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Malon M, Jensen A, Zimakoff AC, Vittrup DM, Lind I, Sørensen JK, Jørgensen NR, Stensballe LG, Svensson J. Hair cortisol is not associated with reactogenicity after MMR-vaccination in 6-month-old infants. Brain Behav Immun Health 2023; 30:100626. [PMID: 37188320 PMCID: PMC10176151 DOI: 10.1016/j.bbih.2023.100626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 04/17/2023] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- Michelle Malon
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
- Corresponding author. The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark.
| | - Andreas Jensen
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Anne Cathrine Zimakoff
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Dorthe Maria Vittrup
- The Pediatric and Adolescent Department, Copenhagen University Hospital, Herlev, Gentofte, Denmark
| | - Ida Lind
- Department of Neonatology, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Jesper Kiehn Sørensen
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Centre of Diagnostic Investigations, The Danish National University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lone Graff Stensballe
- The Child and Adolescent Clinic, The Juliane Marie Center, The Danish National University Hospital “Rigshospitalet”, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jannet Svensson
- The Pediatric and Adolescent Department, Copenhagen University Hospital, Herlev, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
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Baran L, Güneş Ü, Dönmez H. Investigation of the Necessity of Aspiration During the Intramuscular Injection Administered in the Ventrogluteal Site and Its Effect on Pain: A Randomized Controlled Trial. Clin Nurs Res 2022; 32:821-829. [PMID: 36540016 DOI: 10.1177/10547738221136470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This experimental study, which was conducted to examine the necessity of aspiration procedure and its effect on pain in intramuscular (IM) injections made into the ventrogluteal site (VGS), is randomized controlled and double-blind. The patients in the study group ( n = 834) were assigned to the IM group with the aspiration period of 5 to 10 seconds (Implementation Group A-IGA), the aspiration period of 1 to 2 seconds (Control Group-CG), and no aspiration (Implementation Group B-IGB) according to stratified block randomization list. Patients’ pain levels were evaluated with the Visual Analog Scale (VAS). No bleeding was observed when aspiration periods of 1 to 2 and 5 to 10 seconds were followed during the injections administered to the VGS. The difference between the pain medians of patients in IGB and the CG were not significant ( p = .521). It can be said that there is no need to apply aspiration in IM applied into the VGS if the correct site is determined.
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Silva AMODAD, Santos RCS, Araujo MGS, Silva LHL, Santos DFD. Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial. Rev Bras Enferm 2021; 75:e20201119. [PMID: 34431926 DOI: 10.1590/0034-7167-2020-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/29/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to compare adverse events after administrating hepatitis A vaccine intramuscularly in the ventro-gluteal region between techniques with and without aspiration. METHODS randomized double-blind clinical trial, using hepatitis A vaccine (inactivated) in the ventro-gluteal region, with a sample of 74 participants in the intervention group, vaccinated with the slow injection technique without aspiration, and 74 participants in the control group undergoing slow injection with aspiration. Daily assessment of participants was carried out in the 72 hours after vaccination, in order to ascertain local, systemic adverse events, local and contralateral temperatures. RESULTS the occurrence of local and systemic adverse events was homogeneous between the groups in the three days after vaccination (p>0.05). There was no influence of sex, race, pre-existing disease and use of medication. CONCLUSIONS the intramuscular vaccination technique without aspiration in the ventro-gluteal region is safe for adverse events following immunization compared to the conventional technique with aspiration.
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Hoffmann A, Dumke C, Hanschmann KMO, Wicker S. Local thermal reaction after influenza vaccination: Quantification by infrared imaging and biometric considerations. Vaccine 2018; 36:2783-2787. [PMID: 29653847 DOI: 10.1016/j.vaccine.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 03/28/2018] [Accepted: 04/02/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extensive clinical investigations are mandatory to evaluate the safety and reactogenicity of vaccines. The recording of common adverse events like injection site soreness or general discomfort derives from individual subjective perceptions. Thermal imaging at the injection site possibly provides a non-subjective and a non-invasive approach to supplement this evaluation. RESULTS A protocol for quantified injection-site infrared imaging included 86 participants during a flu vaccine campaign, 40% of whom had a thermal reaction of 1 °C; 25-30% had no thermal response. There was little subjective pain reporting and no clinical correlations were observed except with post-vaccination erythema. Higher responses were linked with advanced age and multiple previous vaccinations. CONCLUSION Evan if influenza vaccine was only moderately reactogenic, a thermal response was detectable in about 70% of vaccinees, though no relationship to reactogenicity was seen. Infrared imaging might however be a prospective tool for individual studies of vaccine-induced vascular responses.
