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.
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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.
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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
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Fort Dix, Winter 1968
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