Longer needles best for infant immunisation

Infants vaccinated with a long needle experience fewer reactions but get the same immunogenicity as a shorter needle, claims a study published in the British Medical Journal.

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By  Joanne Bladd Published  September 13, 2006

Infants vaccinated with a long needle experience fewer reactions but get the same immunogenicity as a shorter needle, claims a study published in the British Medical Journal. In the UK, primary care practitioners administer infant immunisations at two, three and four months of age. Despite recommendations for use of a wide-long (23G, 25mm) needle, many practitioners immunise infants using a narrow-short (25G, 16mm) needle. In a previous study, researchers from Oxford found that the wider-longer needle significantly reduced local reactions at four months of age. However, they were unsure whether this was due to difference in needle length or gauge, or whether needle size had an effect on vaccine immunogenicity. To answer these questions, they carried out a second trial comparing three needle sizes. 696 infants were randomly immunised with either a wide-long (23G, 25mm); a narrow-short (25G, 16mm); or a narrow-long (25G, 25mm) needle at two, three and four months. Parents recorded local and general reactions for three days following each dose and antibody concentrations were measured 28-42 days after the third dose. Local reactions decreased significantly with wider-longer over narrower-shorter needles. Significantly fewer infants vaccinated with the longer needle experienced severe local reactions, but immunogenicity remained comparable to that achieved with the shorter needle. Comparisons between the same length, different gauge needles showed little difference in local reaction or immune response suggesting that needle length, rather than gauge, is responsible. The results show a clear benefit of using the longer needle at each dose whilst achieving comparable immunogenicity, say the authors. They suggest policymakers use this evidence in infant immunisation recommendations.

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