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Affiliation(s)
- Andreas Hoffmann
- Paul-Ehrlich-Institute, Federal Institute for Vaccines and Biomedicines, 63225 Langen, Germany.
| | - Claudia Dumke
- Paul-Ehrlich-Institute, Federal Institute for Vaccines and Biomedicines, 63225 Langen, Germany
| | | | - Sabine Wicker
- University Hospital Frankfurt, Goethe University, Occupational Health Service, 60590 Frankfurt am Main, Germany
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Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations. Vaccine 2017; 35:4870-4876. [DOI: 10.1016/j.vaccine.2017.07.055] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 12/11/2022]
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A randomized trial of the effect of vaccine injection speed on acute pain in infants. Vaccine 2016; 34:4672-4677. [DOI: 10.1016/j.vaccine.2016.08.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 11/24/2022]
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Taddio A, Shah V, McMurtry CM, MacDonald NE, Ipp M, Riddell RP, Noel M, Chambers CT. Procedural and Physical Interventions for Vaccine Injections: Systematic Review of Randomized Controlled Trials and Quasi-Randomized Controlled Trials. Clin J Pain 2015; 31:S20-37. [PMID: 26352919 PMCID: PMC4900423 DOI: 10.1097/ajp.0000000000000264] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 06/03/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND This systematic review evaluated the effectiveness of physical and procedural interventions for reducing pain and related outcomes during vaccination. DESIGN/METHODS Databases were searched using a broad search strategy to identify relevant randomized and quasi-randomized controlled trials. Data were extracted according to procedure phase (preprocedure, acute, recovery, and combinations of these) and pooled using established methods. RESULTS A total of 31 studies were included. Acute infant distress was diminished during intramuscular injection without aspiration (n=313): standardized mean difference (SMD) -0.82 (95% confidence interval [CI]: -1.18, -0.46). Injecting the most painful vaccine last during vaccinations reduced acute infant distress (n=196): SMD -0.69 (95% CI: -0.98, -0.4). Simultaneous injections reduced acute infant distress compared with sequential injections (n=172): SMD -0.56 (95% CI: -0.87, -0.25). There was no benefit of simultaneous injections in children. Less infant distress during the acute and recovery phases combined occurred with vastus lateralis (vs. deltoid) injections (n=185): SMD -0.70 (95% CI: -1.00, -0.41). Skin-to-skin contact in neonates (n=736) reduced acute distress: SMD -0.65 (95% CI: -1.05, -0.25). Holding infants reduced acute distress after removal of the data from 1 methodologically diverse study (n=107): SMD -1.25 (95% CI: -2.05, -0.46). Holding after vaccination (n=417) reduced infant distress during the acute and recovery phases combined: SMD -0.65 (95% CI: -1.08, -0.22). Self-reported fear was reduced for children positioned upright (n=107): SMD -0.39 (95% CI: -0.77, -0.01). Non-nutritive sucking (n=186) reduced acute distress in infants: SMD -1.88 (95% CI: -2.57, -1.18). Manual tactile stimulation did not reduce pain across the lifespan. An external vibrating device and cold reduced pain in children (n=145): SMD -1.23 (95% CI: -1.58, -0.87). There was no benefit of warming the vaccine in adults. Muscle tension was beneficial in selected indices of fainting in adolescents and adults. CONCLUSIONS Interventions with evidence of benefit in select populations include: no aspiration, injecting most painful vaccine last, simultaneous injections, vastus lateralis injection, positioning interventions, non-nutritive sucking, external vibrating device with cold, and muscle tension.
