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Arch Pediatr Adolesc Med. 2004;158:708.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We are concerned that the external validity of the findings by Reis et al,¹ who evaluated measures to reduce the acute pain of multiple immunizations in infants, may be limited by their use of inappropriately short needles.

Nearly all inactivated vaccines recommended during infancy in the United States are licensed only for intramuscular injection. An exception, inactivated poliovirus vaccine, may be given intramuscularly or subcutaneously. To ensure intramuscular penetration when immunizing infants approximately 2 months old, the American Academy of Pediatrics, Elk Grove Village, Ill²; the American Academy of Family Physicians, Leawood, Kan; and the federal Advisory Committee on Immunization Practices, Atlanta, Ga,³ recommend a needle length of 2.22 to 2.54 cm (-1 in). In contrast, Reis and colleagues immunized infants of this age with needles 1.59 cm ( in) in length. The bore of the needles used in their study was 26 gauge, narrower than the recommended . . . [Full Text of this Article]

Sandra Jo Hammer, RN, MSN, MPH; Howard Backer, MD, MPH; Robert Schechter, MD

Correspondence: Ms Hammer, Immunization Branch, State of California Health and Human Services Agency, 2151 Berkeley Way, Room 712, Berkeley, CA 94704 (shammer@dhs.ca.gov).

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Arch Pediatr Adolesc Med. 2004;158(7):709.
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