Randomized trial using ultrasound to assess intramuscular vaccination at a 60° or 90° needle angle

Vaccine

Volumn 31, Issue 23, 2013, Pages 2647-2652

  Marshall, Helen Siobhan ^a   Clarke, Michelle Frances ^a   Evans, Susan ^a   Piotto, Lino ^a   Gent, Roger J ^a  

^a WOMEN S AND CHILDREN S HOSPITAL   (Australia)

Author keywords

Intramuscular; Obesity; Ultrasound; Vaccine; Vaccine administration

Indexed keywords

HEPATITIS A HEPATITIS B VACCINE; HEPATITIS A VACCINE; HEPATITIS B VACCINE;

ADULT; ARTICLE; BODY MASS; CHILD; CLINICAL ARTICLE; CONTROLLED STUDY; CROSSOVER PROCEDURE; ECHOGRAPHY; FEMALE; HEPATITIS A; HEPATITIS B; HUMAN; INJECTION; MALE; NEEDLE; PAIN; PRESCHOOL CHILD; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SCHOOL CHILD; SKIN REDNESS; SWELLING; VACCINATION;

ADOLESCENT; ADULT; CHILD; CHILD, PRESCHOOL; COHORT STUDIES; CROSS-OVER STUDIES; DELTOID MUSCLE; FEMALE; HUMANS; INJECTIONS, INTRAMUSCULAR; MALE; MIDDLE AGED; NEEDLES; OBESITY; ULTRASONOGRAPHY, INTERVENTIONAL; VACCINATION; VIRAL HEPATITIS VACCINES; YOUNG ADULT;

EID: 84878350603     PISSN: 0264410X     EISSN: 18732518     Source Type: Journal    
DOI: 10.1016/j.vaccine.2013.03.037     Document Type: Article

References (25)

1. Ehreth J. The global value of vaccination. Vaccine 2003, 21(7-8):596-600. Epub 2003/01/18.
2. Groswasser J., Kahn A., Bouche B., Hanquinet S., Perlmuter N., Hessel L. Needle length and injection technique for efficient intramuscular vaccine delivery in infants and children evaluated through an ultrasonographic determination of subcutaneous and muscle layer thickness. Pediatrics 1997, 100(3 Pt 1):400-403. Epub 1997/09/01.
3. Cook I.F., Pond D., Hartel G. Comparative reactogenicity and immunogenicity of 23 valent pneumococcal vaccine administered by intramuscular or subcutaneous injection in elderly adults. Vaccine 2007, 25(25):4767-4774.
4. Ipp M.M., Gold R., Goldbach M., Maresky D.C., Saunders N., Greenberg S., et al. Adverse reactions to diphtheria, tetanus, pertussis-polio vaccination at 18 months of age: effect of injection site and needle length. Pediatrics 1989, 83(5):679-682. Epub 1989/05/01.
5. Mark A., Carlsson R.-M., Granström M. Subcutaneous versus intramuscular injection for booster DT vaccination of adolescents. Vaccine 1999, 17(15-16):2067-2072.
6. Yamamoto S., Kuroki T., Kurai K., Iino S. Comparison of results for Phase I studies with recombinant and plasma-derived hepatitis B vaccines, and controlled study comparing intramuscular and subcutaneous injections of recombinant hepatitis B vaccine. J Infect 1986, 13(Suppl A):53-60.
7. Petousis-Harris H. Vaccine injection technique and reactogenicity - evidence for practice. Vaccine 2008, 26(50):6299-6304. Epub 2008/09/23.
8. Cook I.F., Murtagh J. Needle length required for intramuscular vaccination of infants and toddlers. An ultrasonographic study. Aust Fam Phys 2002, 31(3):295-297. Epub 2002/04/03.
9. Cook I.F., Williamson M., Pond D. Definition of needle length required for intramuscular deltoid injection in elderly adults: an ultrasonographic study. Vaccine 2006, 24(7):937-940. Epub 2005/09/30.
10. Poland G.A., Borrud A., Jacobson R.M., McDermott K., Wollan P.C., Brakke D., et al. Determination of deltoid fat pad thickness, implications for needle length in adult immunization. JAMA 1997, 277(21):1709-1711. Epub 1997/06/04.
11. Diggle L., Deeks J.J., Pollard A.J. Effect of needle size on immunogenicity and reactogenicity of vaccines in infants: randomised controlled trial. BMJ 2006, 333(7568):571. Epub 2006/08/08.
12. Katsma D.L., Katsma R. The myth of the 90 degrees-angle intramuscular injection. Nurse Educ 2000, 25(1):34-37. Epub 2001/01/06.
13. National Guideline C General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP) 2006, Agency for Healthcare Research and Quality (AHRQ), Rockville MD, Available from: http://guideline.gov/content.aspx?id=25633 (accessed 29.10.12).
14. Department of Health and Ageing (NHMRC) The Australian immunisation handbook 1997, Australian Government, Canberra. 6th ed.
15. Department of Health and Ageing (NHMRC) The Australian Immunisation Handbook 2001, Australian Government, Canberra. 7th ed.
16. Department of Health and Ageing (NHMRC) The Australian immunisation handbook 2003, Australian Government, Canberra. 8th ed.
17. Department of Health and Ageing (NHMRC) The Australian Immunisation Handbook 2008, Australian Government, Canberra. 9th ed.
18. Department of Health Green book - chapter 4: immunisation procedures 2006, The Stationery Office, Great Britain. 3rd ed.
19. The Vaccine Administration Taskforce UK Guidance on Best Practice in Vaccine Administration 2001, Shire Hall Communications, London.
20. Centers for Disease Control and Prevention Epidemiology and prevention of vaccine-preventable diseases the pink book 2012, Public Health Foundation, Washington DC. 12th ed.
21. Skelton J.A., Cook S.R., Auinger P., Klein J.D., Barlow S.E. Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr 2009, 9(5):322-329. Epub 2009/06/30.
22. Walls H.L., Magliano D.J., Stevenson C.E., Backholer K., Mannan H.R., Shaw J.E., et al. Projected progression of the prevalence of obesity in Australia. Obesity 2012, 20(4):872-878. Epub 2011/01/15.
23. Australian Bureau of Statistics, 4125.0 Gender Indicators, Australia, Jan 2012. Available from: (accessed 29.10.12). http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by+Subject/4125.0~Jan+2012~Main+Features~Overweight+and+obesity~3330.
24. OECD obesity update 2012. Available from: (accessed 15.12.12). http://www.oecd.org/health/49716427.pdf.
25. Middleman A.B., Anding R., Tung C. Effect of needle length when immunizing obese adolescents with hepatitis B vaccine. Pediatrics 2010, 125(3):e508-e512. Epub 2010/02/10.