Letters to the Editor
Use of two needles
- W.A.C. Young, Margaret Curran
- Aust Prescr 1999;22:60-3
- 1 April 1999
- DOI: 10.18773/austprescr.1999.028
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Editor, - Irefer to the letter from Dr Justin Coleman and to Dr Paul Nisselle's comment ('Use of two needles' AustPrescr1998;21:60-1). There is one type of injection where it is important to use two needles and that is when giving certain vaccines. The outside of the needle may be contaminated by the toxoids and there is an increased risk of local reactions in the superficial tissues and along the track of the needle.
Dr Margaret Curran, Associate Medical Director, CSL Pharmaceuticals, comments:
Thank you for the opportunity to comment on Dr Young's letter about using two needles for injections.
The Australian Immunisation Handbook1 recommends that, 'for vaccines which are drawn up through a rubber bung, or are reconstituted, a new needle should be used for administration. If the vaccine has been drawn up from an open vial, the same needle may be used'.
For aluminium adsorbed vaccines, there is some suggestion in the literature2,3,4,5 that injection technique may contribute to the severity of local reactions, including abscess formation at the injection site, as a result of the antigen seeding the needle track.
The approved prescribing information for adult tetanus toxoid with diphtheria toxoid (ADT) and tetanus toxoid (Tet-Tox) states that local reactions can be minimised if care is taken to ensure that the intramuscular injection is given deeply and that none of the material (toxoid) is deposited superficially or along the track of the needle.
The approved prescribing information for both children's diphtheria toxoid with tetanus toxoid (CDT) and diphtheria, tetanus, pertussis vaccine(Triple Antigen) suggests the following precautions:
General Practitioner, Mornington, Vic.
Associate Medical Director, CSL Pharmaceuticals,