Journal: Vaccines

Article Title: Alternative vaccine delivery methods

doi: 10.1016/B978-1-4557-0090-5.00063-X

Figure Lengend Snippet: Devices for Smallpox Delivery and Classical Intradermal Vaccination. (A) Vaccinostyle (no longer used for smallpox vaccine), which scratches the skin before or after applying liquid vaccine. (B) Rotary lancet (no longer used for smallpox vaccine), twirled between thumb and fingers to abrade skin. (C) Surgical needle (no longer used for smallpox vaccine), pressed parallel to skin in multiple-pressure method. (D) Pronged end of bifurcated needle (full length, 5 to 7 cm), the current preferred device for smallpox vaccination, holds between its tines approximately 2.5 μL fluid by capillary action. (E) Intradermal nozzle of Ped-O-Jet multiuse-nozzle jet injector (no longer used, see ) (Keystone Industries), showing 0.127-mm-diameter orifice bored into inset sapphire. Recessed cone in the nozzle directs jet stream across a short air gap at ~45-degree angle into skin. (F) “Kuchiki needle” multi-tined applicator for administration of Japanese BCG vaccine by a method termed percutaneous delivery. (G) Traditional Mantoux method for creating intradermal wheal using 26-gauge hypodermic needle and conventional 1-mL syringe. (H) Prefilled version of Soluvia mini-needle intradermal syringe (BD Micro-Delivery System; Becton, Dickinson and Co. ) used for intradermal delivery of Sanofi Pasteur brands of inactivated influenza vaccine (Intanza, IDflu, Fluzone Intradermal ). (From Kis EE, Winter G, Myschik J. Devices for intradermal vaccination. Vaccine 30:523-538, 2012 [Fig. 3, p. 526].) (H inset) The 30-gauge staked mini-needle projects 1.5 mm beyond its hub to limit the depth of injection upon perpendicular insertion into the skin. Marketing of vaccine-device combination product approved in European Union in 2009 and in United States in 2011. (I) Investigational adaptor for conventional tuberculin syringe-needle for quick and consistent Mantoux intradermal injection (SID Technologies, West, PATH ), to be used for rabies vaccination in the developing world, among other indications. The fixed gap of < 1.0 mm underneath the “Ski-tip” guide manipulates the skin to optimize needle placement regardless of bevel orientation. (J) Investigational new version of Tropis needle-free intradermal jet injector (PharmaJet ). (J inset) Unfolded cocking “wings” are used to compress its metal spring between injections. Original model cleared by FDA for US marketing in 2011. (K) Investigational Bioject ID Pen needle-free jet injector for intradermal delivery of 0.1 mL (0.05-mL-dose model not shown) (Bioject Medical Technologies ). Powered by metal spring cocked with built-in lever. Disposable polypropylene spacer on disposable syringe creates the desired air gap to weaken the jet stream for intradermal delivery.

Article Snippet: To circumvent the amount of skill and time needed for successful Mantoux injection, Becton, Dickinson (BD) developed a prefilled glass syringe with a staked, 30-gauge (outer diameter [OD], ~ 0.305 mm) mini-needle, which projects only 1.5 mm beyond its depth-limiting hub for intuitive perpendicular insertion into the skin (see ).

Techniques: Injection