>> Hi, everyone, welcome back to Inside Infection Control, our video blog here at CDC's Project Firstline. I'm Abby Carlson. It's wonderful to have you back with us. Today, we are going to talk about multi-dose vials. Before we get started, I want to note that CDC's the and only injection safety campaign has a lot of great resources on this issue. We're going to put a link to that in the comments. So, I suggest that you check all of that out. They have a lot of wonderful guidance, and we are going to, today, dig into that guidance a little bit and talk about why multi-dose vials are important. So, many vaccines, including the current COVID-9 vaccines, come in small bottles that contain more than one dose of vaccine. We call these multiple-dose or multi-dose files. And those vials can be used to vaccinate more than one person. So, the question is, why is this any different than say a single-dose vial? Well, multi-does vials need to be used with extra care because if anything gets inside that vial, it will get into all the doses of vaccine that are inside the vial. We call this contamination. Basically, it means that the vaccine has gotten dirty or spoiled, and we can't use it anymore, and of course, we don't want to accidentally give dirty vaccine to patients and make them sick. This is actually a real problem. It happens every year in the United States, and it can be avoided with good practices. So, that's what we're going to talk about today. If you think about it, we're providing vaccine to people to protect them from COVID-19. So, of course, we don't want to make them sick with something else, because we got in the vaccine dirty, and that means we need to practice that best safety for the vaccine that we can. Not only that, but if the vaccine gets dirty or spoiled, it has to be thrown away, and we lose doses that could have gone to patients. So, we want to avoid that too. So, how are multi-dose vials different from single-dose vials? Well, the biggest thing is that they are more likely to get dirty than single-dose vials because you're usually putting a needle into that bottle many times to pull out each dose for each separate vaccine. That you're going to get to each patient. Each time that needle goes in, it's a risk. There are things that might be on the needle if the needle is dirty. If the top is dirty, the needle might take them up as it goes to the top. If the syringe is dirty, it could come through the needle and contaminate the vaccine. All of those things mean that vaccine can get dirty from that process, and then, that dirty vaccine is no longer usable. This is different from things a little bit like insulin vials, which are multiple-dose vials about our vials that we use on one patient and one patient only. They have different risks, and the risks are a little more limited, because we're not talking about injecting people from one vial, multiple people from one vial. We're talking about injecting one person from one vial multiple times. Slightly different, but this is one thing you might've seen in healthcare, and you might wonder, well, why are we doing it for one thing and not the other? Those vials are slightly different than a vaccine vials that's going to be used on multiple people. Okay, if a needle gets dirty in any way and goes into the vial, it ends up making the rest of the contents in the vial dirty, and when that happens, the vaccine in the vial can't be used. All the vaccine and the vial has to be thrown away. Well, what happens of the vaccine is used anyway after it's gotten dirty? What if it gets injected into a patient? Patients can get sick, and they have. They've even died from this. Diseases like hepatitis and HIV can spread this way, and it's not just a problem that's about COVID-19. Every year in the US, patients get contaminated medication or contaminated vaccines through multi-dose vials and they get sick, and they can die, and it doesn't have to happen. That's why these steps are so important. What happens if a patient gets contaminated vaccine? Well, then everyone who got a dose from that vial has to be tracked down so that we can monitor them and make sure they do okay. We have to test them to make sure they aren't infected, and we have to follow them over time. We do this for patients, because we want to make sure they're safe as they can be after something like this has happened, but it's a big deal. It's a big deal for the patients, obviously, but also, for your facility, for the health department, and for the healthcare workers. So, don't underestimate how big of a problem this can be and how much we need to avoid it. All right, to sum it up, we've covered multiple points about multi-dose vials and why infection control is so important for them. If you come back for part two, we're going to show you the simple, basic steps that you can take to make sure that you give this vaccine from multi-dose vials safely. In the meantime, don't hesitate to check us out online, CDC.gov/ProjectFirstline, or follow us up on Facebook and Twitter. We'll see you for part two.