COVID-19 VACCINE ADMINISTRATION
North Carolina is in the process of preparing for massive administration of the COVID-19 vaccine. Declared state or national emergencies or mass immunization campaigns may require the immunization of large numbers of citizens within a short, designated time period. At such times, it may be necessary and appropriate for nurses, RNs and LPNs, to delegate the task of immunization administration, consistent with agency policies and procedures, to unlicensed assistive personnel (UAP) as part of the timely, effective mass immunization program. As nurses are preparing for vaccine administration and/or the delegation of vaccine administration to UAP, it is crucial that nurses and UAP receive the appropriate education and training, be validated as competent, and maintain compliance with agency/facility policies and procedures.
Board of Nursing resources for guidance during massive vaccine administration are:
Frequently Asked Questions
Yes, you may assist with administering the vaccine in potentially one of two ways. If your license has been inactive for five or less years, you may reactivate your license through the Emergency Temporary Reinstatement of Inactive and Retired RN’s and LPN’s Waiver. Another way in which you may potentially assist in vaccine administration would be as an unlicensed assistive personnel (UAP). As an UAP, the administration of the vaccine would be under the delegation and supervision of the RN, LPN, physician, nurse practitioner, physician assistant, or other person authorized by State law to provide the delegation and supervision; and within compliance with the agency’s or facility’s policies and procedures.
Information about volunteering as a Health Care Worker is provided by the NC Division of Health and Human Services (DHHS): Volunteer as a Health Care Worker.
The Nursing Practice Act [GS 90-171.20 (7) (8)] and Administrative Rules [21 NCAC 36.0224 and 21 NCAC 36.0225] permit the nurse to delegate the technical task of vaccine administration to unlicensed assistive personnel (UAP) such as CMAs. In order for the RN or LPN to delegate activities to UAP the following criteria listed in Administrative Rule 21 NCAC 36.0221(b) must be met:
Tasks may be delegated to an unlicensed person which:
- frequently recur in the daily care of a client or group of clients;
- are performed according to an established sequence of steps;
- involve little or no modification from one client-care situation to another;
- may be performed with a predictable outcome; and
- do not inherently involve ongoing assessment, interpretation, or decision-making which cannot be logically separated from the procedure(s) itself.
The nurse would need to assure that UAP have received the appropriate education and training, been validated as competent, and agency/facility policies and procedures permit the administration of the vaccine by UAP. The nurse is accountable and responsible for the assessment and evaluation of the client; interpretations, judgements, and decision-making required relative to the client receiving the vaccine; and to provide the appropriate supervision and oversight. The RN or LPN delegating immunization administration must, therefore, remain available to UAP on-site to address any issues identified in pre-administration screening of the client and for the ongoing assessment and evaluation of the client as indicated by the situation. See above resources for additional information.
The Board of Nursing encourages partnerships between clinical agencies and nursing education programs. In collaboration, the agency and nursing education program would determine whether this activity would be an appropriate clinical assignment for the nursing student learning experience and course outcomes. Prior to participation in the clinical experience, nursing students would need education in the principles of COVID-19 vaccine administration. The nursing student clinical experience would be supervised by qualified personnel and directed by the educational program’s nursing faculty [21 NCAC 36.0321].