Why Vaccines Are Not Injected Directly Into The Bloodstream

[Carl Fredrik Ahl]

Hi,

I wonder why vaccines are not injected directly into the bloodstream? Why is it better that it takes like 40 minutes to an hour instead of directly? What would happen if you were to do it?

Edited April 24, 2019 by Carl Fredrik Ahl

[DrP]

Although some are taken via tablet I think some might still be administered via injection. I guess a tablet is less invasive, more hygienic, less painful etc.. Although - I don't see how 40 mins is going to make a difference - it is a prevention rather than a cure.

Most people my age in the UK have a little round scar on the outside of their left arm from vaccinations given by injection at school. Some were sugar pills soaked in the vaccine and others were injections. Some children are traumatised by injections.

 

Edited April 24, 2019 by DrP

[koti]

57 minutes ago, Carl Fredrik Ahl said:

Hi,

I wonder why vaccines are not injected directly into the bloodstream? Why is it better that it takes like 40 minutes to an hour instead of directly? What would happen if you were to do it?

„Although common belief is that vaccines are injected directly into the bloodstream, they are actually administered into muscle or the layer of skin below the dermis where immune cells reside and circulate as occurs following natural infection”

https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-safety/immune-system-and-health

„Most vaccines should be given via the intramuscular route into the deltoid or the anterolateral aspect of the thigh. This optimises the immunogenicity of the vaccine and minimises adverse reactions at the injection site. Recent studies have highlighted the importance of administering vaccines correctly.1–3 Clinical practice needs to reflect considerations about the right length and gauge of needles used to ensure that those vaccinated get the immunological benefit of the vaccines without local side effects”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118997/

 

 

[DrP]

16 minutes ago, koti said:

belief is that vaccines are injected directly into the bloodstream, they are actually administered into muscle or the layer of skin below the dermis where immune cells reside and circulate as occurs following natural infection”

I think I completely missed the point OP, lol, sorry. 

[Carl Fredrik Ahl]

48 minutes ago, koti said:

„Although common belief is that vaccines are injected directly into the bloodstream, they are actually administered into muscle or the layer of skin below the dermis where immune cells reside and circulate as occurs following natural infection”

https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-safety/immune-system-and-health

„Most vaccines should be given via the intramuscular route into the deltoid or the anterolateral aspect of the thigh. This optimises the immunogenicity of the vaccine and minimises adverse reactions at the injection site. Recent studies have highlighted the importance of administering vaccines correctly.1–3 Clinical practice needs to reflect considerations about the right length and gauge of needles used to ensure that those vaccinated get the immunological benefit of the vaccines without local side effects”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118997/

 

 

I have read that, but thanks. Now I wonder what would happen if you were to inject it directly to the blood stream.

[DrP]

Just now, Carl Fredrik Ahl said:

I have read that, but thanks. Now I wonder what would happen if you were to inject it directly to the blood stream.

For what benefit? The receiver of the vaccine has been unvaccinated for their whole life - what benefit would getting into the system 40 mins quicker bring?

 

[Strange]

7 minutes ago, Carl Fredrik Ahl said:

I have read that, but thanks. Now I wonder what would happen if you were to inject it directly to the blood stream.

As that source says: it would not work as well.

[DrP]

Just now, Strange said:

As that source says: it would not work as well.

..and even if it did - what would be the benefit?  I don't think the speed in which it takes effect from injection to immunity has ever been an issue, or at least it isn't now.

 

[Prometheus]

I don't know the particulars of various vaccines (pH and such which may constrain routes of administration), but giving medications I.V. is not entirely risk free: phlebitis, infiltration, hematomas etc... Not to mention most vaccine are given to kids - and they have harder veins to find and tend to squirm. Much easier to hit a moving target with SC or IM injections. (although some vaccines are sub-dermal and that's just as tricky as IV).

If you don't have to give something IV, don't.

[koti]

We need @CharonY or @Arete to the rescue. 

1 hour ago, DrP said:

I think I completely missed the point OP, lol, sorry. 

I noticed, no worries though  

I have that knowledge only because I have some anti vax nut cases in my family and I got a lot of that knowledge from the two resident experts above. 

Edited April 24, 2019 by koti

[StringJunky]

47 minutes ago, Prometheus said:

I don't know the particulars of various vaccines (pH and such which may constrain routes of administration), but giving medications I.V. is not entirely risk free: phlebitis, infiltration, hematomas etc... Not to mention most vaccine are given to kids - and they have harder veins to find and tend to squirm. Much easier to hit a moving target with SC or IM injections. (although some vaccines are sub-dermal and that's just as tricky as IV).

If you don't have to give something IV, don't.

To sum: IM is more idiot-proof.

