Germany’s vaccination board STIKO ständige Impfkomission, Standing commission for vaccination
https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/Ausgaben/07_22.pdf?__blob=publicationFile
Now recommends aspiration
The vaccine is to be injected only intramuscular (i.m.),
and in no case intradermal, subcutaneous, or intravenous.
In animal models, direct intravenous injection of an mRNA vaccine has led to Myopericarditis (both clinically and histopathologically).
Although inadvertent intravenous injections are rare during application of intramuscular vaccines,
aspiration of the needle is a sensible precaution when vaccinating against COVID-19 and can lead to increased safety.
Ferdinand, thank you
Denmark
https://en.ssi.dk/news/epi-news/2021/no-19-21—2021
Basically, we need to change the vaccine administration guidelines to include precautionary aspiration, prior to pushing in the vaccine. This will prevent cases of inadvertent intravascular administration of vaccine.
Here is some discussion to suggest inadvertent intravascular vaccine administration is a variable in the aetiology of complications after adenoviral vector vaccine administration and after mRNA vaccines.
These adverse events, although rare have reduced public confidence in covid vaccination, especially amongst the young, where vaccine rates are lowest.
It has long been known that intravenous injection of adenovirus leads to TTS in mice
https://ashpublications.org/blood/article/109/7/2832/125650/Adenovirus-induced-thrombocytopenia-the-role-of
Now, new covid vaccine specific work agrees with this previous work
Thrombocytopenia and splenic platelet directed immune responses after intravenous ChAdOx1 nCov-19 administration (29th June 2021)
https://www.biorxiv.org/content/10.1101/2021.06.29.450356v1
The authors conclude, ‘Our work contributes to the understanding of TTS and highlights accidental intravenous injection as potential mechanism for post-vaccination TTS.’
‘We show that intravenous but not intramuscular injection of ChAdOx1 triggers platelet-adenovirus aggregate formation and platelet activation.’
‘Hence, safe intramuscular injection, with aspiration prior to injection, could be a potential preventive measure when administering adenovirus-based vaccines.’
Also after giving mRNA vaccines
A new study finds that giving mice intravenous mRNA vaccine also causes heart inflammation in mice.
Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model (August 2021)
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab707/6353927
‘Our study indicates that IV injection of vaccines might partially contribute to this clinical phenotype, thus warranting a reconsideration of the practice of IM injection without aspiration, which carries the risk of inadvertent IV injection.’
Agreement from ‘fact check’ from Leo Nicolai, Cardiology Fellow, Ludwig Maximilian University of Munich:
(German Centre for Cardiovascular Research)
‘Indeed, there is peer-reviewed work showing in mice that possibly intravenous injection of mRNA vaccine leads to myocardial inflammation.’
‘that intravenous injection of adenoviral vector based vaccine (AZ1222, ChAdOx1) leads to thrombocytopenia and platelet-directed immune responses, offering a possible explanation for vaccine-induced thrombosis/thrombocytopenia’
‘these data might indicate a simple measure to lower the incidence of vaccine-induced side effects,’
‘There is a lack of data on frequency and effects of IV injection in humans.’
Denmark has changed their national guidelines
https://en.ssi.dk/news/epi-news/2021/no-19-21—2021
Based on a precautionary principle, we recommend aspiration before injection.
Evidence from Dr. Peter Gaillard (microparticulate pharmacologist)
https://www.linkedin.com/pulse/astrazeneca-vaccine-pull-back-push-through-pieter-j-gaillard/?trk=pulse-article_more-articles_related-content-card
Case study evidence
Metallic taste in the mouth seconds after ‘intramuscular’ mRNA vaccine administration, (in the absence of an allergic reaction)
Other video-based discussions
26th September 2021
30th September 2021