Abstract
We previously investigated the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone based on measurements taken from the ultrasonic echograms of Japanese infants aged 2, 3, 4, 5, 6, and 12 - 15 months. The appropriate needle length for intramuscular injection was 16 mm (5/8 inch) in Japanese infants at any age and site. In the present study, we examined these lengths in 21 infants with physical growth from 2 to 15 months. Average height increased from 58.5 to 73.6 cm and average body weight from 5835 to 9226 g until 15 months. The circumference of the thigh increased from 22.3 cm at 2 months to a maximum of 25.9 cm at 6 months, while that of the deltoid area was 15.2 cm at 2 months and 15.9 cm at 6 months. Subcutaneous mass (length from the skin surface to the muscle fascia) at the thigh increased between 3 and 4 months and decreased at 12 - 15 months and showed good relationship to the circumference of the thigh. Subcutaneous mass at the center of the deltoid area showed the same size until 6 months. Muscle mass (lengths from the muscle fascia to the bone) at thigh and deltoid areas remained the same until 6 months. Ultrasonic echogram is an effective tool for evaluating subcutaneous and muscle mass in young infants.
Highlights
We previously investigated the thickness of the epidermis and lengths from the skin surface to the muscle fascia and bone based on measurements taken from the ultrasonic echograms of Japanese infants aged 2, 3, 4, 5, 6, and 12 15 months
Alum-adjuvanted vaccines have been used since the introduction of diphtheria and tetanus toxoids combined with the acellular pertussis vaccine (DTaP) in 1981
Pneumococcal (PCV13) and hepatitis B virus (HBV) vaccines were introduced into recommended immunization in 2010 and 2016, respectively
Summary
Alum-adjuvanted vaccines have been used since the introduction of diphtheria and tetanus toxoids combined with the acellular pertussis vaccine (DTaP) in 1981. Pneumococcal (PCV13) and hepatitis B virus (HBV) vaccines were introduced into recommended immunization in 2010 and 2016, respectively. These alum-adjuvanted vaccines are administered from two months of age [1]. They are administered intramuscularly (IM) in most countries, but subcutaneously (SC) in Japan. Muscle contracture was reported in the 1960s caused by multiple IM injections of antibiotics and antipyretics. There was no case caused by vaccine administration, but IM procedure has been prohibited. Serious local pain has been reported through SC administration, and among them some recipients exhibited local induration for several weeks [2]. All adjuvanted vaccines are administered IM worldwide without serious local reactions [3]
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