[koti]

1 hour ago, Carl Fredrik Ahl said:

I have read that, but thanks. Now I wonder what would happen if you were to inject it directly to the blood stream.

I’m not an expert but I presume that there is no need for a blood stream injection in case of vaccines because it requires more skill, an intramuscular injection is a quick and easy jab. I presume nothing special would happen if you properly administered a vaccine directly into the blood stream.  

[studiot]

3 hours ago, Carl Fredrik Ahl said:

Hi,

I wonder why vaccines are not injected directly into the bloodstream? Why is it better that it takes like 40 minutes to an hour instead of directly? What would happen if you were to do it? 

Well the purpose of vaccines is to prepare and stimulate the human or animal immunological system - ie the lymphatic system.

This is not the blood system.

https://en.wikipedia.org/wiki/Lymphatic_system

Are you asking would put the stuff into a vein or an artery?

Arteries carry oxygen-rich blood away from the heart to all of the body's tissues. ... Veins become larger as they get closer to the heart. The superior vena cava is the large vein that brings blood from the head and arms to the heart, and the inferior vena cava brings blood from the abdomen and legs into the heart.

What are the three main types of blood vessels? - WebMD

Putting stuff into a vein or an artery will may take it to the wrong place!

Here is a readable medical publication on the subject.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287301/

[CharonY]

50 minutes ago, StringJunky said:

To sum: IM is more idiot-proof.

That is a good summary. I believe we had discussed it in an earlier thread somewhere. But essentially, when vaccines were developed, it was assumed that local accumulation followed by a slow release would yield the highest immunogenic response. This is generally referred to as a the depot effect. However, this effect was not unequivocally shown to be relevant or even present, and especially the use of adjuvants makes it questionable whether intramuscular injection site is really that important for immune activation. There are other considerations, of course, as injection into subcutaneous fat layers may result in too low mobilization.

Nonetheless, it is quite likely that with the proper adjuvants IV injection are feasible. However, as the vaccination methods were developed and tested with the "classic" method in mind and because they were shown to be reliable with minimal discomfort, there is generally no good reason to change it. One has to keep in mind that the medical profession is generally required to follow protocol rather strictly (i.e. based on the specifics that has been tested and documented), for good reasons.

 

Edit: regarding the lymphatic system, one could really extend the whole thing to a rather large lecture. The immune system is quite complicated but in this context it is important to recognize that both  systems (i.e. blood and lymphatic system) intersect and the lymph nodes is where the lymph fluid is drained into the circulatory system. Thus while the success of vaccines is ultimately determined by the actions within the lymphatic system, they can (and have to be) detected throughout the circulatory system (typically via antigen presenting cells of sorts), where they are then directed to secondary lymphoid tissue (via the lymphatic system). The antigens can also directly enter the lymphatic system, but it is not required per se.

[StringJunky]

14 minutes ago, CharonY said:

That is a good summary. I believe we had discussed it in an earlier thread somewhere. But essentially, when vaccines were developed, it was assumed that local accumulation followed by a slow release would yield the highest immunogenic response. This is generally referred to as a the depot effect. However, this effect was not unequivocally shown to be relevant or even present, and especially the use of adjuvants makes it questionable whether intramuscular injection site is really that important for immune activation. There are other considerations, of course, as injection into subcutaneous fat layers may result in too low mobilization.

Nonetheless, it is quite likely that with the proper adjuvants IV injection are feasible. However, as the vaccination methods were developed and tested with the "classic" method in mind and because they were shown to be reliable with minimal discomfort, there is generally no good reason to change it. One has to keep in mind that the medical profession is generally required to follow protocol rather strictly (i.e. based on the specifics that has been tested and documented), for good reasons.

Yes, in November:

Quote

The interesting bit is that while the depot effect was assumed to be true, there actually has not been any systematic study on depot effects (and as Phil mentioned, adjuvants are now routinely used). Rather since the development was rather early on already focused on intramuscular (or subcutaneous) injections and shown to be effective at that, that intravenous injection never really became relevant. As such there were at best only case studies of accidental IV injection, but really no systematic investigation of possible issues. -CharonY  

 

 

[Carl Fredrik Ahl]

18 hours ago, Strange said:

As that source says: it would not work as well.

But why will it not work?

[DrP]

10 minutes ago, Carl Fredrik Ahl said:

But why will it not work?

Read the replies from Studiot and CharonY.

17 hours ago, studiot said:

Well the purpose of vaccines is to prepare and stimulate the human or animal immunological system - ie the lymphatic system.

This is not the blood system.

https://en.wikipedia.org/wiki/Lymphatic_system

Are you asking would put the stuff into a vein or an artery?

