Aspiration During Vaccination: Evidence for SARS-CoV-2 Vaccination

Do we ignore the facts because of unfounded guidelines? (Review article)

Abstract

Aspiration has always been performed during intramuscular vaccine injections to ensure that the needle does not puncture one of the blood vessels. However, at the beginning of the twenty-first century, this procedure became debatable.

Using an advanced search builder and logical operators, we searched the PubMed database for all articles about aspiration guidelines. The deltoid blood vessels are large and diverse, with potentially dangerous changes occurring in certain groups such as athletes or people with connective tissue diseases. The pharmacokinetics and reported side effects of improperly applied vaccines differ. Some reported vaccine-related injuries, such as subacromial bursitis, can be avoided by using the aspiration technique. We discussed experiments that provide evidence that intravenous administration of mRNA vaccines can cause myopericarditis. Aspiration during vaccination is not technically demanding and does not require much time. Previous arguments against aspiration were based on efforts to make the procedure of vaccinating children less painful. In response to public concern about vaccine-induced thrombotic thrombocytopenia as a possible side effect, Denmark issued a guideline on mandatory aspiration during vaccination in March 2021.

Guidelines vary by country, and there is a need for an updated and globally applicable instruction manual. Countries should carefully document vaccine side effects so that they could be compared between countries that aspirate and those who do not. More focused research experiments are needed to determine the relationship between aspiration and side effects. We propose a randomized study to compare the effectiveness of aspiration.