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Phuket kicks off AstraZeneca booster shots using under skin method


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PHUKET (NNT) - Phuket today launched its booster shot campaign, for the benefit of those who were vaccinated earlier with two doses of Sinovac. The campaign is being conducted using the ’under the skin’ method of vaccination, instead of injecting into muscle, as is done with AstraZeneca jabs.

 

Doctors will vaccinate around 200,000 residents and those people living on the island without the house registration, aiming to complete the process by the middle of October. When done, Dr. Withita Changaium, Deputy Director of Vachira Phuket Hospital said a second group consisting of migrants and foreign residents will be inoculated.

 

The subcutaneous, or under-the-skin injection is method used in this latest campaign, replaces vaccination into muscle, with only 10-15 minutes of observation needed following the jab, instead of the previous 30 minutes, as acute side effects, such as low temperature, exhaustion, and headaches are less likely than in the conventional method, with an equivalent immunity boost, based on scientific research,

 

The subcutaneous injection will allow doctors to administer approximately four times more shots of vaccine than in the conventional method, speeding up the prevention of the Delta variant,Dr. Withita says.

 

The island is the only province in Thailand with an 80-100% vaccination rate, the highest vaccination rate in the country, as it is the pilot area for the "Phuket Sandbox" scheme that welcomes fully-vaccinated international tourists.

 

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3 minutes ago, Bkk Brian said:

Here is the link for your find. https://pmj.bmj.com/content/97/1148/400

 

So why is Phuket doing this when there is no international evidence this works for covid vaccines in fact according to the article it advises against this method.

Exactly Brian, where is the evidence and trial data to support this methodology and on who's recommendation?   I'm really surprised that there hasn't been concerns raised, particularly from the Thai medical community.

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35 minutes ago, pagallim said:

I'll just leave this here from the British Medical Journal.....

 

Like most other vaccines, the COVID-19 vaccine should be given intramuscularly.   Muscles have good vascularity, and therefore allowing injected drug to reach systemic circulation quickly, bypassing the first-pass metabolism.   Intramuscular injection of the deltoid muscle should be given along a line drawn vertically downwards from the mid acromion.   

 

The manufacturers advise that the vaccine should not be injected intravascularly, subcutaneously or intradermally. Injecting a vaccine into the layer of subcutaneous fat with poor vascularity resulting in slow mobilisation and processing of antigen leading to vaccine failure.  The antigen may take longer to reach the circulation after being deposited in fat, delaying presentation to T and B cells that are essential for immune response. In addition, there is a risk that the antigens may be denatured by enzymes if they remain subcutaneously for prolonged period. Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess.

 

The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly.   Subcutaneous injection can happen inadvertently, affecting efficacy of vaccination and potentiate local adverse events.   It is vital importance to reinforce intramuscular injection training with competency assessment at intervals in order to maximise efficacy and maintain public confidence.

But Sh*tovac/pharm aren't 'vaccines'. They're just saline solution! It can be administered anywhere with the same effect. Maybe put it in a bottle and spray it into the axilla! 

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6 hours ago, pagallim said:

These scenes from Kantang, Trang (one of the southernmost provinces badly affected by the latest outbreak), this morning.   These people are queuing to receive their first Sinovac dose.  An absolute shambles of a national policy.

southern Thailand - they're not really Thai so don't deserve 

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How can the suctaneous vac process be 4X faster than the intramuscilar injection when the dose of .5ml is the same?   The under skin method is NOT recommended by WHO or the manufacturers! So why is TH risking the lives of people for no clear or positive advantage? Seems like a recipe fo disaster!

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15 hours ago, pagallim said:

I'll just leave this here from the British Medical Journal.....

 

Like most other vaccines, the COVID-19 vaccine should be given intramuscularly.   Muscles have good vascularity, and therefore allowing injected drug to reach systemic circulation quickly, bypassing the first-pass metabolism.   Intramuscular injection of the deltoid muscle should be given along a line drawn vertically downwards from the mid acromion.   

 

The manufacturers advise that the vaccine should not be injected intravascularly, subcutaneously or intradermally. Injecting a vaccine into the layer of subcutaneous fat with poor vascularity resulting in slow mobilisation and processing of antigen leading to vaccine failure.  The antigen may take longer to reach the circulation after being deposited in fat, delaying presentation to T and B cells that are essential for immune response. In addition, there is a risk that the antigens may be denatured by enzymes if they remain subcutaneously for prolonged period. Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess.

