POST 01044E : USE OF ETHANOL FOR VACCINE INJECTIONS
Follow-up on Posts 01029E and 01036E
23 January 2007
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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.
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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
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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
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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
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