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Immunizations by Jet Gun

Boot Camp, Paris Island 1968

UPDATE 2009 - THE VA HAS RECOGNIZED IMMUNIZATIONS BY JET GUN AS A CAUSE OF HEP C - follow the link to the right for more information.


THE ASSISTANT SECRETARY OF DEFENSE
WASHINGTON, D.C. 20301-1200
HEALTH AFFAIRS


Honorable Alan B. Mollohan
United States House of Representatives
Washington, DC 20515-4801

Dear Congressman Mollohan:

JUL 9, 1998

Thank you for your letter dated June 1, 1998, regarding Mr. [constituent name deleted] concerns about the use within the Department of Defense (DoD) of jet injectors for immunization.

We have no evidence that service members have acquired bloodborne infections (such as hepatitis B, hepatitis C, or human immunodeficiency virus) as a result of DoD's use of jet injectors. Concerns about the safety of jet injectors, however, have prompted us to discontinue the routine use of jet injectors within DoD. We are very interested in the development of new multi-dose, needle-free injectors that have no risk for transmission of bloodborne infections.

Hepatitis B, hepatitis C, and human immunodeficiency virus infections do occur among military members but at rates that are lower than those seen in civilian populations of the same age. Risk factors for acquiring these infections include: injecting illegal drugs (low in the military because of drug screening); unsafe sexual practices, including having multiple sexual partners; receiving blood transfusions in the years before donated blood was tested for these infections; and occupations, such as health care, involving exposure to blood and body fluids.

Jet injectors that use the same nozzle tip to vaccinate more than one person have been used worldwide since 1952 to administer vaccines when many persons must be vaccinated with the same vaccine within a short time period. The jet injector developed and most widely used by the military has never been implicated in transmission of bloodborne infections. However, there is concern that use of jet injectors may pose a potential risk for translating bloodborne infections to vaccine recipients. In 1985 there was an outbreak of hepatitis B caused by non-standard use of another type of jet injector in a civilian weight loss clinic. Laboratory studies in Brazil and the United Kingdom suggest that bloodborne transmission theoretically could occur with use of jet injectors. Recent U.S. Centers for Disease Control and Prevention and World Health Organization reviews of these issues highlight that worldwide jet injectors have been generally considered safe and effective for delivering vaccines if used properly by trained personnel. Both organizations, however, strongly encourage the development of new multi-dose, needle-free injectors with no risk of transmission of bloodborne infections.

Although DoD has used jet injectors for many years, a DoD Medical Quality Assurance System Device Alert on December 9, 1997, recommended that use of all jet injectors be discontinued. This action was taken in response to a letter from Ped-O-Jet International, the manufacturer of the jet injector product most commonly used in DoD. The manufacturer notified us that they were discontinuing producing and servicing their product. Although their product never had a reported case of cross- contamination and has had an exemplary record, they "strongly urged the Armed Forces to discontinue use of the product" until studies conclude that no risk is present for bloodborne disease transmission. The Armed Forces Epidemiological Board (AFEB), a civilian scientific advisory board, reviewed DoD's action to discontinue use of jet injectors within the Department. The AFEB noted the highly probable safety record of the use of jet injectors in the military, but found that "there are no current data to counteract the current recommendation that jet injectors not be used within the DoD for routine immunization."

We hope that this information has been informative. Thank you for your continued interest in the health and welfare of the men and women in uniform who serve our Nation.

Sincerely,
Dr Sue Bailey

 

Fort Dix, Winter 1968
For more information, visit:

HEP C from Jet Gun