Wiesenthal A M, Lauer B A
Colorado Permanente Medical Group, Denver.
Pediatr Infect Dis J. 1987 Nov;6(11):1048-50.
Minor local reactions and subcutaneous abscesses following diphtheria, tetanus and pertussis immunization have been attributed to vaccine left in the subcutaneous needle path from vaccine coating the needle. Various syringe preparation techniques have therefore been advocated to prevent reactions. To evaluate these recommendations we compared rates of minor reactions in 200 children randomly assigned to one of three groups that differed only in the handling of the filled syringe: in Group 1 the needle was changed before injection; in Group 2 the needle was wiped with sterile gauze before injection; in Group 3 the same needle was used to draw up and to inject the dose and was not wiped. Overall 27% of children had febrile (greater than 38 degrees C) reactions, 62% became fussy and 79% had a local reaction. Rates of reactions were nearly identical in the three groups, except that children in group 2 receiving their second dose or more of diphtheria-tetanus toxoid-pertussis vaccine were more likely to become febrile at greater than 38 degrees C (32%) or fussy (78%) (P less than 0.05 and P less than 0.02, respectively). We conclude that changing needles does not reduce the rate of minor local and systemic reactions. Wiping needles may increase the rate of reactions.
白喉、破伤风和百日咳免疫接种后出现的轻微局部反应和皮下脓肿，被认为是由于疫苗附着在针头，残留在皮下针道所致。因此，人们提倡采用各种注射器准备技术来预防这些反应。为了评估这些建议，我们将200名儿童随机分为三组，这三组仅在已装药注射器的处理方式上有所不同，然后比较了三组儿童轻微反应的发生率：第一组在注射前更换针头；第二组在注射前用无菌纱布擦拭针头；第三组使用同一根针头抽取和注射疫苗，且不进行擦拭。总体而言，27%的儿童出现发热（体温高于38摄氏度）反应，62%的儿童变得烦躁不安，79%的儿童出现局部反应。三组的反应发生率几乎相同，但第二组中接受第二剂或更多剂白喉-破伤风类毒素-百日咳疫苗的儿童，体温高于38摄氏度（32%）或变得烦躁不安（78%）的可能性更高（P值分别小于0.05和0.02）。我们得出结论，更换针头并不能降低轻微局部和全身反应的发生率。擦拭针头可能会增加反应发生率。
