Petousis-Harris Helen
Immunisation Advisory Centre, Department of General Practice & Primary Health Care, School of Population Health, University of Auckland, PB 92 019 Auckland, New Zealand.
Vaccine. 2008 Nov 25;26(50):6299-304. doi: 10.1016/j.vaccine.2008.08.052. Epub 2008 Sep 17.
There are inconsistencies in recommendations and practice with regards to how best to administer vaccines. This review evaluates the literature on intramuscular vaccine administration technique in primarily paediatric populations and concludes from available evidence which aspects of vaccine administration are associated with reactogenicity. Variables with best evidence to support practice to reduce reactogenicity were: Site of injection--less reactogenicity has been noted when the buttock is used rather than the thigh; tissue (muscle or subcutaneous)--less reactions are noted when vaccine is administered intramuscularly rather than subcutaneously; length of needle--longer needles are associated with less reactogenicity. Angle of injection--a 90 degrees angle is associated with less reactogenicity than a reduced angle. Despite a need for more empirical studies, there appears to be several vaccine administration techniques relating to needle angle, length, site and depth of injection that result in fewer reactions and these could be considered for public health policy, in conjunction with immunogenicity.
关于如何以最佳方式接种疫苗，在建议和实践方面存在不一致之处。本综述评估了主要针对儿童群体的肌肉注射疫苗接种技术的文献，并根据现有证据得出疫苗接种的哪些方面与反应原性相关。有最佳证据支持可减少反应原性的实践变量包括：注射部位——使用臀部而非大腿时，反应原性较低；组织（肌肉或皮下）——肌肉注射疫苗比皮下注射产生的反应更少；针头长度——较长的针头与较低的反应原性相关。注射角度——90度角比减小的角度反应原性更低。尽管需要更多的实证研究，但似乎有几种与针头角度、长度、注射部位和深度相关的疫苗接种技术可减少反应，结合免疫原性，这些可纳入公共卫生政策考虑。
