When your immunization clinic is running, there are several activities that will happen. Some of these are not directly tied to individual patient flow and some are. We have outlined these below.
Patient Flow While Running Your Clinic
Below are the activities to follow for each patient as they move through a COVID-19 immunization clinic.
Check-in
As people arrive at the location, there should be a quick check-in to confirm that they are there for an immunization and are scheduled for that day. Other people (e.g. family members) should be invited to wait at a distance from the clinic. People who are not there for a scheduled immunization should be asked to return on a different day.
Check-in may happen outside.
Screen for Symptoms
As people arrive, they should be quickly screened for any COVID-19 symptoms, even before they are registered. Most practices do this already, here are the criteria to consider (from PHAC):
- Common COVID-19 symptoms (PHAC)
Registration
Registration for the immunization includes confirming identification and contact information. Also at this step, confirm that each patient has reviewed the pre-visit materials and / or had a virtual pre-visit (hand out if needed). Confirm consent for immunization (verbal or written as required by your jurisdiction).
Complete Surveys
Prior to receiving the immunization is a good time to complete any required documentation, including consent. If you have additional information you want to collect from patients internally, this would be a good time to do that with your own survey. Also consider how to support patients who are not able to complete the surveys on their own.
(Pre-Wait)
Ideally, your flow of patients is booked so that there is no pre-waiting needed (i.e. you have enough immunizers and everyone is coming on time), but if people cannot wait outside or there is some other unforeseen delay, patients may need a space to wait prior to receiving the immunization.
In your planning, you will have confirmed your capacity for waiting space while maintaining social distancing and whether patients will wait in a shared space or in an exam room.
All patients should, of course, wear masks throughout the clinic, use hand sanitizer, etc.
Immunize
At your designated immunization stations (e.g. exam rooms), take a brief history to:
- Confirm patient identification
- Review contraindications
- Ensure the patient has had a a pre-visit review (if applicable).
Then, with permission, follow the jurisdictional guidelines for immunization and the manufacturers instructions. Document the immunization.
Observe (Post-Immunization)
The current standards include a 15 minute observation period. Patients should be observed (with social distances, while still wearing masks). The clinic must ensure that people are not leaving early and operating a vehicle.
This would be an excellent opportunity to collect feedback, including a patient evaluation of the clinic, such as the one by PHAC:
- FORM: Client Immunization Evaluation Form (PHAC)
Give Follow up Reminder
Before each patient leaves, ensure that patients are aware of the follow up plan for their follow up immunization, if this is not their final dose.
Ideally the follow up plan should be specific (e.g. provide a visit date and time). Stressing to patients the importance of the follow up dose is critical to ensure better follow up for the second dose.
Provide Immunization Materials to Patient
Provide documentation to each patient outlining the immunization they received as per provincial recommendations.
Alberta’s Immunization Materials
Ensure patients do not have contraindications to COVID-19 vaccination. Consider screening patients using AHS Fit to Immunize Tool for COVID-19 Vaccine
Record of COVID-19 vaccination is expected to be completed at point of care and submitted through IDSM within 1 day (required to be submitted within 7 days). A patient immunization record and aftercare sheet is expected to be completed at point of care and provided to the patient before departure.
BC’s Immunization Materials
BC’s Provincial Documentation of COVID-19 Immunization: we have not received specific provincial materials for primary care. There will be a paper and digital patient immunization documentation.
Manitoba’s Immunization Materials
COVID-19 vaccine: Updated Clincial Practice Guidelines now available online
Please be advised that updated Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers are now available at:
Updated guidance for the use of the viral vector vaccine, including information on Vaccine-induced Pro-thrombotic Immune Thrombocytopenia (VIPIT). Please be advised that the National Advisory Committee on Immunization (NACI) released a Rapid Reponse: Recommended use of AstraZeneca COVID-19 vaccine in younger adults on March 29, 2021 available at:
New Brunswick’s Immunization Materials
- Moderna After Care Sheet (English)
- Moderna After Care Sheet (French)
Newfoundland’s Immunization Materials
- Moderna After Care Sheet (English)
- Moderna Vaccine After Care Sheet (Mushuau Innu-aimun)
- Moderna Vaccine After Care Sheet – Inuktitut (Nunatsiavut)
- Vaccine Information Sheet
- Clinic Guidance for COVID-19 Immunization
- After Care and Immunization Record
Confirm as a team what should be documented, where and how it will be stored (paper, within your electronic record, in provincial information system).
