Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial
Objectives: Recommendations regarding the need to use alcohol prior to vaccine injections are inconsistent and based on low-level evidence. The objective was to assess the effectiveness of alcohol in reducing local skin reactions and infection post-vaccination. Methods: Randomized controlled trial i...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-04-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/21645515.2018.1553474 |
| _version_ | 1797677430397206528 |
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| author | Horace Wong Corinne Moss Steven M. Moss Vibhuti Shah Scott A. Halperin Shinya Ito Priyanjali Mithal Angie Qu Anna Taddio |
| author_facet | Horace Wong Corinne Moss Steven M. Moss Vibhuti Shah Scott A. Halperin Shinya Ito Priyanjali Mithal Angie Qu Anna Taddio |
| author_sort | Horace Wong |
| collection | DOAJ |
| description | Objectives: Recommendations regarding the need to use alcohol prior to vaccine injections are inconsistent and based on low-level evidence. The objective was to assess the effectiveness of alcohol in reducing local skin reactions and infection post-vaccination. Methods: Randomized controlled trial in a pediatric clinic. A research assistant cleansed the skin with alcohol at (swab group) or adjacent to (control group) the pre-defined injection site(s). Clinicians, parents and children were blinded to group allocation. Parents reported local skin reactions using paper diaries for 15 days post-vaccination (Day 0–14). Telephone interviews were conducted Day 1, 5, and 14. The Brighton Collaboration criteria were used to diagnose cellulitis and infectious abscess Day 5 and afterward. Results: 170 children participated (May-November 2017). Baseline characteristics did not differ (p > 0.05) between groups. Children received 1–4 separate injections. There were no differences between swab and control groups in the incidence of any local skin reactions (58% vs. 54%), and specifically, pain (45% vs. 40%), redness (26% vs. 21%), swelling (20% vs. 13%), warmth (19% vs. 27%), and spontaneous drainage of pus (0% in both groups) over the post-vaccination follow-up period. Day 5 data was available for 99% of participants from diaries and telephone surveys; there were no cases of cellulitis or infectious abscess. Conclusion: These findings are the first direct evidence for vaccine injections demonstrating that cleansing the skin with alcohol may not be needed. Our study is underpowered; however, to detect a difference in incidence of skin infection, future research is recommended. |
| first_indexed | 2024-03-11T22:45:06Z |
| format | Article |
| id | doaj.art-ac3415a7d67447e9b45dc0ccabafbd80 |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T22:45:06Z |
| publishDate | 2019-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-ac3415a7d67447e9b45dc0ccabafbd802023-09-22T08:38:25ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2019-04-01154995100210.1080/21645515.2018.15534741553474Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trialHorace Wong0Corinne Moss1Steven M. Moss2Vibhuti Shah3Scott A. Halperin4Shinya Ito5Priyanjali Mithal6Angie Qu7Anna Taddio8University of TorontoUniversity of TorontoUniversity of TorontoMount Sinai HospitalIWK Health Centre and Dalhousie UniversityThe Hospital for Sick ChildrenUniversity of TorontoUniversity of TorontoUniversity of TorontoObjectives: Recommendations regarding the need to use alcohol prior to vaccine injections are inconsistent and based on low-level evidence. The objective was to assess the effectiveness of alcohol in reducing local skin reactions and infection post-vaccination. Methods: Randomized controlled trial in a pediatric clinic. A research assistant cleansed the skin with alcohol at (swab group) or adjacent to (control group) the pre-defined injection site(s). Clinicians, parents and children were blinded to group allocation. Parents reported local skin reactions using paper diaries for 15 days post-vaccination (Day 0–14). Telephone interviews were conducted Day 1, 5, and 14. The Brighton Collaboration criteria were used to diagnose cellulitis and infectious abscess Day 5 and afterward. Results: 170 children participated (May-November 2017). Baseline characteristics did not differ (p > 0.05) between groups. Children received 1–4 separate injections. There were no differences between swab and control groups in the incidence of any local skin reactions (58% vs. 54%), and specifically, pain (45% vs. 40%), redness (26% vs. 21%), swelling (20% vs. 13%), warmth (19% vs. 27%), and spontaneous drainage of pus (0% in both groups) over the post-vaccination follow-up period. Day 5 data was available for 99% of participants from diaries and telephone surveys; there were no cases of cellulitis or infectious abscess. Conclusion: These findings are the first direct evidence for vaccine injections demonstrating that cleansing the skin with alcohol may not be needed. Our study is underpowered; however, to detect a difference in incidence of skin infection, future research is recommended.http://dx.doi.org/10.1080/21645515.2018.1553474vaccinesinfectionsalcohol swabsimmunizationcellulitisadverse events |
| spellingShingle | Horace Wong Corinne Moss Steven M. Moss Vibhuti Shah Scott A. Halperin Shinya Ito Priyanjali Mithal Angie Qu Anna Taddio Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial Human Vaccines & Immunotherapeutics vaccines infections alcohol swabs immunization cellulitis adverse events |
| title | Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial |
| title_full | Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial |
| title_fullStr | Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial |
| title_full_unstemmed | Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial |
| title_short | Effect of alcohol skin cleansing on vaccination-associated infections and local skin reactions: a randomized controlled trial |
| title_sort | effect of alcohol skin cleansing on vaccination associated infections and local skin reactions a randomized controlled trial |
| topic | vaccines infections alcohol swabs immunization cellulitis adverse events |
| url | http://dx.doi.org/10.1080/21645515.2018.1553474 |
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