Should an Alcohol Swab Be Used before an Injection?

At a free flu shot event at Town Hall I sat down, exposed my shoulder, and before I realised the injecterlocture (not a real word) jabbed me. I was expecting the cold feel of an alcohol swab but there was no swab. I asked the injecterlocture about the swab and he said it was "old fashioned" and that they don't do that anymore which surprised me.

Then when I was at a mass COVID vaccination centre they were jabbing people without alcohol swabs and luckily I brought my own. When I was at the Chemist for a flu shot they didn't use alcohol swabs either and I had to ask for one. It annoyed me that I couldn't purchase a small quantity of swabs. I had to buy a big box at Chemist Warehouse so I've been giving out swabs as gifts and I always carry some in my bag. They're quite useful to clean things.

I was concerned about it so I looked it up. Various papers state that there is no difference between infection rates to the injection site between swabbing and not swabbing. However, I feel safer having an alcohol swab before an injection. The hands of the person giving the injection could have been anywhere. What if they scratched their face and popped a pimple and they had hepatitis B?

My feeling is that the real reason for not using swabs is about saving money.

SHOULD AN ALCOHOL SWAB BE USED BEFORE AN INJECTION?

Sample articles are at:
https://www.researchgate.net/publication/287867934_Routine_s…
https://pubmed.ncbi.nlm.nih.gov/33074639/
https://www.ajicjournal.org/article/S0196-6553(13)00023-0/fulltext
https://www.ncbi.nlm.nih.gov/books/NBK138495/
https://hospitalnews.com/the-alcohol-swab-before-the-needle-…

Poll Options

  • 16
    Yes (I'm old fashioned)
  • 57
    No (Get with the times)

Comments

  • +13
    • Probably one of Pam's (street) cats.

      • +2

        We know it's not SlavOz as OP is getting shots.

  • +9

    Complete and utter waste of resources. Much like this question.

    • +1

      Yes I am sure those resources were redirected somewhere more essential, like some consultant's pocket.

  • +5

    I asked my doctor this - I was told are different theories some suggest swabbing before the jab is bad because it doesn't allow your own germs on the skin to work with the vaccine to do it's thing. Others believe cleaning is necessary to stop infection.

    If you ask me I think it's a cost cut strategy. I prefer the swab

  • +2

    Your research is correct - alcohol swabs are now no longer required before IM injections as the evidence for benefit is not there. The injection is given with a sterile technique and the 5 moments of hand hygiene are followed meaning the risk for infection is absolutely minimal.

    • I watch very carefully now. There is always a risk of human error in any medical procedure. Examples I've observed are a) patting the area with an ungloved finger before injection, b) dropping a vial and then picking it up and carrying on (I had to insist on a change of gloves), c) touching the pan, cushion, and other paraphernalia which are the same ones used with earlier patients, d) applying the swab and then blowing on the alcohol with their mouth (where I pointed it out and asked to be swabbed again). If it can go wrong it'll go wrong so the 5 moments of hand hygiene in practice is subject to human error. A risk which can be greatly minimised by using a swab before inserting a needle.

      There should be research done like with Mythbusters where they use fluorescent dye and then shine a blacklight afterwards to see how easily the dye was spread by touching things. There's all this talk about bacterial infection but nothing about viruses? What about highly infectious hepatitis B?

      I'm squarely in the camp of the precautionary principle. If they won't provide swabs I bring my own and ask for it to be used even if it's for reassurance. I just say I'm old fashioned. I also ensure that I bring 2 swabs. The last person opened the packet and dropped the swab in front of me.

      • There should be research done like with Mythbusters where they use fluorescent dye and then shine a blacklight afterwards to see how easily the dye was spread by touching things.

        My sister-in-law is a surgical nurse. They already perform something akin to this in hygiene training for surgery. A substance is sprayed on their hands, it is not a visible material. They have to then wash as if prepping for surgery. Having done so, hands are then placed under a UV light source, which shows any area not adequately washed. This training on her site is repeated periodical to ensure best hygiene practice.