 

The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly.   Subcutaneous injection can happen inadvertently, affecting efficacy of vaccination and potentiate local adverse events.   It is vital importance to reinforce intramuscular injection training with competency assessment at intervals in order to maximise efficacy and maintain public confidence.

Hi Pagallim ,

                    If your quote from the BMJ is accurate ( no reason to suspect otherwise ) , the under the skin vaccination of 200,000 + people is not only a complete waste of time and against the vaccination procedure it is putting people at risk from the effects of using the wrong vaccination recommended method . I am truly astonished at what is happening in Phuket . The outside world ( especially the UK ) will be thinking what the xxxx are the Thai medics doing ? Any recent progress in vaccination numbers achieved has been wiped out by this event , along with any recently gained credibility . You would have thought that before taking the new under the skin method , Thailand medical chiefs would have sought endorsements from the WHO . They are becoming a laughing stock because all they are concerned about is getting as many people inoculated with anything , as quickly as possible in order to tell the world Thailand is fully vaccinated and we are open for tourists . What could possibly go wrong ? 

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16 hours ago, pagallim said:

I'll just leave this here from the British Medical Journal.....

 

Like most other vaccines, the COVID-19 vaccine should be given intramuscularly.   Muscles have good vascularity, and therefore allowing injected drug to reach systemic circulation quickly, bypassing the first-pass metabolism.   Intramuscular injection of the deltoid muscle should be given along a line drawn vertically downwards from the mid acromion.   

 

The manufacturers advise that the vaccine should not be injected intravascularly, subcutaneously or intradermally. Injecting a vaccine into the layer of subcutaneous fat with poor vascularity resulting in slow mobilisation and processing of antigen leading to vaccine failure.  The antigen may take longer to reach the circulation after being deposited in fat, delaying presentation to T and B cells that are essential for immune response. In addition, there is a risk that the antigens may be denatured by enzymes if they remain subcutaneously for prolonged period. Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess.

 

The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly.   Subcutaneous injection can happen inadvertently, affecting efficacy of vaccination and potentiate local adverse events.   It is vital importance to reinforce intramuscular injection training with competency assessment at intervals in order to maximise efficacy and maintain public confidence.

I think you're conflating subcutaneous and intradermal injection.

 

That article talks about the hazards and possible reduced efficacy of inadvertent subcutaneous injection.

 

While it does also mention that intradermal injection is not recommended by the manufacturer that's mainly because of the lack of data. Intradermal injection does not suffer from all the same drawbacks listed in that BMJ piece for subcutaneous injection.

 

The article linked to below gives the findings of a study on using the intradermal route and says that: 

 

Quote

The trial findings reveal that the fractional dose [intradermal] regimen of the Moderna vaccine is well tolerated and safe and is capable of inducing robust antibody responses in vaccine recipients. 

Intradermal administration of low-dose mRNA COVID-19 vaccine induces strong immune response, study finds

 

While that study is only available on a preprint server, it doesn't alter the fact that intradermal injections have been used with various different vaccines in the past and were found in many cases to produce robust immune responses with a reduced dose while having minimal side effects.

 

As explained in another piece about intradermal injection:

 

Quote

Vaccination through intradermal injection holds many advantages compared to other types of vaccination, such as an improved immune response to vaccine, a potential reduction of the antigen dose, and decreased anxiety and pain.

Intradermal Injection

 

However, it should be noted that it also mentions that:

 

Quote

It is a difficult technique which requires a lot of experience: the needle has to be inserted into the skin at a 5 to 15-degree angle. For that reason, intradermal injection is at present not often used for vaccination.

 

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16 hours ago, pagallim said:

I'll just leave this here from the British Medical Journal.....

 

Like most other vaccines, the COVID-19 vaccine should be given intramuscularly.   Muscles have good vascularity, and therefore allowing injected drug to reach systemic circulation quickly, bypassing the first-pass metabolism.   Intramuscular injection of the deltoid muscle should be given along a line drawn vertically downwards from the mid acromion.   

 

The manufacturers advise that the vaccine should not be injected intravascularly, subcutaneously or intradermally. Injecting a vaccine into the layer of subcutaneous fat with poor vascularity resulting in slow mobilisation and processing of antigen leading to vaccine failure.  The antigen may take longer to reach the circulation after being deposited in fat, delaying presentation to T and B cells that are essential for immune response. In addition, there is a risk that the antigens may be denatured by enzymes if they remain subcutaneously for prolonged period. Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess.

