title: Subcutaneous versus intramuscular injection for booster DT vaccination of adolescents.
abstract: The importance of the injection technique in booster vaccination was investigated in an open randomized study with 252 10-year-old Swedish school-children receiving routine DT vaccination either by subcutaneous or by intramuscular route in the upper arm. The adolescents had previously been primed with DT vaccine at 3, 5 and 12 months of age. Adverse reactions, monitored for 2 weeks, showed the same low rates for systemic reactions in both groups, while the intramuscular administration gave significantly less redness (p < 0.001), swelling (p < 0.001), itching (p < 0.01) and pain (p < 0.05). These reactions were also of shorter duration (p < 0.01 to p < 0.001). Girls were found to have more pain and itching than boys (p < 0.001). No significant differences in antibody responses between the two administration routes were found in the 99 samples drawn 2 weeks after the booster. However, girls were found to have a lower response to diphtheria toxoid than boys (p = 0.009). Local reactions to a booster can thus be significantly reduced by choice of injection technique, which may be necessary if increased dosages and/or further valences are to be given to adolescents and adults.
authors.affiliation: School Health Services, Goteborg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Mark
authors.forename: R M
authors.initials: RM
authors.lastname: Carlsson
authors.forename: M
authors.initials: M
authors.lastname: Granström
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D002648:Child; D004167:Diphtheria Toxin / Q000276:immunology; D004168:Diphtheria Toxoid / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D022422:Diphtheria-Tetanus Vaccine; D005260:Female; D006801:Humans; D007117:Immunization, Secondary / Q000009:adverse effects*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D008297:Male; D012727:Sex Characteristics; D016037:Single-Blind Method; D013548:Sweden; D013744:Tetanus Toxin / Q000276:immunology; D013745:Tetanus Toxoid / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology*; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D004167:Diphtheria Toxin; D004168:Diphtheria Toxoid; D022422:Diphtheria-Tetanus Vaccine; D013744:Tetanus Toxin; D013745:Tetanus Toxoid; D017778:Vaccines, Combined