Question

1. Imagine that a parent has brought their child in for a routine vaccination. They say, “Before you give my child the shot, make sure to sanitize their skin!” Should you sanitize their child’s skin? Why or why not? Make sure to show your understanding of the word sanitize in your answer.

Answer 1

The word "sanitization" in this case refers to destruction of any microorganisms present on the area of the skin where the injection will be inserted, usually with the help of 60%-70% alcohol. The role of alcohol is to mechanically remove any microorganisms and denature any vegetative bodies present of the surface of the skin in order to prevent them from entering into the layers of dermis or further along with the injection needle and causing infections.

This practice, however, is not always recommended, especially during administration of a vaccine. This is because vaccines are usually attenuated or inactivated forms of a pathogen while alcohol is a disinfectant. Mixing of the two may cause a vaccine failure as the alcohol interfers with the immunization process. For example, according to Preventive and Social Medicine Department guidelines, the site of BCG vaccination should be wiped with sterile water only and no antiseptic solution should be used for cleaning (From Indian Pediatrics, Immunization Dialogue).

Other examples for vaccines that are inactivated by alcohol include viral vaccines with glycoprotein coats (attenuated or live vaccines), such as measles or yellow fever. Also, incase of the smallpox vaccine, where the vaccination technique includes multiple punctures, the potential for inactivation of vaccine is increased.