What should be done if a 15-month-old child barely received a booster shot due to movement during administration?

Repeat the Booster Dose Immediately

If a 15-month-old child barely received a booster shot due to movement during administration, the dose must be repeated immediately during the same visit, or as soon as the child can return to the clinic. 1

Why This Dose Must Be Repeated

• Administering less than the full recommended volume results in inadequate protection against vaccine-preventable diseases. 1
• The incomplete dose should not be counted as valid in the child's immunization record. 1
• The child should be revaccinated according to age-appropriate schedules, treating this as if the dose was never given. 1

Immediate Action Steps

• If the error is discovered while the child is still in the office, administer a complete repeat dose at full volume during the same visit. 1
• If measuring the exact remaining volume is challenging, give a full repeat dose rather than attempting to calculate partial volumes. 1
• If the error is discovered after the child has left, schedule the child to return as soon as possible for a complete dose. 1

Safety Considerations

• The primary concern with vaccine administration errors is inadequate disease protection, not safety from re-administration. 1
• Repeating the dose poses minimal risk and is the standard approach to ensure adequate immunization. 1

Documentation Requirements

• Do not count the incomplete dose in the vaccination record. 1
• Document the incident and the corrective action taken (repeat dose administered). 1
• Ensure proper injection technique for the repeat dose, considering having an assistant gently stabilize the injection site to prevent recurrence. 1

Critical Context for Booster Doses at 15 Months

• The booster dose of Hib or pneumococcal conjugate vaccines at 12-15 months is critical for boosting antibody titers and ensuring continued protection. 2
• These booster doses should be administered at least 8 weeks after the most recent vaccination in the primary series. 2
• Any monovalent or combination Hib conjugate vaccine is acceptable for the booster dose, regardless of the product used for the primary series. 2

Common Pitfall to Avoid

Split doses or reduced volumes have not been adequately studied for serologic response or clinical efficacy, and such practices are explicitly not endorsed by ACIP. 1 Never attempt to "make up" the remaining volume at a later date—always give a full repeat dose.