Echographic measurement of skin thickness in sites suitable for intradermal vaccine injection in infants and children

Intradermal vaccination using the novel microneedle device MicronJet600: Past, present, and future

“…110 In addition to having a low response to vaccination at a young age (below 6 months), 111 the pediatric population also poses specific mechanical challenges, due to their thin skin, making them unsuitable for immunization with certain delivery technologies. 112 However, the MicronJet600 device was recently utilized in a large Phase III inactivated polio vaccine (IPV) study in 6-14 week-old infants sponsored by the US CDC and the International Center for Diarrheal Disease Research, Bangladesh (icddr, b) (NCT01813604). The device performed very well in this setting (publication in preparation).…”

Skin thickness in young infants and adolescents: Applications for intradermal vaccination

“…Regarding age-related change in skin thickness in infants and children, a previous study found that average deltoid skin thicknesses generally remained at around 1.22 mm in infants and children aged 4-66 month [11]. In contrast, another study showed that mean (SD) skin thickness at age 2-3 years, 4-10 years, and 11-13 years was 1.18 (0.22) mm, 1.50 (0.49) mm, 1.56 (0.36) mm, respectively, in the forearm and 1.48 (0.26) mm, 1.72 (0.73) mm, and 1.97 (0.31) mm in the interscapular region [21].…”

“…In a previous study [11] the skin of French infants was investigated at 4 anatomical sites: deltoid, suprascapular, upper back and lumber area. We selected deltoid and suprascapular area, not thigh area because of the following reasons.…”

“…Skin thickness was evaluated at the deltoid and suprascapular regions, and body weight and height were measured to assess the association between these anthropometric variables and skin thickness. The reasons why the skin regions were selected were previous literatures evaluated the two sites [10,11], and the regions were recommended as ID vaccination site by World Health Organization (WHO) [12]. In addition, it is valuable to compare our results with the previous results from other countries.…”

Effective use of transdermal drug delivery in children

“…It was suggested that lowering the flow rate, addition of hyaluronidase, and increasing the MN size to reduce the infusion pressure would improve the acceptability of the approach. Another investigation in 384 (4-66 m) children has evaluated skin thickness (epidermis + dermis) at four different body sites (deltoid, suprascapular, upper back and lumbar area) considered suitable for intradermal vaccine injection [200]. Skin thickness did not depend upon age, gender, BMI, and phototype, but was significantly higher (a) at the suprascapular area (1.30 mm) than the deltoid (1.22 mm), and (b) on the upper back (1.39 mm) than the lumbar area (1.31 mm).…”