Seeking advice - Nurse gave infant adult vaccine.
🧐 Research Wanted 🤔
My wife took our child in for a 1 month appointment. They asked my wife if she wanted to give the child the RSV antinbody shot and she agreed. Later that day the doctor called and said the nurse mistakenly gave a full dose of the adult RSV vaccine. I don't what to do. Im tracking down what brand they gave and what lot number, ill update asap.
I get it I am a physician. But the new rsv shots like nirsemivab are antibodies not vaccines and the amount of medication that should have been in one vial is the 50 mg per 0.5 ml for a neonate. The dose the child should have received would be 50 mg the entire vial. This is not a large amount of volume for a child. They would have had to inject multiple vials which seems insane to me!
I am a nurse. I've witnessed nurses do shit like multiple vials and think WTF, how, why, WTF? Physicians and nurses aren't allowed to critically think any more. I witness it everyday I go to work. Do my best to protect our patients.
As an RN also, I now wonder why we don’t have a double check by another RN to verify dose for everything injected since neonates are at the highest risk for wrong dosage? I’m terrified of even pediatric patients receiving wrong dose for versed which we give almost always preop. And we do our own math in front of another RN to verify pharmacy is correct. And then witness the waste. Seems this should be standard practice for all medications for our most small and vulnerable patients.
Unless the brand you are familiar with is not the only brand of RSV vaccine available, and other manufacturers are not producing single-use vials like that. Vaccines traditionally have been produced in vials containing a volume equating to a set number of adult doses per vial. 10 doses per vial is a common volume for many vaccines.
And I understand the difference between antibodies and vaccines, but I see no reason (other than safety) why an antibody infusion would be manufactured in different vials than vaccines, especially since they're marketing it as an 'RSV vaccine', not an 'RSV antibody infusion'. Single use vials are definitely safer in order to prevent the type of mistake made by the OP's pediatrician, but single use vials are also a lot more expensive per dose to produce. Some companies may take the hit to their profit margin in the name of safety, but I'd bet that not all of them do.
There are a few new antibodies being used in children for rsv. From reviewing package inserts etc it appears most are single use. But you are right if they are using multi dose vials they could easily screw up the dose.
There *shouldn't be any multi-use vials. It is one of the safety standards most hospitals and clinics follow per TJC. However the vial May not be being reused, but depending on patients weight, the whole vial may not be utilized. See my comment to u/BWolf79 and doing double verify.