 

The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly.   Subcutaneous injection can happen inadvertently, affecting efficacy of vaccination and potentiate local adverse events.   It is vital importance to reinforce intramuscular injection training with competency assessment at intervals in order to maximise efficacy and maintain public confidence.

No wonder the British do not recognize and approve Thai vaccinations at all.

If a country's medical experts (here) recommend and do against manufacturers advise only to save money... Yes, according to other news, it's "allow" them to give less of vaccine quantity in each jab.

Might be correct, but personally I would wait for FDA approval for such process and not university staff at any country.

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16 hours ago, pagallim said:

I'll just leave this here from the British Medical Journal.....

 

Like most other vaccines, the COVID-19 vaccine should be given intramuscularly.   Muscles have good vascularity, and therefore allowing injected drug to reach systemic circulation quickly, bypassing the first-pass metabolism.   Intramuscular injection of the deltoid muscle should be given along a line drawn vertically downwards from the mid acromion.   

 

The manufacturers advise that the vaccine should not be injected intravascularly, subcutaneously or intradermally. Injecting a vaccine into the layer of subcutaneous fat with poor vascularity resulting in slow mobilisation and processing of antigen leading to vaccine failure.  The antigen may take longer to reach the circulation after being deposited in fat, delaying presentation to T and B cells that are essential for immune response. In addition, there is a risk that the antigens may be denatured by enzymes if they remain subcutaneously for prolonged period. Subcutaneous injections can lead to localised cellulitis, granuloma formation and abscess.

 

The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly.   Subcutaneous injection can happen inadvertently, affecting efficacy of vaccination and potentiate local adverse events.   It is vital importance to reinforce intramuscular injection training with competency assessment at intervals in order to maximise efficacy and maintain public confidence.

This report as posted basically says all that we need to know about the practice of Subcutaneous Injections of the vaccines,

I guess the AZ are doing research on this method of inoculation using their Vaccine, and that is why they seem to be very silent upon the matter.

Research, and Data, need time to be taken in achieving the correct knowledge, and that could also be a reason for AZ,s silence,

It is not just the method of administration that  AZ will be surely looking at, but also the massive reduction in Vaccine amount being given in any one shot.

 

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1 hour ago, wensiensheng said:

Madness. There is no medical basis for this.

I could not agree with you more.

This program of Vaccination against all recognized methodology and manufacturers recommendation, that is now being undertaken in Phuket, will definitely shine a very bright spotlight onto the entire Thai Medical Profession.

This practice is just not unethical, its Dangerous, as there have not been any Clinical Trials Etc undertaken to ascertain the Safety of the Practice.

And Safety should be the paramount consideration, not costs.

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Well if people were not vaccine hesitant before, they will be now.   Surely the consent form they are signing must include the fact that this is being administered against the advice of the manufacturer?    

 

If the people getting the jabs administered in this way get the same certificate and "proof of jab" as those who had it administered according to the manufacturers recommendations then I presume that not a single country on the planet will accept what we have as "proof" for being jabbed when it comes to travel.   As someone who cannot mentally cope with being quarantined for even 24 hours, this is very concerning.   

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19 hours ago, snoop1130 said:

with an equivalent immunity boost, based on scientific research,

My guess is that scientific research is equivalent to a Thai university conducting a small lab study to effect positive political results (use less vaccine and address vaccine shortages).
Mix and match and subcutaneous injections - all "scientific" they say.

Were the results and new techniques peer reviewed and given the green light by the vaccine manufacturers - you know - the people who actually developed the vaccines?  How about peer reviewed by the global scientific communities?  My guess - probably not.  I sounds like this is all done in-house with the rationale of side-stepping real vaccine shortages.
This is the problem with Thailand's approach.  Universities which support their political-class's political agendas and then call in "science." 

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2 hours ago, Cake Monster said:

This program of Vaccination against all recognized methodology and manufacturers recommendation, that is now being undertaken in Phuket, will definitely shine a very bright spotlight onto the entire Thai Medical Profession.

Globally?  This is where it ends up going.  Other countries will simply not accept vaccines that have been administered in Thailand as mix and match and subcutaneous injections are both not recognized methodology globally nor are they in line with the vaccine developers recommendations. 
 

 

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