Guidance

Training recommendations for COVID-19 vaccinators

Updated 3 October 2024

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This publication is available at https://www.gov.uk/government/publications/covid-19-vaccinator-training-recommendations/training-recommendations-for-covid-19-vaccinators

The authorisation of several different vaccines against COVID-19 and the need to vaccinate millions of people with these as rapidly as possible required a substantial workforce to give the vaccine safely and effectively. The number of vaccinators required exceeded the number of trained and experienced vaccinators who were giving vaccines prior to the pandemic and many of those who were already giving vaccines were required to maintain the national routine immunisation schedule. It was therefore necessary to rapidly train healthcare workers who had not vaccinated for some time or who had not previously given a vaccine in order to maximise vaccine uptake in a short time period.

Since it began in December 2020, the COVID-19 vaccination programme has been adapted in response to changing disease epidemiology - including the emergence of variant strains of the virus - and the development of a range of vaccine products. It has been hugely successful.

There is a continued need for vaccination, however, as the virus continues to mutate and to cause infection, hospitalisation and death, particularly amongst those most vulnerable.

The programme is now based upon a proportionate, focussed, and sustainable ‘Living with COVID-19’ approach, delivered via specific time-limited campaigns, which aims to continue to reduce severe disease (hospitalisation and mortality), and thus also to protect NHS capacity.

It follows that it remains vitally important for the COVID-19 vaccinator workforce to receive comprehensive training and competency assessment in order that COVID-19 vaccines are administered safely and effectively, so that those who receive these vaccines are protected and public confidence in the COVID-19 vaccination programme is maintained.

This document sets out the recommendations for training a workforce who are knowledgeable and able to deliver the COVID-19 vaccine programme confidently, competently and safely. These recommendations are intended to complement the recommendations made for training the COVID-19 vaccinator workforce by NHS England.

These training recommendations should in no way undermine the recommendations made in the PHE (now UKHSA) National Minimum Standards for Immunisation Training. The training standards still apply to all other vaccines and in all other situations. This COVID-19 vaccinator training guidance was written to meet a very specific need in an emergency pandemic situation. The intention was to maximise delivery whilst ensuring that COVID-19 vaccines were given safely and effectively. The commissioning arrangements for the COVID-19 vaccination programme are not yet aligned to those of other vaccination programmes, and there is still a need for this COVID-19 specific training guidance. It is expected that the contents of this document will eventually be absorbed into the National Minimum Training Standards. The two publications have the same guiding principles. These recommendations were reviewed in September 2024 when minor changes to update wording were made.

Who needs to be trained?

  • experienced and competent vaccinators (both registered Healthcare Practitioners (RHCPs) and unregistered Healthcare Support Workers (HCSWs) who have vaccinated within the past 12 months
  • registered Healthcare Practitioners (RHCPs) who are either new to, or returning to vaccination after a prolonged period
  • unregistered healthcare support workers (HCSWs) new to immunisation with a specific role in vaccine administration (may be referred to as Vaccination Support Workers)
  • administrative support staff

What training do COVID-19 vaccinators require?

(summarised in Appendix A)

Experienced and competent vaccinators (both registered HCPs and unregistered HCSWs) who have vaccinated within the past 12 months

This group require training specifically about the COVID-19 vaccines including:

  • vaccine specifics – for example, how COVID vaccines are made, how they work, what they contain
  • who the vaccines should be given to
  • contraindications and precautions
  • legal issues including obtaining consent and legal framework to supply/administer the vaccine (PGD/PSD/protocol/patient specific prescription)
  • how the vaccines should be stored
  • how to prepare the vaccines
  • how and at which anatomical site to administer the vaccines
  • how to recognise and respond to an adverse reaction following vaccination
  • how to dispose of vaccine equipment
  • what to expect after vaccination and other information to give those who have been vaccinated
  • where to record that a COVID-19 vaccine has been given and what to record
  • supervision and delegation responsibilities
  • how to put on and take off any personal protective equipment (PPE) required for vaccination
  • infection prevention and control measures

Basic Life Support (BLS) (adult and/or paediatric as required) and anaphylaxis training should have been undertaken within the last year. Update training for this should be undertaken now if it has not. It is recommended that this group should also undertake the administration, storage and legal aspects elearning sessions available in the immunisation elearning programme if they have not received any vaccine update training in the past year.

