Immunisation against infectious disease / Joint Committee on Vaccination and Immunisation.

  • Joint Committee on Vaccination and Immunisation
Date:
1988
Catalogue details

Licence: Open Government Licence

Credit: Immunisation against infectious disease / Joint Committee on Vaccination and Immunisation. Source: Wellcome Collection.

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    lumps should be prepared with OPV immediately before administra- tion; allowing them to stand at room temperature for any length of time may decrease the potency of the vaccine. b.Subcutaneous and intramuscular injection. With the exception of BCG, intramuscular or deep subcutaneous injection should be used for all vaccines. In infants, the antero-lateral aspect of the thigh or upper arm are recommended. If the buttock is used, injection into the upper outer quadrant avoids the risk of sciatic nerve damage, but injection into fatty tissue may reduce the efficacy of some vaccines. c. Intradermal injection. BCG vaccine is ALWAYS given intradermally; rabies vaccine may also be given this way. When giving an intradermal injection, the operator should stretch the skin between the thumb and forefinger of one hand, and with the other slowly insert the needle (size 25G), bevel upwards, for about 2mm into the superficial layers of the dermis, almost parallel | with the surface. A raised, blanched bleb showing the tips of the hair follicles is a sign that the injection has been made correctly and its diameter gives a useful indication of the amount that has been injected. Considerable resistance is felt from a correctly given intradermal injection. If this is not felt, and it is suspected that the needle is too deep, it should be removed and reinserted before more vaccine is given. A bleb of 7mm diameter is approximately equivalent to 0.1ml. d. Suitable sites for intradermal injections. i) For BCG the site of injection is over the insertion of the left deltoid muscle; the tip of the shoulder must be avoided because of the increased risk of keloid formation at this site. ii) For tuberculin sensitivity tests (Mantoux or Heaf), intradermal injections are given in the middle of the flexor surface of the forearm. This site should not be used for injecting vaccines. ili) The use of jet injectors is NOT recommended. iv) For intradermal rabies vaccine, the site of injection is behind the posterior border of the distal portion of the deltoid muscle. 2.5 Immunisation by nurses A doctor may delegate responsibility for immunisation to a nurse provided the following conditions are fulfilled: i) The nurse is willing to be professionally accountable for this work.
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