Arteries carry oxygen-rich blood away from the heart to all of the body's tissues. ... Veins become larger as they get closer to the heart. The superior vena cava is the large vein that brings blood from the head and arms to the heart, and the inferior vena cava brings blood from the abdomen and legs into the heart.

What are the three main types of blood vessels? - WebMD

Putting stuff into a vein or an artery will may take it to the wrong place!

Here is a readable medical publication on the subject.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287301/

and

16 hours ago, CharonY said:

That is a good summary. I believe we had discussed it in an earlier thread somewhere. But essentially, when vaccines were developed, it was assumed that local accumulation followed by a slow release would yield the highest immunogenic response. This is generally referred to as a the depot effect. However, this effect was not unequivocally shown to be relevant or even present, and especially the use of adjuvants makes it questionable whether intramuscular injection site is really that important for immune activation. There are other considerations, of course, as injection into subcutaneous fat layers may result in too low mobilization.

Nonetheless, it is quite likely that with the proper adjuvants IV injection are feasible. However, as the vaccination methods were developed and tested with the "classic" method in mind and because they were shown to be reliable with minimal discomfort, there is generally no good reason to change it. One has to keep in mind that the medical profession is generally required to follow protocol rather strictly (i.e. based on the specifics that has been tested and documented), for good reasons.

 

Edit: regarding the lymphatic system, one could really extend the whole thing to a rather large lecture. The immune system is quite complicated but in this context it is important to recognize that both  systems (i.e. blood and lymphatic system) intersect and the lymph nodes is where the lymph fluid is drained into the circulatory system. Thus while the success of vaccines is ultimately determined by the actions within the lymphatic system, they can (and have to be) detected throughout the circulatory system (typically via antigen presenting cells of sorts), where they are then directed to secondary lymphoid tissue (via the lymphatic system). The antigens can also directly enter the lymphatic system, but it is not required per se.

 

Also - I'll ask again, why the perceived need to speed up the intake by a few minutes? What benefit is there from having the vaccine act instantly or over a period of an hour or 2 or even a day? 

 

 

[studiot]

1 hour ago, DrP said:

Read the replies from Studiot and CharonY.

and

 

Also - I'll ask again, why the perceived need to speed up the intake by a few minutes? What benefit is there from having the vaccine act instantly or over a period of an hour or 2 or even a day? 

 

 

It's not a question of speeding up the response - quite the reverse in fact.

You want the body to have time to react and produce the antibodies/antigens, using the blood route would be too fast for current formulations.
Vaccines and booster would need reformulation. (There are some such available).

However for very good reasons (in the UK at least) medical staff are not allowed to give intravenous substances without substantial extra training.
These reasons include.

1) IV substances are normally given over a longer time period, hours or more.

2) Some vaccines carry with them the danger of a potentially fatal anaphylactic shock reaction in the patient. This is more likely with a rapid introduction into the bloodstream.

3) Accidentally giving the wrong substance has more chance of being caught and reversed if its action is slower.

[DrP]

12 minutes ago, studiot said:

It's not a question of speeding up the response - quite the reverse in fact.

Yea - I am fine with all that  -  I was wondering why the OP thought it was important. Even if it could be speeded up somehow so that you have 'instant' immunity with a single hypospray shot I can't see the need for it outside of a Sci Fi novel. Vaccines are a prevention not a cure. Surely it doesn't matter if it takes 10 minutes or 10 days for the immunity to take effect.

Sorry - I must have been in a clicky mood yesterday afternoon and I have seemed to have used up all of my likes for the 24 hour period   +1 in spirit or until I'm back on line with a full clip again. ;-)

[koti]

Just a side note...Anti vaxers are obsessed with the concept of delivering the contents of the vaccine by needle into the body claiming that the body is incapable of getting rid of „deadly” mercury and aluminium allegedly present in the vaccines as opposed to (according to them) the body being well capable of filtering out heavy metals when ingested or breathed in.

I would ask the OP what is the reason behind the original question and why is it hard to digest the obvious answer which was given by members in this thread? 

[Carl Fredrik Ahl]

19 hours ago, studiot said:

Well the purpose of vaccines is to prepare and stimulate the human or animal immunological system - ie the lymphatic system.

This is not the blood system.

https://en.wikipedia.org/wiki/Lymphatic_system

Are you asking would put the stuff into a vein or an artery?

Arteries carry oxygen-rich blood away from the heart to all of the body's tissues. ... Veins become larger as they get closer to the heart. The superior vena cava is the large vein that brings blood from the head and arms to the heart, and the inferior vena cava brings blood from the abdomen and legs into the heart.

What are the three main types of blood vessels? - WebMD

Putting stuff into a vein or an artery will may take it to the wrong place!