Registered healthcare practitioners who are either new to, or returning to vaccination after a prolonged period

This group require specific training about the COVID-19 vaccines as listed above and it is recommended that they should also undertake the administration, storage and legal aspects elearning sessions available in the immunisation elearning programme if they cannot attend any face to face training which covers this.

Work-based practical training, supervision until confident and assessment of competency using the competency assessment tool will also be required. BLS and anaphylaxis training should have been undertaken within the last year. Update training for this should be undertaken now if it has not.

Unregistered healthcare support workers (HCSWs) new to immunisation with a specific role in vaccine administration

New unregistered vaccinators who are required to deliver the COVID vaccines may have come from various backgrounds and not all may have worked directly in healthcare delivery previously. Experienced HCSWs with a wider healthcare role may also be new to COVID-19 vaccine administration. However, as it is envisaged that this particular group in the workforce will only be responsible for a specific role in vaccine administration, with assessment of suitability to vaccinate an individual and obtaining consent carried out by an experienced healthcare professional, the main focus of their training should be very specific to their role.

This group require training specifically about the COVID-19 vaccines including:

  • vaccine specifics – for example, how they are made, how they work, what they contain
  • how the vaccines should be stored
  • how to prepare the vaccines
  • how and at which anatomical site to administer COVID vaccines
  • legal aspects including accountability and the legal framework by which they can administer COVID vaccine
  • what to do following vaccine administration including where to record that COVID-19 vaccine has been given and what to record
  • how to recognise and respond to an adverse reaction following immunisation
  • how to dispose of vaccine equipment
  • how to put on and take off any PPE required for immunisation
  • infection prevention and control measures
  • an understanding of their role and its limitations and action to take if unsure

Work-based practical training (for example. how to give an intramuscular (IM) injection, BLS skills), supervision until confident and assessment of competency using the COVID-19 vaccinator competency assessment tool is also required.

New vaccinators should be supervised and supported by experienced, competent and knowledgeable vaccinators (see section below). Consideration should be given as to whether there are any particular groups who would be more appropriately vaccinated by experienced vaccinators.  

Administrative support staff

Training for this group of staff depends on the role assigned to them. If they are responsible for vaccine storage, they could undertake the vaccine storage elearning session available from eLfH. They may also require specific training in areas such as information governance, infection prevention and control and/or basic life support.

How can training be provided?

Consideration needs to be given as to how comprehensive training can be most effectively provided.

Both theoretical and practical training will be required.

Theoretical training

A number of resources have been made available to support theoretical training including:

The COVID-19 vaccination elearning programme, covering the topics listed in the bullet-pointed section above, has been written by UKHSA and developed by the NHS England eLearning for Healthcare (eLfH) team. The programme consists of a Core Knowledge session with an assessment and adult and young persons and children’s vaccine-specific sessions together with accompanying assessments for each of the COVID-19 vaccines currently in use. All of the sessions are regularly and rapidly updated as new information becomes available and any changes to the programme, including to vaccine products, are made.

The amount of time it takes to complete the COVID-19 vaccination elearning programme depends on the previous knowledge and experience of the vaccinator, with those familiar with giving and advising on immunisation being able to complete it more quickly than those who are new to immunisation. Time taken to complete it also depends on the role of the vaccinator as those responsible for assessing suitability for vaccination and taking consent may spend longer on these aspects than those who are responsible for administration only.

Additional existing elearning sessions on administration, storage and legal aspects of vaccination can be undertaken depending on role, previous training and experience. These are available as part of the e-LfH Immunisation programme.

