wait in designated recovery area for 15 minutes post immunization
• Is aware of location of AED
• Follows procedures for CANImmunize downtime, if CANImmunize is inaccessible
• Enforces proper masking, social distancing, hand hygiene, and respiratory etiquette practices, as required
• SIMS reporting
• Flags issues or concerns for Clinic Team Lead

CANImmunize is an online tool that is used nationally to support the COVID-19 vaccination response by providing access to online booking and screening, and electronic documentation.

Regulated health care providers who administer vaccinations will use CANImmunize either on a computer or tablet (e.g., iPads) to document care provided and to validate informed consent as well as current health status.

• Patients can digitally book appointments, complete COVID-19 screening and provide digital consent for immunization prior to vaccination
• Vaccine administrators digitally document vaccination details (e.g. vaccine product, lot number, etc.) at the time of vaccination
• After immunization, patients receive a digital immunization receipt and can upload it directly into their free CANImmunize record
• Organization receives patient data with consent, as applicable

Please review these resources:

Accessing CANImmunize

Information regarding your CANImmunize account will be sent your email shortly before your first clinic shift. When you get to your first clinic shift, an experienced immunizer at the clinic will assist you with CANImmunize and documenting your immunizations.

Clinic Contingency Plan (for when CANImmunize is Inaccessible)

Should CANImmunize access be interrupted at any stage of the COVID-19 Mass Immunization Clinic process, staff will:

• First attempt to connect to the system and check with team immunizers to see if they are experiencing the same
• Inform the Clinic Team Lead 
• Revert to paper-based documentation, if determined that CANImmunize is inaccessible. This includes:
  • Immunizer prints and completes the appropriate consent form.
  • When clinical notes or other additional documentation is required, it should be documented on a Public Health Progress Record form or Progress Note: COVID-19 Vaccine Immunization.
• All information will be entered into CANImmunize as soon as possible, following any downtime event.
• Zones will be accountable to allot the resources required for data entry to occur within the timeframe required.

The COVID-19 Mass Immunization Clinic Flow Chart was developed to illustrate a high-level process regarding clinic space, staffing, and throughput estimates. The following diagram represents a high level clinic flow:

In order to be prepared to run a mass immunization clinic efficiently, the following roles have been defined, as well as a description and the potential public health staff position that could fulfill each corresponding role. Clinic size, location, and staffing complement may require that an individual staff member may be assigned to more than one role at any given clinic. 

Please review the following document which outlines the various staff roles and responsibilities at the Community Immunization Clinics: