Our objective was to assess whether the occurrence of medically attended local reactions to intramuscularly administered vaccines varies by injection site (arm versus thigh) in children 1 to 6 years of age.
This is a retrospective cohort study of children in the Vaccine Safety Datalink population from 2002 to 2009. Site of injection and the outcome of medically attended local reactions were identified from administrative data.
The study cohort of 1.4 million children received 6.0 million intramuscular (IM) vaccines during the study period. The primary analyses evaluated the IM vaccines most commonly administered alone, which included inactivated influenza, hepatitis A, and diphtheria-tetanus-acellular pertussis (DTaP) vaccines. For inactivated influenza and hepatitis A vaccines, local reactions were relatively uncommon, and there was no difference in risk of these events with arm versus thigh injections. The rate of local reactions after DTaP vaccines was higher, and vaccination in the arm was associated with a significantly greater risk of this outcome compared with vaccination in the thigh, both for children 12 to 35 months (relative risk: 1.88 [95% confidence interval: 1.34-2.65]) and 3 to 6 years of age (relative risk: 1.41 [95% confidence interval: 0.84-2.34]), although this difference was not statistically significant in the older age group.
Injection in the thigh is associated with a significantly lower risk of a medically attended local reaction to a DTaP vaccination among children 12 to 35 months of age, supporting current recommendations to administer IM vaccinations in the thigh for children younger than 3 years of age.
[Show abstract][Hide abstract] ABSTRACT: Die Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut haben das Ziel, Infektionskrankheiten und damit assoziierte Komplikationen, die für das öffentliche Gesundheitswesen von Bedeutung (,,von öffentlichem Interesse“) sind, durch populationsbezogene Impfprogramme zu verhindern. Darüber hinaus enthalten die STIKO-Empfehlungen Hinweise für Indikationsimpfungen bei besonderer Gefährdungslage und umfassende Informationen zur Durchführung von Nachholimpfungen. Im vorliegenden Beitrag werden die Grundlagen der Impfpraxis sowie die aktuellen Empfehlungen der STIKO mit den wichtigsten Neuerungen beschrieben.
[Show abstract][Hide abstract] ABSTRACT: The administration of injections is a fundamental nursing skill; however, it is not without risk. Children receive numerous vaccines, and pediatric nurses administer the majority of these vaccines via the intramuscular route, and thus must be knowledgeable about safe and evidence-based immunization programs. Nurses may not be aware of the potential consequences associated with poor injection practices, and historically have relied on their basic nursing training or the advice of colleagues as a substitute for newer evidence about how to administer injections today. Evidence-based nursing practice requires pediatric nurses to review current literature to establish best practices and thus improved patient outcomes.
MCN. The American journal of maternal child nursing 11/2013; DOI:10.1097/NMC.0000000000000009 · 0.90 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.