Face to face training: Face to face training is particularly valuable for new vaccinators as practical elements such as BLS and IM injection practice may be possible at these sessions and it enables them to ask questions and gain peer support through meeting other new vaccinators. It is strongly recommended that interactive training (in person or through webinars etc) which provides the opportunity to ask questions is made available to all vaccinators where possible.

Information for Healthcare Practitioners about the COVID-19 vaccine programme has been developed to answer questions from vaccinators and is regularly updated to include issues that are arising as the programme is being delivered.

Practical skills

In addition to acquiring theoretical knowledge, it is essential that new vaccinators develop clinical skills, competency and confidence in immunisation. Consideration should be given as to how this training can most effectively take place. The importance and benefits of work-based training and experience should not be underestimated. See section below for further discussion of this.

Supervision and assessment of competency

A period of supervised practice to allow observation of, and development of skills in vaccine administration and application of knowledge to practice is required. Supervision for new vaccinators and support for all vaccinators is critical to the safe and successful delivery of the COVID-19 immunisation programme. The supervisor must be a registered, appropriately trained, experienced and knowledgeable practitioner in immunisation.

All new vaccinators, and those returning to immunisation after a prolonged interval, should complete a competency assessment for formal assessment and sign-off of their clinical competency. They should be supervised administering the vaccine until both they, and their supervisor or trainer, feel confident that they have the necessary knowledge and skills to administer vaccines safely and competently.

Experienced vaccinators should use the competency tool to self-assess that they are able to meet all the competencies listed and confirm that they have the knowledge and skills necessary to administer COVID-19 vaccine. This is required to work to the COVID-19 PGDs and Protocols.

The time required to gain competence and confidence will vary from person to person and attainment needs to be agreed by both supervisor and vaccinator. Those with a clinical background who have given IM injections before are likely to feel confident and competent more quickly than those who have not.

What additional training is required

Additional sessions on Basic Life Support (BLS), management of anaphylaxis, safeguarding (adults and/or children as required), infection control, information governance etc will be required in addition to immunisation specific training. This should either be provided by the employer or the employer should indicate where and how the training should be undertaken. Specific training requirements for those involved in delivering the COVID-19 vaccine programme are set out by NHS England.

Remaining up to date

Given the rapidly evolving and constantly changing nature of the COVID-19 programme, it is essential that COVID-19 vaccinators ensure they remain up to date with the latest relevant information available about the COVID-19 vaccination programme.

They should check that they have read the most recent versions of the following publications:

Updating should be seen as a continuous process rather than purely as an annual one-off requirement. However, it is recommended that vaccinators do take the opportunity, annually, to review what training updates are required (including statutory and mandatory training). If they have not undertaken the COVID-19 vaccination elearning sessions since first completing them, vaccinators may wish to revisit these to refresh their knowledge and undertake any additional reading/training required to assure themselves that they are familiar with the latest information and resources and feel confident in their practice. They may also wish to self-assess against the competency tool and confirm that they are confident in all of the areas assessed. Vaccinators should ensure they meet CQC regulation requirements for training and updating and any continuing professional development requirements as set by their professional regulator (where applicable). Managers should confirm with vaccinators that they are able to access the relevant resources in a timely manner and check that they are given the opportunity to update themselves.

It is important that an effective method of regular and ongoing updating of all those involved in giving COVID-19 vaccine is identified and utilised. This may include daily briefings, safety huddles, etc. Local cascade systems for vaccinators should be used (or developed if not currently in place) to rapidly alert vaccinators of any key changes to vaccine recommendations or updated guidance.

Summary

With an ongoing pandemic which continues to cause hundreds of infections and between one and two hundred deaths across the UK every week, it remains crucial that COVID-19 vaccines are safely and effectively delivered to as many of those eligible as possible. This requires knowledgeable, confident and competent vaccinators. It is therefore vital that anyone administering the vaccine is given the time and opportunity to undertake the comprehensive training and ongoing updating they need and that they are supervised and supported in practice as required.

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