Prevaccine alcohol swab shows little clinical value in children

Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Prevaccination skin swabbing with alcohol does not appear to influence local skin reactions or infection (cellulitis, infectious abscess) in children receiving vaccine injections.

Why this matters

  • Clinicians might consider changing protocols/strategies for vaccination practices, especially in pediatric patients for whom the swab is a cue for impending acute injection pain.
  • Authors note the study was underpowered to detect a difference in incidence of skin infection.

Key results

  • 170 children (85 alcohol swab; 85 control; mean age, 5.6 years).
  • 58% (n=49), 54% (n=45), alcohol swab, control groups, respectively, had local skin reactions (P=.59).
  • Incidence of delayed pain was 45% (n=38) vs 40% (n=33), swab, control groups, respectively (P=.47).
  • No cases of cellulitis, infectious abscess occurred.
  • No significant influence (P>.05) of vaccine type/formulation or frequency was observed.

Study design

  • Randomized, controlled, partially blinded study evaluating alcohol effectiveness for reducing local skin reactions, infections, postvaccination in children.
  • Funding: Dean’s award, others.

Limitation

  • Self-report bias.
  • Inconclusive, unpowered.
  • Nongeneralizable.