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NEEDLE LENGTH AND IMMUNIZATIONS
The length and size of the needles used to administer immunizations may affect
rates of local reactions. These British investigators randomized 110 infants to
immunization with either 25 gauge, 16-mm needles or 23 gauge, 25-mm needles. The
vaccine was diphtheria/pertussis/tetanus-Haemophilus influenzae type B (DPT/Hib)
administratered at 16 weeks of age.
Local reactions were far more common with 25 gauge, 16-mm needles than
with the 23 gauge, 25-mm needles. For example, at 6 hours following vaccination,
infants immunized with the shorter needles had higher rates of redness (60% vs.
40%), swelling (58% vs. 23%), and tenderness ( 28% vs. 17%). Differences between
groups were similar throughout 3 days of observation.
Comment: Use of longer (25-,,) needles appears to reduce the
extent of local reactions following immunization of young infants. This outcome
occurred despite the fact that the longer needles also were thicker. Whether
these results are similar for vaccines used in the U.S. is unclear, but it's
worth a shot. - H Bauchner
Diggle L and Deeks J. Effect of
needle length on incidence of local reactions to routine immunization in infants
aged 4 months. Randomized controlled trial. BMJ
2000 Oct 14; 321:931-3
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