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Affiliation(s)
- Anna Taddio
- Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario
| | - Vibhuti Shah
- Faculty of Medicine, University of Toronto
- Department of Pediatrics, Mount Sinai Hospital
| | - C. Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph, Ontario
- Children’s Health Research Institute
- Department of Paediatrics, Western University, London, ON
| | - Noni E. MacDonald
- Department of Paediatrics, IWK Health Centre, Dalhousie University and Canadian Center for Vaccinology
| | - Moshe Ipp
- Faculty of Medicine, University of Toronto
- Department of Paediatrics, The Hospital for Sick Children
| | - Rebecca Pillai Riddell
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario
- Department of Psychology, York University, Toronto
| | - Melanie Noel
- Department of Psychology, University of Calgary, AB, Canada
| | - Christine T. Chambers
- Department of Pediatrics and Psychology, Faculty of Science, Dalhousie University, IWK Health Centre, Halifax, NS, Canada
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Okada C, Fujieda M, Fukushima W, Ohfuji S, Kondo K, Maeda A, Nakano T, Kaji M, Hirota Y. Reactogenicity of trivalent inactivated influenza vaccine in young children: Pronounced reactions by previous successive vaccinations. Vaccine 2015; 33:3586-91. [PMID: 26044492 DOI: 10.1016/j.vaccine.2015.05.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 05/04/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022]
Abstract
In order to assess factors associated with reactogenicity of trivalent inactivated influenza vaccine (IIV3) among young children, data on 1538 vaccinees aged 0-5 years in a previous vaccine effectiveness study were analyzed. The most frequent reaction was redness (19%), followed by induration, swelling, itching, and pain (6-12%); there were no serious adverse events. For some local reactions, multivariate analyses indicated associations of younger age, preschool attendance, presence of siblings, and allergy with lower risk, and use of thinner needles with higher risk. Most notably, administration of one or more IIV3 vaccines during the previous 3 seasons was positively associated with each local reaction (adjusted odds ratios: 3.6-5.4). For subjects aged ≥3 years, prior successive annual vaccinations were associated with substantially increased local reactions, with clear dose-response relationships (P for trend: <0.001 for each); for example, an 9.8-fold greater risk of swelling following three successive annual vaccinations before the study season.
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Affiliation(s)
- Chika Okada
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan.
| | - Megumi Fujieda
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
| | - Wakaba Fukushima
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
| | - Kyoko Kondo
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
| | - Akiko Maeda
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
| | - Takashi Nakano
- National Mie Hospital, 357 Ozato-Kubota, Tsu, Mie, 514-0125, Japan
| | - Masaro Kaji
- Kurume University, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan
| | - Yoshio Hirota
- Department of Public Health, Osaka City University Faculty of Medicine, 1-4-3 Asahi-machi, Abeno-ku, , Osaka, 545-8585, Japan
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Kashiwagi Y, Maeda M, Kawashima H, Nakayama T. Inflammatory responses following intramuscular and subcutaneous immunization with aluminum-adjuvanted or non-adjuvanted vaccines. Vaccine 2014; 32:3393-401. [DOI: 10.1016/j.vaccine.2014.04.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/24/2014] [Accepted: 04/02/2014] [Indexed: 01/01/2023]
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10
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Herzog C. Influence of parenteral administration routes and additional factors on vaccine safety and immunogenicity: a review of recent literature. Expert Rev Vaccines 2014; 13:399-415. [DOI: 10.1586/14760584.2014.883285] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Tang DCC, Nguyen HH. The Yin-Yang arms of vaccines: disease-fighting power versus tissue-destructive inflammation. Expert Rev Vaccines 2014; 13:417-27. [PMID: 24502690 DOI: 10.1586/14760584.2014.882775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The disease-fighting power of vaccines has defeated many pathogens and has been credited with global reduction of mortality and morbidity. However, most vaccine developments focus on the enhancement of effector responses with systemic inflammation and the consequences overlooked. Recent evidence shows that systemic inflammatory phenotypes, acute or chronic, are both detrimental and should be avoided if possible. Since noninvasive vaccination by painless delivery of nasal vaccines and skin patch vaccines could elicit potent protective immunity without inducing systemic inflammation, it can be predicted that vaccinology will increasingly see the abandonment of the 'needle-injection' paradigm for vaccine development. The findings that specific viral particles could rapidly remodel the tissue environment postinfection in favor of some pathogens with the capacity to suppress others illustrate the pressing need for a deeper understanding of the underlying mechanisms in order to unlock the full potential of immunological intervention.
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Affiliation(s)
- De-Chu Christopher Tang
- International Vaccine Institute, SNU Research Park , 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 , Korea
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Cook IF. Subdeltoid/subacromial bursitis associated with influenza vaccination. Hum Vaccin Immunother 2013; 10:605-6. [PMID: 24284281 DOI: 10.4161/hv.27232] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 76-year-old male presented with subacromial/subdeltoid bursitis following influenza vaccine administration into the left deltoid muscle. This shoulder injury related to vaccine administration (SIRVA) could have been prevented by the use of a safe, evidence based protocol for the intramuscular injection of the deltoid muscle.
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Affiliation(s)
- Ian F Cook
- Newcastle University; Newcastle, NSW Australia; University of NSW; Sydney, NSW Australia
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