Why The CDC is “OK” With No Gloves To Administer Vaccines
A few weeks ago, I took my oldest daughter in for a flu shot. I signed the paperwork, looked over the informational pamphlet, and reassured her when the medical assistant brought the imposing-looking syringe into the room.
And then, I cringed when she proceeded to shut the door behind her, pull open a band-aid and stick it to her bare hand, then jab my daughter with the shot, all without wearing any gloves. I thought back to my time as a nurse at the hospital—had I ever administered a vaccine without wearing gloves? Was it required? Was I overreacting in thinking she should wear gloves?
I honestly couldn’t think of a time when I hadn’t worn gloves to give a vaccine, so I piped up and said something to the assistant, not-very-kindly suggested that she should be sure to wear gloves next time. But when I got home and did some research, I sheepishly realized that I was the one who had been wrong, not her. Turns out, gloves aren’t required to give vaccinations and I was actually a big ol’ jerk to the poor young woman.
Frequently Asked Questions on Gloves and Injections
- Does the CDC require gloves to administer injections? The CDC follows OSHA recommendations for injection administration that state gloves do not have to be worn unless there is “reasonable anticipation of employee hand contact with blood, other potentially infectious material, mucous membranes, or non-intact skin; when performing vascular access procedures; or when handling or touching contaminated surfaces or items.”
- Why are gloves not required to administer vaccines? Gloves aren’t required to administer vaccines because there is not usually contact with bodily fluids and because gloves may discourage the use of proper hand hygiene techniques.
- When should a nurse wear gloves to give a vaccine? A nurse should wear gloves to give a vaccine if there is a risk of contact with infectious bodily fluids or if there are any open lesions on the hand.
- What is the hygiene protocol for administering injections? Proper hand hygiene for vaccine injection stipulates that the healthcare professional should wash their hands with soap and water or use an antiseptic hand rub between every patient contact, even if gloves are worn.
- What should you do if a patient confronts you about not wearing gloves? You can defer to your facility’s policy on wearing gloves while giving a vaccine; however, providing proper hand hygiene is performed between each patient, you always have the choice to wear gloves while giving vaccines if it makes you or your patient feel more comfortable.
According to the Centers for Disease Control (CDC) and Administration’s Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP), wearing gloves is not required for healthcare workers who are administering vaccinations to both adults and children. The official guidelines state: “Occupational Safety and Health Administration (OSHA) regulations do not require gloves to be worn when administering vaccinations unless persons administering vaccinations have open lesions on their hands or are likely to come into contact with a patient’s body fluids.”
The rules on Vaccines + Gloves
So, if gloves aren’t required, what is required? Well, basic handwashing and clean hygiene, essentially. As the guidelines state: “Persons administering vaccinations should follow appropriate precautions to minimize risk for disease exposure and spread. Hands should be cleaned with an alcohol-based waterless antiseptic hand rub or washed with soap and water before preparing vaccines for administration and between each patient contact.”
Kasey Baylis, 26, a public health nurse for Oakland County in Michigan who works with the Vaccine for Children program as a partner provider and immunization nurse educator, tells Nurse.org that she has given “hundreds of shots” in her life as a nurse.
With a job that literally entails making sure vaccines are stored, handled, and administered correctly, Baylis is a woman who knows about vaccine safety. She explains that the way she was trained and the way she continues to train others on vaccine administration is that the administrator should properly wash his/her hands and use an aseptic technique when administering the vaccine (i.e. using alcohol to clean the injection site, not contaminating the site after cleaned and not contaminating the needle), but that gloves are not required unless the nurse or healthcare worker has any open lesions or is likely to come in contact with the person’s bodily fluids.
Gloves Aren't Really That Clean
Baylis also points out that if a vaccine is administered correctly, there should be little, if any, bodily fluid exposure and that contrary to popular belief, the gloves sitting in an open box in a doctor’s office or health clinic really aren’t all that much more sanitary than a clean pair of hands. In fact, the gloves may even contain more germs than clean hands. “Gloves are not required and generally do not provide any additional benefit to the patient,” she adds.
The fact that gloves can actually spread germs more than bare hands can come as a surprise to some people, but it’s true. In fact, The Association for Professionals in Infection Control and Epidemiology (APIC) lists some key reasons why gloves generally shouldn’t be worn while administering vaccines:
Gloves can actually collect germs on their surface that can’t be washed off (unlike bare hands)
Gloves are not impenetrable; they actually have micro-sized holes that can allow germs to seep both in from the outside. This means that if good hand hygiene is being skipped in lieu of just wearing gloves, any germs on the wearer’s hand might still be finding their way to the glove’s surface anyway. Yuck.
Gloves can give both the wearer and the patient a false sense of security and may inadvertently lead to a decrease in handwashing, which should always be done between patients.
If gloves are worn, the administrator is still required to wash his or her hands between injections and patients, to remove any germs that may have transferred from the gloves to their hands. And many times, the only benefit to wearing gloves during vaccine administration is for protection for the administrator, not the patient.
Should Gloves Be Worn With the COVID Vaccine?
You may be wondering if the rules on vaccines and gloves have changed in wake of COVID-19, but the answer is: nope. The COVID-19 vaccine is given via an intramuscular (IM) route, which means it’s injected directly into muscle tissue-- most commonly, the deltoid muscle on your upper arm. Because the COVID-19 vaccine is injected just like any other type of IM vaccine, such as the flu shot, the same guidelines for glove use apply.
The CDC’s guidelines on intramuscular (IM) vaccine administration for adults detail that gloves are not required to be worn by the vaccinator. They state: “Gloves are not required unless the person administering the vaccine is likely to come in contact with potentially infectious body fluids or has open lesions on the hands. If worn, perform hand hygiene and change gloves between patients.”
Additional guidance from the Washington State Department of Health specifically on the use of gloves with the administration of the COVID-19 vaccine points out that not only are gloves not necessary, they aren’t actually recommended. If anything, as we already mentioned, the gloves may give a false sense of security. The person giving the vaccine, for instance, might forget to change gloves between patients and assume they are clean, while bare hands can be easily cleaned in between patients with simple hand sanitizer. The individual getting the vaccine too, can clearly see if the administrator washes their hands before injecting them, but if that individual has gloves on, do they really know if they’re clean or if they’ve been wearing them all day?
While gloves aren’t required to administer the COVID-19 vaccine, it is required for the administrator to wear both a face mask and eye protection, however.
Should You Ask For Gloves if You Want Them?
That being said, if you are just plain uncomfortable with the idea of a healthcare worker giving you or your family a vaccine without wearing gloves, Baylis encourages the idea of speaking up and asking them to don a pair of gloves before an injection, simply because in her mind, if that means one more person is vaccinated against preventable disease, then it’s worth it.
“When it comes to vaccines and all of the negative propaganda out there, I feel that gloves should not be another barrier to being immunized,” she says. “Adhering to the ACIP recommended schedule is your best protection against vaccine-preventable diseases that still exist today, so ultimately, if that means wearing gloves for a patient then I would gladly do it!”
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