Nova Scotia’s Immunization Materials
- Moderna Patient Information Sheet – includes aftercare. (English)
Ontario’s Immunization Materials
COVID-19 After Care Sheet (mRNA vaccines)
PEI’s Immunization Materials
- Moderna Patient Information Sheet – includes aftercare. (English)
- AstraZeneca COVID-19 Vaccine (Includes aftercare)
- CoviShield COVID-19 Vaccine (Includes aftercare)
Quebec’s Immunization Materials
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan’s Immunization Materials
- Moderna Aftercare Sheet (PDF download)
Error: we are not able to resolve your region and cannot show you provincial content at this time.
Alberta
Alberta’s Immunization Materials
Ensure patients do not have contraindications to COVID-19 vaccination. Consider screening patients using AHS Fit to Immunize Tool for COVID-19 Vaccine
Record of COVID-19 vaccination is expected to be completed at point of care and submitted through IDSM within 1 day (required to be submitted within 7 days). A patient immunization record and aftercare sheet is expected to be completed at point of care and provided to the patient before departure.
BC
BC’s Provincial Documentation of COVID-19 Immunization: we have not received specific provincial materials for primary care. There will be a paper and digital patient immunization documentation.
COVID-19 After Care Sheet (for mRNA vaccines)
Manitoba
Manitoba’s Immunization Materials
COVID-19 vaccine: Updated Clincial Practice Guidelines now available online
Please be advised that updated Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers are now available at:
Manitoba COVID-19 Vaccine: Clinical Practice Guidelines for Immunizers and Health Care Providers
Updated guidance for the use of the viral vector vaccine, including information on Vaccine-induced Pro-thrombotic Immune Thrombocytopenia (VIPIT). Please be advised that the National Advisory Committee on Immunization (NACI) released a Rapid Reponse: Recommended use of AstraZeneca COVID-19 vaccine in younger adults on March 29, 2021 available at:
Rapid Reponse: Recommended use of AstraZeneca COVID-19 vaccine in younger adults
New Brunswick
- Moderna After Care Sheet (English)
- Moderna After Care Sheet (French)
Newfoundland
Newfoundland’s Immunization Materials
- Moderna After Care Sheet (English)
- Moderna Vaccine After Care Sheet (Mushuau Innu-aimun)
- Moderna Vaccine After Care Sheet – Inuktitut (Nunatsiavut)
- Vaccine Information Sheet
- Clinic Guidance for COVID-19 Immunization
- After Care and Immunization Record
Confirm as a team what should be documented, where and how it will be stored (paper, within your electronic record, in provincial information system).
Nova Scotia
Moderna Patient Information Sheet – includes aftercare. (English)
Ontario
COVID-19 After Care Sheet (mRNA vaccines)
PEI
- Moderna Patient Information Sheet – includes aftercare. (English)
- AstraZeneca COVID-19 Vaccine (Includes aftercare)
- CoviShield COVID-19 Vaccine (Includes aftercare)
Quebec
Nous n’avons pas reçu de contenu provincial spécifique pour ici, veuillez vous référer aux documents nationaux ou à votre site CDC provincial.
We have not received specific provincial content for here, please refer to the national materials or your provincial CDC site.
Saskatchewan
Moderna Aftercare Sheet (PDF download)
Document Immunization
Documentation will likely need to be in two places:
- Your own record (electronic or otherwise)
- Provincial Immunization Record
Based on your planning step you will have decided when this happens, and it is good practice to document during the process in at least one system.