Here is a readable medical publication on the subject.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287301/

Thanks for the answer. The following website that you gave to me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287301/ states "Whereas subcutaneous fat and muscle tissue contain relatively few DCs (dendritic cells), the dermis and the epidermis are densely populated by different subsets of DCs. Consequently, antigen delivery by hypodermic injection will bypass the skin's immune cells leading to less efficient vaccination". It also says that these dendritic cells processed the antigen. Why will the antigen get bypassed when there is much DCs? Wouldn't it be more affective? And how about the DC-level direct in the blood stream?

1 hour ago, studiot said:

It's not a question of speeding up the response - quite the reverse in fact.

You want the body to have time to react and produce the antibodies/antigens, using the blood route would be too fast for current formulations.
Vaccines and booster would need reformulation. (There are some such available).

However for very good reasons (in the UK at least) medical staff are not allowed to give intravenous substances without substantial extra training.
These reasons include.

1) IV substances are normally given over a longer time period, hours or more.

2) Some vaccines carry with them the danger of a potentially fatal anaphylactic shock reaction in the patient. This is more likely with a rapid introduction into the bloodstream.

3) Accidentally giving the wrong substance has more chance of being caught and reversed if its action is slower.

Why is this except that it's good if the person can't handle the vaccine? Why can the body get into shock if it's taken up fast?

[Prometheus]

1 hour ago, studiot said:

However for very good reasons (in the UK at least) medical staff are not allowed to give intravenous substances without substantial extra training.

Less substantial than you might hope, but that's an entirely different thread...

 

[studiot]

3 hours ago, koti said:

Just a side note...Anti vaxers are obsessed with the concept of delivering the contents of the vaccine by needle into the body claiming that the body is incapable of getting rid of „deadly” mercury and aluminium allegedly present in the vaccines as opposed to (according to them) the body being well capable of filtering out heavy metals when ingested or breathed in.

I would ask the OP what is the reason behind the original question and why is it hard to digest the obvious answer which was given by members in this thread? 

 

This, of course, may be because the the ignorant do not have any understanding of vaccination chemistry and immunology.

Quote

British National Formulary

Tetanus vaccine contains a cell-free purified toxin of Clostridium tetani adsorbed on aluminium hydroxide or aluminium phosphate to improve antigenicity.

 

Would you rather have this injected or C. tetani?

 

 

2 hours ago, Prometheus said:

Less substantial than you might hope, but that's an entirely different thread...

 

Not sure what you mean but imagine the following (real world) scenario.

You have 200 patients to innoculate at your morning session.

You can either

1) Choose the conventional intra msucular quick in and out routine

Next patient
Roll your sleeve up
Jab
Hold this pad against your arm, you may go straight home or sit down outside for 5 minutes first.
Next patient

2)

Find space for 200 number 1 - 2 hour drips. (Hire the local hall ?)
Set each patient up with the IV drip (what about the difficult ones?)
Remove the IV drip after the alloted time period
Continue to monitor each patient for at least a further hour in case of any complications before discharge.

 

2 hours ago, Carl Fredrik Ahl said:

Thanks for the answer. The following website that you gave to me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287301/ states "Whereas subcutaneous fat and muscle tissue contain relatively few DCs (dendritic cells), the dermis and the epidermis are densely populated by different subsets of DCs. Consequently, antigen delivery by hypodermic injection will bypass the skin's immune cells leading to less efficient vaccination". It also says that these dendritic cells processed the antigen. Why will the antigen get bypassed when there is much DCs? Wouldn't it be more affective? And how about the DC-level direct in the blood stream?

Why is this except that it's good if the person can't handle the vaccine? Why can the body get into shock if it's taken up fast?

 

Some injections are sub dermis, some are deep muscle for these reasons.

Do you understand how and why a vaccine works?

How fast do you think a bee sting allergy or peanut allergy operates? They can kill.

 

Dr P was quite right about the timescale why do you think that is?

Further some vaccines are only available as oral preparations (eg Cholera)
 

Some are injecton only (eg Tetanus)

and some are both (eg Typhoid)

Source :  BNF 74

 

Edited April 25, 2019 by studiot

[Prometheus]

1 minute ago, studiot said:

Not sure what you mean but imagine the following (real world) scenario...

The point was an off-topic remark about the quality of teaching in the NHS - i feel i earned the right to moan a bit after more than 10 years in the NHS and some truly awful training (foremost IV administration training). 

 

[studiot]

7 minutes ago, Prometheus said:

The point was an off-topic remark about the quality of teaching in the NHS - i feel i earned the right to moan a bit after more than 10 years in the NHS and some truly awful training (foremost IV administration training). 

 

And did you ever give or witness an intravenous vaccination in that time?

Edited April 25, 2019 by studiot