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Glove use and vaccinations: what the COVID-19 guidance says

There has been some confusion over whether gloves should be worn by vaccinators

There has been some confusion over whether gloves should be worn by vaccinators

  • Some images of the UKs COVID-19 vaccination programme have shown nurses wearing gloves, others without
  • What the latest PHE guidance for nurses says, plus what other PPE and infection control measures should be used during vaccinations
  • Advice on dealing with broken skin, and what to do if a patient bleeds following their injection

Images of patients receiving COVID-19 vaccines in hospital hubs, general practices and mass vaccination centres have been beamed around the world.

These images are undoubtedly cause for celebration, but they have also sparked an important debate among nurses. Some vaccinators are sporting gloves,

There has been some confusion over whether gloves should be worn by vaccinators

  • Some images of the UK’s COVID-19 vaccination programme have shown nurses wearing gloves, others without
  • What the latest PHE guidance for nurses says, plus what other PPE and infection control measures should be used during vaccinations
  • Advice on dealing with broken skin, and what to do if a patient bleeds following their injection
A nurse administering a COVID-19 vaccination
Picture: Alamy

Images of patients receiving COVID-19 vaccines in hospital hubs, general practices and mass vaccination centres have been beamed around the world.

These images are undoubtedly cause for celebration, but they have also sparked an important debate among nurses. Some vaccinators are sporting gloves, while others are not – so which approach is the correct one?

Here, we review the guidance and speak to nursing experts.

What are the rules on gloves for COVID-19 vaccination?

According to Public Health England (PHE), glove use is generally unnecessary during the COVID-19 vaccination programme.

In its infection prevention and control guidance for COVID-19, it states explicitly that in vaccination/injection clinics, where contact with individuals is minimal, the need for single-use personal protective equipment (PPE) items for each encounter (for example, gloves and aprons) is not necessary.

Are there any circumstances gloves should be worn?

PHE says staff should assess when gloves may be needed.

For example, gloves and aprons are recommended when there is anticipated exposure to blood or body fluids or non-intact skin. This could include the nurse having non-intact skin on their hands.

A healthcare professional using a hand sanitiser station at work
Picture: iStock

What about other forms of PPE and infection prevention measures?

Staff administering COVID-19 vaccines must apply hand hygiene between each individual seen and wear a sessional facemask, PHE says.

How does this advice differ to other COVID-19 guidance?

For low-risk pathways, single-use gloves should only be worn when ‘contact with blood and/or body fluids is anticipated’, the same as for vaccination clinics.

Should gloves be worn when administering non-COVID-19 vaccines?

No. World Health Organization guidance advises that gloves should not be worn for routine intradermal, subcutaneous or intramuscular injections, providing the health worker’s skin is intact as gloves do not provide protection against needle stick injury.

What does the RCN say?

RCN professional lead for public health Helen Donovan is clear that the risk is low in a vaccination clinic.

‘Official guidance makes it clear that gloves are not routinely required unless there is an additional risk of exposure to blood or body fluid contamination or broken skin,’ she says.

‘This risk is generally very low. If gloves are worn, they are single use and must be removed and changed in between each patient. Hand hygiene must be rigorously applied between each vaccination episode and person contact.’

What are the drawbacks of wearing gloves?

Infection prevention and control nurse Jo Reynard, who is also Infection Prevention Society deputy secretary, is clear that there are good reasons for not wearing gloves, in line with national and international guidance.

Having to change gloves and aprons between each patient when not needed wastes time, reducing the numbers of patients who can be seen in each clinic, creates huge volumes of unnecessary waste that is bad for the environment and costly, and uses up precious PPE resources.

‘There is often a public expectation that they should be worn, and also concerns from nursing and unregistered staff about catching the virus. But wearing gloves will not make them safer’

Jo Reynard, infection prevention and control nurse

‘I feel so strongly about people wrongly wearing gloves during vaccinations,’ Ms Reynard says.

‘The confusion has come because there has been some mixed messaging from the government, especially with time and distancing when performing patient care.

Helen Dovovan
Helen Dovovan: ‘Official guidance is clear routine glove use is unnecessary’
Picture: Barney Newman

‘There is often a public expectation that they should be worn, and also concerns from nursing and unregistered staff about catching the virus. But wearing gloves will not make them safer. It is about the right PPE at the right time.’

Gloves can also sometimes pose a risk to infection prevention and control if not used properly, she adds.

‘Staff often take them off incorrectly, the national doffing guidance is very clear, and they should always be single use, but I have seen nurses use alcohol gel on them and keep them on,’ she says.

‘Also, I have seen nurses put them on well before they see a patient, so they may have their hands on their hips or have picked up a pen, or because they have worn gloves forget to do hand hygiene after they have taken them off.’

What if a patient bleeds after receiving the injection?

Ms Reynard says this is a rare occurrence with an intramuscular vaccination and, if it does happen, generally produces a tiny amount of blood.

‘I would give the person being vaccinated a piece of cotton wool to press on the vaccination site themselves. Then I don’t need to come into contact with it.’

Some people with certain conditions or on treatments such as warfarin may bleed a little more, she says.

‘It should come up during the vaccination assessment, which has to be with a registrant, whether they have a condition that could make them bleed more. PPE should be available at the point of care, and the vaccinator can make a risk assessment about whether to wear gloves for that individual at that point.’

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Further information

Public Health England: COVID-19: Guidance for maintaining services within health and care settings Infection prevention and control recommendations

World Health Organization: Best practices for injections and related procedures toolkit


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