SARS-CoV-2/COVID-19 immunisation concerns

As many of you know, although now retired, I was formerly a medical professional on several levels over the past 45 years, involved principally with cardiovascular and pulmonary medicine, but also across a range of other areas of medical involvement. Back when I was serving in the US Air Force (during the Vietnam War era), I began my medical career as an Air Force medical service specialist who went through all the basic and advanced medical training programs that all military service ‘medics’ (corpsmen) undergo. Much later, I attended Antioch College as an undergrad in the academic field of health services administration, although I ultimately realised that American health care management was most definitely NOT a field I wished to be professionally employed in. After the HMO movement swept all private medical practice traditions largely under the rug and became the monstrous conglomerates that corporate health has morphed into today, this last awareness became all too clear! Somewhat after that I became involved in the area of medical defense against chemical and biological threats for a number of years.

My point here is that I know a thing or two about a great many aspects of health care, spanning a number of medical and health care inter-disciplines. Thus, in the course of following the ‘fielding’ processes that have produced the COVID-19 serums presently approved for use in America, I have been both keenly interested in and somewhat alarmed by the haphazard hastiness of ‘Project Warp-Speed’ that finds the first vaccines now being actively administered to the public in a breathtakingly brief period of time.

It is clear enough that in its urgent concern over getting vaccines to the public (i.e. ‘immunisation programs’ and vaccine administration), our public health agencies responsible for coordinating actual vaccine immunisations are cutting corners in some rather concerning ways. This trend seems to reach to and also stem from incompetence at the highest levels of our government, sad to note!

One of these ‘cut corners’ consists of drafting a varied mix of people with some or partial medical backgrounds to serve as the clinical vaccine injection functionaries. Thus, instead of highly trained MD, RN or LVN/Technologist personnel being employed to give the injections, the vaccine delivery programs that have been set up are now using a great number of inadequately trained people to inject people who demonstrate (to me, at least) a sorely ‘incomplete’ knowledge of a subject as utterly simple and basic (and yet vitally important) as ‘how to safely perform intradermal or intramuscular injections.’

You can see the evidence of this with your own eyes every evening on the local and national news media reports about the vaccine rollout, typically consisting of a million and one video clips, played largely over and over (it’s visual background ‘filler material’, of course) of some ‘health care worker’ at an immunisation clinic jabbing a needle into someone’s arm.

It should be noted here that all influenza injections are of the what we call ‘intra-muscular’ type (not the more common ‘intra-dermal’ types most people are used to receiving in a doctor’s office). These injections are typically given to dense, large muscle masses (such as the dorsogluteal of the ‘butt’…and the arm’s deltoid muscle on the upper, outer arm). And although these sites are theoretically clear of major veins and arteries, standardized medical (clinical) practice requires that after locating the correct insertion site, the needle on the syringe is inserted at a 90 degree angle to the external surface of the upper arm with a rapid, but preferably smooth motion.

The next procedural step of an intramuscular injection (which is NOT being done; carefully watch all those media news clips that show the vaccines being administered!) is to pause, with the needle in situ, and slightly aspirate the syringe (pull the plunger backwards just the slightest bit). That is, a slight back-pressure is applied to the syringe’s plunger to determine whether or not, by some fluke, the needle has ended up in a vein!

You do NOT want, you see, to inject influenza anti-viral vaccine directly into a blood vessel. The whole purpose of an intramuscular injection is to place the vaccine into a large muscle mass where it will be absorbed at a slower and more uniform rate. Injecting a vaccine of this type directly into a blood vessel can cause some very serious side-effects and reactions, hence the ‘aspiration’ step. [Noting reports of some ‘reactions’ to the vaccines that have been circulated, and being aware of this lack of proper injection technique by so many ‘hastily employed’ immunisers, I am not especially surprised.]

It absolutely appalls me to watch all those media news video clips showing the COVID-19 vaccine immunisations being injected without first aspirating (directly after placement of the needle) to be assured that the needle has not been inadvertently placed in a blood vessel! And yet, I have only personally seen one or two COVID-19 vaccine injections being done competently, properly and CORRECTLY, in the several dozens of media video clips showing patients being given the vaccines in clinic settings, that I have watched.

For someone like me, that is a VERY telling and also disturbing further indication of the total chaos that characterises America’s imprudence in not just not fully training ALL those who inject this newly developed vaccine clinically, using the proper technique, but putting into effect what can be easily witnessed and regarded as a horribly mismanaged immunization effort, across the country!

Naturally the United States is a very large country with an equally large population, a set of logistical circumstances that immeasurably complicates any ambitious program such as the COVID-19 immunisation activity that is presently underway. All the more reason why complete and comprehensive contingency plans should have long ago been set up, capable of being instantly put into operation smoothly and efficiently, and long before the actual need for such a major health care crisis requiring them might arise.

The semi-chaotic and confused lack of any ‘standardised’ immunization plan to carry out mass immunisations I cite here is merely further damning evidence of the total lack of due diligence and normative prudence that characterises America’s health care establishment failure to both anticipate and meet the easily anticipated needs of its people, over the past several decades. After all, it’s not as if a number of astute, prescient health authorities all failed to recognise the distinct possibility of another 1918 ‘Spanish Flu’ pandemic arising. My colleagues and I have been discussing these possibilities with serious concern quite frequently in recent years!

Professional medical and CBRN (Chemical, Biological, Radiological and Nuclear) professional journals (as well as a number of books) have all been warning us about this potential debacle for many years. All to little or no avail. The result is that America has been caught (once again) with its collective pants down and this may now be added to our other many national embarrassments suffered in recent months (such as the ‘assault on the capitol’ protest occupation that has recently occurred) as, in the eyes of the rest of the world, a further failure of the vaunted American system.

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[For some further background on this mess, read my earlier paper, found here.]

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Postscript (added 5 Feb 21):

Had my periodic Tetanus Toxoid/Diptheria booster recently (which is an IM injection) and it was given me by an HMO LVN. Since she seemed to have been well-trained, I asked her about the SARS-COV-2/COVID-19 IM injection technique (mentioned above), expressing curiosity about why none of the injection team were aspirating the syringe immediately after the IM jab had been made.

I was a bit surprised to hear her reply that "...the technique has been changed in parenteral (injected) meds training courses to the extent that only 'medications' require aspiration (so as to avoid injecting into a vein or venule), whereas 'routine injections' do not require that step."

I didn't bother to ask what her definition of 'meds' included, and what differentiates 'routine injections' from 'meds', since her answer seemed to me a bit ambiguous, but I gather that the bottom line in current 'sub-professional' medical training (i.e. LVN, Licensed Nursing Aide, etc.) is that cautionary aspiration is largely no longer felt to be a necessary step in the proper administration of parenteral meds.

I intend to consult a higher authority (DoN, FHP, PA or MD) on this question, but have not yet done so. Interesting, however.