Vaccine intramuscular injection

Vaccines (intramuscular injection bypasses intestinal barrier)... 

A Q may be administered to females from 9 years onwards B Q eliminates the need for routine cervical screening C is administered by intramuscular injection as a single dose D is a bivalent vaccine... 

Gardasil is a quadrivalent vaccine of the human papilloma virus (type 6, 11, 16, 18). It is used for the prevention of cervical cancer and other pre-cancerous lesions. It should be given early in a female s sexual life and it is licensed for use in females between 9 and 26 years of age. Administration is by intramuscular injection and three doses are required. Because the vaccine does not protect against all the strains of the virus, cervical screening is still required. Duration of protection after a complete course is... 

Dupuis, M., Denis-Mize, K., Woo, C., Goldbeck, C., Selby, M. J., Chen, M. et al. (2000) Distribution of DNA vaccines determines their immunogenicity after intramuscular injection in mice. J. Immunol, 165, 2850-2858. 

Ledwith, B.J., Manam, S., Troilo, P.J., Bamum, A.B., Pauley, I, Griffiths, T.G. et al. (2000) Plasmid DNA vaccines investigation of integration following intramuscular injection in mice. Intervirology, 43, 258-272. 

Han, R., Reed, C.A., Cladel, N.M. and Christensen, N.D. (2000) Immunization of rabbits with cottontail rabbit papillomavirus El and E2 genes protective immunity induced by gene gun-mediated intracutaneous delivery but not by intramuscular injection. Vaccine, 18,2937-2944. 

Intramuscular. The large quantity of skeletal muscle in the body allows this route to be an easily accessible site for parenteral administration. Intramuscular injections can be used to treat a problem located directly in the injected muscle. For example, botu-linum toxin and other substances can be injected directly into hyperexcitable muscles to control certain types of muscle spasms or spasticity (see Chapter 13).7,78 Alternatively, intramuscular injection can be used as a method for a relatively steady, prolonged release of the drug into the systemic circulation to control conditions such as psychosis,2 or to administer certain vaccines. 

Ledwith BJ, Manam S, Troilo PJ, Barnum AB, Pauley CJ, Griffiths TG, Harper LB, Beare CM, Bagdon WJ, Nichols WW. Plasmid DNA vaccines investigation of integration into host cellular DNA following intramuscular injection in mice. 

Following intramuscular (IM) administration, drugs must cross one or more biological membranes in order to enter the systemic circulation. Intramuscular injection is used mainly for drugs and vaccines that are not absorbed orally, for example, aminoglycosides, insulin, and hepatitis vaccine. The IM route is often used for sustained medication and specialized vehicles, such as aqueous suspensions, oily vehicles, complexes and microencapsulation, which has been developed for slow delivery of drugs by this route. ... 

Corn oil is used primarily in pharmaceutical formulations as a solvent for intramuscular injections or as a vehicle for topical preparations. Emulsions containing up to 67% corn oil are also used as oral nutritional supplements see also Section 18. When combined with surfactants and gel-forming polymers, it is used to formulate veterinary vaccines. 

Macrophagic myofasciitis (MMF) is a recently identified demye-linating central nervous system disorder attributed to intramuscular injections of aluminum-containing vaccines. Symptoms of 1 of 92 cases included cognitive and behavioral changes (Authier et al. 2001). Another new disorder attributed to an inherited abnormality of aluminum metabolism causes progressive and fatal central nervous system calcification (Meshitsuka et al. 2001). 

Production of pDNA using up to 100-m scale fermentation is performed by specialized industries [106]. Batches of more than 1kg of pDNA can be produced. As functional doses for vaccination in humans were of ca. 800 pg (intramuscular injection) or 4pg (gene-gun), 1 kg of pDNA is enough for 1,250,000 or 250,000,000 doses, respectively. This is largely enough for pDNA-based therapies to be commercialized worldwide as treatments against infectious diseases, cancer, or genetic diseases. 

In a randomised study in 26 patients stabilised on warfarin, there was no difference in injection site adverse events between intramuscular or subcutaneous injection of a standard trivalent influenza vaccine, and no patient had bruising or swelling. In addition, both routes of administration produced similar levels of antibody titres. In another study that specifically assessed the local reactions to intramuscular influenza vaccination, there were no detectable local complications after intramuscular injection, including no change in arm circumference. ... 

The absorption rate after intramuscular administration differs depending on type of muscle chosen. Studies have shown that intramuscular injections result in different plasma concentrations of narcotics and perceived pain relief depending oti the type of muscle used for administration. This was also found for the response to vaccination and use of antibiotics and insulin [7]. Absorption of active substances from the intramuscular site depends mi the quantity and composition of the connective tissue and the rate of vascular perfusion of the area. Blood flow in the muscles varies (it is increased in deltoid muscle) and is influenced by the exercise of the muscle and morbidity. The muscles are covered with the subcutaneous connective tissue, a hpid layer (adipose layer) and the skin. The thickness and the Upid content of these tissues are different in different body areas. The subcutaneous fat layer at the gluteal intramuscular injection site is thicker in females (mostly > 3 cm) than in males. The medication should be administered with a needle long enough to reach the muscle without penetrating underlying structures. 

The most common adverse effects in adults include injection site reactions (e.g., tenderness, pain, and warmth), headaches within 5 days after vaccination, and fatigue. Local reactions may be minimized by using an appropriate needle length based on the person s age and size and by administering the injection intramuscularly in the deltoid muscle. Children may also have feeding disturbances. Hepatitis A vaccine given... 

Sustained-release injections, subcutaneous and intramuscular, have been investigated in a variety of different formulations [217,218], Injections of degradable microspheres have efficiently prolonged delivery of numerous drugs [219-222], even antigenic substances and vaccines to produce immunity [223,224]. 

Epstein, J.E., E.J. Gorak, Y. Charoenvit, et al.. Safety, tolerability, and lack of antibody responses after administration of a PfCSP DNA malaria vaccine via needle or needle-free jet injection, and comparison of intramuscular and combination intramus-cular/intradermal routes. Hum Gene Ther, 2002.13(13) 1551-60. 

Trials of therapeutic vaccination against prostate cancer used OncoVax-P (Jenner Biotherapies, Inc, San Ramon, California). OncoVax-P consists of 200 pg monophosphoryl lipid A (similar to that used in Detox) added to 1 ml liposomes and 100 pg PSA (prostate-specific antigen). Patients received injections by different routes (intramuscular, intravenous or subcutaneous) according to the trial, with or without GM-CSF, IL-2 or BCG and cyclophosphamide pretreatment. No serious side effects were seen. DTH and antibody responses were achieved. Vaccination increased the PSA-reactive T cell frequency as determined by IFN-y secretion, but no toxicity against PSA-expressing target cells was detected. The most effective strategy could not be determined, and no conclusion about the clinical efficacy of the treatment was possible [214,215],... 

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