Asokan G. Vaithinathan, Leena Khonji, Gayathripriya Narayanan
{"title":"在大流行期间,在科学/证据不确定的背景下,需要以证据为基础的COVID-19肌肉注射疫苗技术(是否抽吸)实践","authors":"Asokan G. Vaithinathan, Leena Khonji, Gayathripriya Narayanan","doi":"10.1111/jebm.12537","DOIUrl":null,"url":null,"abstract":"Globally, on average, 16 billion injections are administered every year; of these, vaccination accounts for 5%.1 The World Health Organization’s (WHO) toolkit on best practices classifies injections based on target tissue of delivery as intradermal (ID), subcutaneous (SC), intramuscular (IM), intravenous (IV), intraosseous, intraarterial, and peritoneal. Adhering to the safety standards, the choice of the IM sites (deltoid, dorsogluteal, rectus femoris, vastus lateralis, and ventrogluteal muscles) depends on the volume to be administered2; a “safe injection” does not harm the recipient, provider, or health of the community.1 The Centers for Disease Control and Prevention (CDC) says: aspiration before injection of vaccines or toxoids (i.e., pulling back on the syringe plunger after needle insertion before injection) is not necessary because no large blood vessels are present at the recommended injection sites.3 Most vaccines are given via the IM route to optimize immunogenicity, whereas inadvertent administration may lead toadverseevents, vaccine failure, or poor seroconversion. The status of the coronavirus (COVID-19) vaccinations as of May 23, 2023, indicates that 70% of the world’s population had received at least one dose of a COVID-19 vaccine, 13.38 billion doses have been administered globally, and 3.09million doses each day. Only 29.9% of people in low-income countries have received at least one dose.4 The purpose of this perspective is to appraise the prevailing IM injection techniques while administering the authorized COVID-19 vaccines in the context of adverse events reported; identify the evidence and knowledge gaps chiefly on aspiration technique before administering the COVID-19 vaccine; and address the best evidencebased practice to adopt. An EUA is a mechanism to facilitate the use of therapeutics and vaccines during public health emergencies. The US Food and Drug Administration (FDA) approved five vaccines under EUA; the European Medicines Agency (EMA) approved eight vaccines for marketing or conditional marketing (Table 1). Almost 50 COVID-19 vaccines that have been approved by various agencies around the world, but the WHO has granted emergency use status for the 11 vaccines. Currently, there are 242 vaccine candidates and 821 vaccine trials in 80 countries.5 The COVID-19 vaccines are considered safe and effective. Like any other vaccine, vaccinees have reported mild to moderate side","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Necessitating evidence-based practice in COVID-19 intramuscular vaccination techniques (to aspirate or not) in the context of scientific/evidence uncertainty amidst the pandemic\",\"authors\":\"Asokan G. Vaithinathan, Leena Khonji, Gayathripriya Narayanan\",\"doi\":\"10.1111/jebm.12537\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Globally, on average, 16 billion injections are administered every year; of these, vaccination accounts for 5%.1 The World Health Organization’s (WHO) toolkit on best practices classifies injections based on target tissue of delivery as intradermal (ID), subcutaneous (SC), intramuscular (IM), intravenous (IV), intraosseous, intraarterial, and peritoneal. Adhering to the safety standards, the choice of the IM sites (deltoid, dorsogluteal, rectus femoris, vastus lateralis, and ventrogluteal muscles) depends on the volume to be administered2; a “safe injection” does not harm the recipient, provider, or health of the community.1 The Centers for Disease Control and Prevention (CDC) says: aspiration before injection of vaccines or toxoids (i.e., pulling back on the syringe plunger after needle insertion before injection) is not necessary because no large blood vessels are present at the recommended injection sites.3 Most vaccines are given via the IM route to optimize immunogenicity, whereas inadvertent administration may lead toadverseevents, vaccine failure, or poor seroconversion. The status of the coronavirus (COVID-19) vaccinations as of May 23, 2023, indicates that 70% of the world’s population had received at least one dose of a COVID-19 vaccine, 13.38 billion doses have been administered globally, and 3.09million doses each day. Only 29.9% of people in low-income countries have received at least one dose.4 The purpose of this perspective is to appraise the prevailing IM injection techniques while administering the authorized COVID-19 vaccines in the context of adverse events reported; identify the evidence and knowledge gaps chiefly on aspiration technique before administering the COVID-19 vaccine; and address the best evidencebased practice to adopt. An EUA is a mechanism to facilitate the use of therapeutics and vaccines during public health emergencies. The US Food and Drug Administration (FDA) approved five vaccines under EUA; the European Medicines Agency (EMA) approved eight vaccines for marketing or conditional marketing (Table 1). Almost 50 COVID-19 vaccines that have been approved by various agencies around the world, but the WHO has granted emergency use status for the 11 vaccines. Currently, there are 242 vaccine candidates and 821 vaccine trials in 80 countries.5 The COVID-19 vaccines are considered safe and effective. 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Necessitating evidence-based practice in COVID-19 intramuscular vaccination techniques (to aspirate or not) in the context of scientific/evidence uncertainty amidst the pandemic
Globally, on average, 16 billion injections are administered every year; of these, vaccination accounts for 5%.1 The World Health Organization’s (WHO) toolkit on best practices classifies injections based on target tissue of delivery as intradermal (ID), subcutaneous (SC), intramuscular (IM), intravenous (IV), intraosseous, intraarterial, and peritoneal. Adhering to the safety standards, the choice of the IM sites (deltoid, dorsogluteal, rectus femoris, vastus lateralis, and ventrogluteal muscles) depends on the volume to be administered2; a “safe injection” does not harm the recipient, provider, or health of the community.1 The Centers for Disease Control and Prevention (CDC) says: aspiration before injection of vaccines or toxoids (i.e., pulling back on the syringe plunger after needle insertion before injection) is not necessary because no large blood vessels are present at the recommended injection sites.3 Most vaccines are given via the IM route to optimize immunogenicity, whereas inadvertent administration may lead toadverseevents, vaccine failure, or poor seroconversion. The status of the coronavirus (COVID-19) vaccinations as of May 23, 2023, indicates that 70% of the world’s population had received at least one dose of a COVID-19 vaccine, 13.38 billion doses have been administered globally, and 3.09million doses each day. Only 29.9% of people in low-income countries have received at least one dose.4 The purpose of this perspective is to appraise the prevailing IM injection techniques while administering the authorized COVID-19 vaccines in the context of adverse events reported; identify the evidence and knowledge gaps chiefly on aspiration technique before administering the COVID-19 vaccine; and address the best evidencebased practice to adopt. An EUA is a mechanism to facilitate the use of therapeutics and vaccines during public health emergencies. The US Food and Drug Administration (FDA) approved five vaccines under EUA; the European Medicines Agency (EMA) approved eight vaccines for marketing or conditional marketing (Table 1). Almost 50 COVID-19 vaccines that have been approved by various agencies around the world, but the WHO has granted emergency use status for the 11 vaccines. Currently, there are 242 vaccine candidates and 821 vaccine trials in 80 countries.5 The COVID-19 vaccines are considered safe and effective. Like any other vaccine, vaccinees have reported mild to moderate side
期刊介绍:
The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.