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Immunization Injections—Reply
Arch Pediatr Adolesc Med. 2004;158:709.
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In reply
I appreciate the thoughtful review of our report of pain reduction for infant immunization injections1 by Ms Hammer and Drs Schechter and Backer. These readers point out that the needles used for injection in our study do not conform to current immunization recommendations. However, it should be noted that, as stated in our "Results" section, our study was conducted from June 1, 2000, to April 10, 2001. This study period predated the publication of the cited Advisory Committee on Immunization Practices/American Academy of Family Physicians and the American Academy of Pediatrics recommendations in 2002 and 2003, respectively. In 2002, we changed our standard intramuscular injection procedure to use the recommended 25-gauge, 1-in needles.
I welcome the replication of our trial using longer, larger bore needles. However, it is unlikely that local inflammation, which may have resulted from using shorter needles, influenced the immediate pain responses that we measured.
Evelyn C. Reis, MD
Correspondence: Dr Reis, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, 3705 Fifth Ave, Pittsburgh, PA 15213-2583 (evelyn.reis@chp.edu).
1. Reis EC, Roth EK, Syphan JL, Tarbell SE, Holubkov R. Effective pain reduction for multiple immunization injections in young infants. Arch Pediatr Adolesc Med. 2003;157:1115-1120.
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Immunization Injections
Sandra Jo Hammer, Howard Backer, and Robert Schechter
Arch Pediatr Adolesc Med. 2004;158(7):708.
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