Dr Rajive Gupta
27Scientifically, Covid 19 vaccination is the only way to develop immunity against the dreadful Covid 19 infection and to resist and fight against this pandemic. The vaccine has to be given by intramuscular injection over the deltoid muscle in the upper arm and two doses of the vaccine have been recommended, second dose 6-8 weeks after the first dose.
For many of us, getting a vaccine or other routine injection is not a pleasant experience.
When I got first dose of Covid 19 vaccine, I was surprised to see that without cleaning the skin with some antiseptic solution at the site of injection, the nurse given the job of administering vaccine straight away introduced the needle into the deltoid muscle and injected the dose. She had just touched the skin with a dry unsterilized cotton swab. Being a doctor I had already thoroughly cleaned the area with antiseptic solution a few minutes before and kept the sleeve of my shirt rolled up and area exposed till I got injection. On inquiring the nurse without disclosing my identity that why she has not cleaned the skin with antiseptic before giving vaccine, I was surprised to get the reply that she has been told that no antiseptic is to be applied as it interferes with the vaccine and moreover, she is not provided with any antiseptic by the administration for this purpose.
This is for the general public to know that our skin is full of bacteria and unless it is properly sterlised before any vaccine or injection, these bacteria can enter the skin through the puncture wound leading to skin reaction, pain, redness, swelling or feelings of heat and even abscess formation at the infection site.
Being a practicing surgeon, I have seen many patients who get intramuscular injections by untrained paramedics who don’t take sterilization measures and don’t adopt proper technique to administer injection and develop cellulitis or abscess formation at the site of injection leading to lot of morbidity and may need surgery under general anesthesia for abscess drainage and even nerve injury by the injection needle.
When all the Indians above 18 years age are being administered Covid vaccine , even if one percent of them get problems due to wrong technique adopted by the vaccinator, one can count the number of cases who can develop these preventable complications of vaccination.
To clean the skin before vaccination or other injection, suggested standard practice according to the World Health Organization (WHO) is to swab the injection site with a saturated 60-70 percent alcohol swab for 30 seconds, then let the area dry for another 30 seconds so that alcohol doesn’t enter the puncture and sting. Through this article, the administration is requested to give proper training to the vaccinators and provide them antiseptic along with sterilized cotton swabs to prevent injection related complications among masses.
(The author is General and Laparoscopic Surgeon in Jammu)
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