·       Store vaccines at 2-8°C but never freeze them as this can destroy potency.

·       Suitable treatment and medical supervision should be availably promptly in case of anaphylactic reaction.

·       Immune response may be impaired in immuno-compromised people, allowing the vaccination to cause vaccine-associated disease or fail to stimulate a protective response.20

·       The route of injection may be important:

o   subcutaneous injection may reduce the immune response from a vaccine intended for intramuscular administration;

o   intravascular routes are generally contraindicated;

o   a body location may be recommended (eg the upper shoulder/deltoid muscle), but alternatives sites may be possible or needed for some patients.

·       Vaccine dose size may depend on patient age or size

·       People with a short term illness, for example with a fever or upset stomach, may need to let symptoms clear before starting the vaccination course.

·       Special consideration should be given for women who are already or are planning to become pregnant, young children, and the frail elderly.