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Giving vaccines safely and Colombia's PAI schedule

  • Safe practice

Before vaccinating, check the card and the true contraindications; then give it safely, observe, record it in PAIWEB and watch for ESAVI.

Updated

What it is

This page covers vaccination from the nursing side: what is checked before, during and after giving a vaccine. The schedule by age is on the PAI schedule page, and the programme and the cold chain have their own pages. The principle is to miss no opportunity: every contact with the service is a chance to check the card and complete the schedule, and most mild illnesses do not prevent vaccination.

What it requires

  • At birth, the PAI gives BCG and hepatitis B; the other ages are on the PAI schedule page.
  • Intramuscular site: anterolateral thigh under 12 months; thigh or deltoid from 12 months to 2 years; deltoid from 3 years.
  • Angle: 90° for intramuscular and 45° for subcutaneous injection; aspiration is not needed.
  • Several vaccines at one visit: each at a different site, at least 2.5 cm apart, recording the site of each.
  • Vaccines stay in the refrigerator at 2 to 8 °C until the moment they are given.

Components

  • The vaccination card and the person's history in PAIWEB.
  • Screening questions: current illness, allergies, previous reactions, immunosuppression, pregnancy and recent vaccines.
  • A cold box or refrigerator with the temperature recorded.
  • A new syringe and needle for each injection, a sharps container and equipment to treat a severe allergic reaction.

How it is applied (and why)

  1. Check the card and PAIWEB to see which vaccines are due — avoids missed opportunities and repeat doses.
  2. Ask the screening questions and separate true from false contraindications — do not defer a vaccine without reason.
  3. Check the right vaccine, the expiry date and the cold box temperature — a damaged vaccine can look normal.
  4. Clean your hands and use a new syringe and needle for each injection — prevents infection.
  5. Choose the site by age and inject at the correct angle — the vaccine reaches the intended tissue.
  6. If there are several, use different sites and record which went where — lets a local reaction be traced.
  7. Comfort the child during the injection, for example by breastfeeding or holding — reduces pain.
  8. Observe the person after vaccination per protocol — allows an immediate reaction to be treated in time.
  9. Record in PAIWEB and on the card and explain which reactions to expect and when to seek care — the nominal record follows each person.

In nursing practice

  • ESAVI: an event supposedly attributable to vaccination or immunisation; any unfavourable health event after vaccination, not necessarily caused by the vaccine.
  • Non-serious ESAVI: usually appears at 24 or 48 hours, does not threaten life and resolves without treatment.
  • Serious ESAVI: causes death, threatens life, needs hospital admission, leaves disability or is suspected to be linked to a congenital anomaly, fetal death or miscarriage; reported per protocol.
  • If a person has no record of a vaccine on the card or in PAIWEB, they are considered susceptible and caught up for their age.
  • Never mix vaccines in one syringe or combine vials to make up a dose.

Common mistakes

  • Deferring a vaccine for a cold or a low fever.
  • Giving two vaccines in the same site or not recording the site of each.
  • Leaving the vaccine outside the cold box during the session.
  • Not recording the dose in PAIWEB or not handing over the card.

Test yourself

Think of the answer, then tap the question to see it.

Which contraindication applies to every vaccine?

A severe allergic reaction, such as anaphylaxis, to a previous dose or to a vaccine component.

Can a child with a cold and a low fever be vaccinated?

Yes. Mild illness, with or without fever, is not a contraindication; the vaccine is given on time.

Where is an intramuscular vaccine given in an infant under 12 months?

In the anterolateral thigh.

What is PAIWEB?

The nominal information system of Colombia's PAI, where each person's vaccinations are recorded.

What does ESAVI mean?

An event supposedly attributable to vaccination or immunisation: an event after vaccination that was not necessarily caused by the vaccine.

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Elsewhere in DurgiPedia

Connections

← All of nursing

Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: Contraindications and Precautions (General Best Practice Guidelines for Immunization) (Centers for Disease Control and Prevention (CDC), 2024); Vaccine Administration (General Best Practice Guidelines for Immunization) (Centers for Disease Control and Prevention (CDC), 2024); Registro de vacunación (Ministerio de Salud y Protección Social de Colombia (PAI), 2026); Vigilancia en vacunación EAPV/ESAVI (Ministerio de Salud y Protección Social de Colombia (PAI), 2026).

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Representative model, for educational purposes only.