Tuesday, 23 January 2007
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POST 01044E : USE OF ETHANOL FOR VACCINE INJECTIONS Follow-up on Posts 01029E and 01036E 23 January 2007 ___________________________________________ Akhter Hamid (mailto:[email protected]) from WHO/Bangladesh is restating the question originally asked by Jedeth Mamora. David Hipgrave (mailto:[email protected]) from UNICEF/Indonesia brings elements of reply including the copy of a medical journal's column (Medical Journal of Australia). I added some comments at the bottom. ___________________________________________ Is there any effect on vaccine efficacy in case of vaccines given subcutaneously after cleaning the skin area with Ethanol? Dr A Hamid NPO-Immunization WHO-Bangladesh ---------------------- The Australian Immunisation Guidelines, available online at http://www9.health.gov.au/immhandbook/pdf/handbook.pdf specifically state on page 6 that: "When the skin is visibly clean, there is no evidence that skin antisepsis is necessary (ref attached). If the skin needs to be cleaned, alcohol and other disinfecting agents must be allowed to dry before injection of the vaccine, since they can inactivate live vaccine preparations and increase pain (no ref given)." The article they refer to is attached, but I have not gone to the original source articles and they do not give a reference to the statement about inactivation of live vaccine preparations. Dr David Hipgrave, Chief, Health and Nutrition Unit, UNICEF Indonesia Jakarta, Indonesia ---------------------- NOTE : I also went to consult the recommendations of the ACIP (Advisory Committee on Immunization Practices) of the United States, published by in the MMWR. Incidently a new version has just been published on 1 December 2006. MMWR ; December 1, 2006, vol. 55, No RR-15. It is available at : http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm or in PDF : http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf This new version on page 14 (Vaccine Administration) makes no mention of this issue. I went back to find the 1994 issue, and it was then as silent on this question... CDC does not recommend alcohol in the case of smallpox vaccination (yes, smallpox) but acetone instead. I have some difficulty in believing that alcohol can inactivate live viruses but acetone wouldn't. Maybe it is just a question of drying speed as acetone dries so fast and the risk, if risk exists, disappears when dry? The moderator ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de, Canada (http://www.ccisd.org) ______________________________________________________________________________ ##text##
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