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Sir.—In their excellent article on abscesses in children given diphtheria and tetanus toxoids and pertussis vaccine (DTP vaccine), which appeared in the September issue (Journal 1981; 135:826-828), I think that Bernier et al too hastily assumed that improper injection could be ruled out as a cause. I am sure most DTP injections are given by nurses, as they are in my office. For my 30 years in practice I have had no one but graduate, registered nurses give them and have only hired nurses with hospital experience. I naturally assumed they knew how to give this injection, but I discovered after some years that abscesses always occurred after I had hired a new nurse, and I can tell you why. Except for antibiotics, which they are usually taught to give with a 3.8-cm needle intramuscularly (IM), nurses are taught to inject all drugs with a 26- or 27-gauge 1.3-cm
ROGERS WB. DTP Vaccine Injection Technique. Am J Dis Child. 1982;136(10):953. doi:10.1001/archpedi.1982.03970460083024