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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Wednesday, June 15, 2011

Shorter Needles for Flu Vaccine — That’s OK with Me

It is amazing how many people have “needle phobia.” I have seen big ‘ol, strapping high school football players cry like babies when I tell them that the need a “shot” or a simple blood test. Just yesterday, one of my favorite, long-time patients needed a blood test for his cholesterol. He refused because he “hates needles.”

More recently, I have been using some white lies when it comes to injections. When I get a refusal or a child or teenager decompensates when I inform them that an injection is needed, I tell them the following:

“The good news is that we ran out of the normal needles that we use for shots. All we have are the tiny (more expensive) newborn needles — the one’s we use for babies. We are not supposed to use them for older kids, but if you promise not to say anything I can use them for your injection today…or, you can wait until tomorrow when the bigger needles come in.”

So far, 100% have agreed to get the shots with the baby needles. Of course, there is no such thing as a special baby needle.

People getting flu vaccines typically have a choice since flu vaccine comes in two forms. One is the intranasal vaccine that is a mist sprayed painlessly in the nose. The other requires a needle from one inch to 1.5 inches long. The FDA has now approved using a much shorter needle for next season’s flu vaccine  — one that is 90% shorter, about 1/10 of an inch long.  So far, has only been approved for adult patients over 18; not children. The shorter needle has been used successfully in Europe, Australia, and Canada for a few years.

It would be wonderful if all vaccines could be delivered without the use of any needles. Pharmaceutical companies have been scrambling to get an inexpensive and effective, needless delivery system.

In the mid-1970s, I worked with a physician who used a special air gun to give certain hormonal medications to patients requiring a daily injection. Similar to the military version used for mass immunizations, this needless method required a large canister of compressed air that shot the vaccine directly through the skin. The area would still bleed a bit, just like a needle, and it still hurt. Patients stated that it was not as painful as getting a needle every day, so 90% preferred the air gun method.

I can’t wait to see this newer shorter needle for the adult flu vaccine. Hopefully, this will hallmark a pediatric version soon.

Posted by: Rod Moser, PA, PhD at 8:35 am

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