  • +2

    … so I've been giving out swabs as gifts

    I hope people weren't receiving these 'gifts' for their birthdays or wedding anniversaries! lol

    • +11

      Goodness, I'm not a tight ass. For birthdays and weddings I give lettuce.

      • +6

        What… lettuce now? I thought it was human hair cushions? 🤣

        • Ha ha ha, someone's been following my posts. I only have enough hair saved up for 1 cushion so I'm going to save it for an extra special occasion lol

  • +1

    Swabs are not routinely used for jabs as the benefit is not there, but some of us still use them routinely purely so patient's don't freak out.

    • +1

      You need to tren harder

  • +2

    Do you also freak out when they don't put a Band-Aid on your injection spot after?

    • +1

      Special Bart Simpson Band Aid.

    • I freak out when they don't give me a sucker after the jab. Walking out without sugar after a boo boo ruins yo day.

      • What you're after, I think you're at the wrong place for it!

  • -1

    I was taught (by a hospital) to do my own subcutaneous ivig weekly which requires 4 needles into my stomach,They were adamant that i Swab each needle site….

  • No need to wipe with it - but ask nicely and they'll give it to you to suck on. Nothing like that quick medical grade alcohol to get a quick buzz before the lil prick.

    Well thats what my wife says anyway….drum roll and queue canned laughtrack

  • +4

    The alcohol swab isn't there to protect you against the germs of the administrator. If their hands get anywhere near the tip of the needle that's a serious breech of protocol.

    No, It's there to guard against the possibility of dangerous bacteria on your skin being carried into the muscle when the needle breeches the skin. If you roll around in dirt and don't wash for weeks at a time, this might be a serious issue. For most people, it's probably not.

    Add to that, the whole point of a vaccination is to stimulate the immune system, so the local area is going to be swarming with white blood cells anyway. When I got the first two jabs, my arm was hot for 3 days. Very hard for any pesky bacteria that have sneakily caught a ride to stay under the radar when the place is lit up like a stage.

  • Various papers state that there is no difference between infection rates to the injection site between swabbing and not swabbing

    I feel safer

    my feeling is

    Facts don't care about your feelings

  • Like OP, I've never had any kind of injection without the alcohol swab so hearing that they don't do it seems foreign to me but after reading comments above seems like I live in some kind of bubble neighbourhood from 10 years ago!

    Yeah I prefer a wipe before stab.

  • -1

    Too late now.

  • +2

    "Preparing the person receiving the vaccine
    Skin cleaning

    If the skin is visibly clean, there is no need to wipe it with an antiseptic (such as an alcohol wipe).

    If you use alcohol or other disinfecting agents to clean skin that is visibly dirty, the skin must be allowed to dry before injecting the vaccine. This prevents inactivation of live vaccines and reduces the likelihood of irritation at the injection site."

    https://immunisationhandbook.health.gov.au/contents/vaccinat…

  • I was concerned about it so I looked it up. Various papers state that there is no difference between infection rates to the injection site between swabbing and not swabbing. However, I feel safer having an alcohol swab before an injection

    Ok so you have confirmed they don't have to do it, it offers no value if they do.

    If you want it done, then take your own to do before they jab you.

    • He he he, you left out the defence against pooping cats.

  • Needle gauge size comes into it as well.
    Insulin + flu injections are fine size needles … and personally reckon don't/shouldn't need swabbing, unless it's clear that skin is dirty beforehand.

    For flu injections it's usually around a 25 gauge needle. Insulin injections is 29 - 31 gauge.
    Years ago, I used to get 21- 23 gauge injections … those were big suckers - bigger injection site = bigger risk of infection.

    Reading google it's interesting, as there's papers from major clinical sources (both for and against use of swabs).

    Also, reckon Covid has played a part … isopropyl alcohol has been in such short supply … it's best utilised elsewhere … lest we go back to using ethanol based (a splash of bourbon/whiskey anyone?)

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