GREGORY A. POLAND, M.D.
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To the editor: I wish to draw the attention of readers to a persistent error in Cecil's Textbook of Medicine, including the newest edition released this month (1). Table 17-2, "Commonly Used Active Immunizing Agents in Adults," states that influenza vaccine should be given annually by the subcutaneous route. Although some research has been done on subcutaneous delivery of influenza vaccine, this is not the established route. Recommendations are now uniformly for intramuscular injection to insure optimal antibody levels. (2-4). Unfortunately, influenza vaccine given subcutaneously may not be as immunogenic and may have greater associated side effects. (5; Unpublished data.
POLAND GA. Influenza Vaccine. Ann Intern Med. ;108:495. doi: 10.7326/0003-4819-108-3-495_1
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Published: Ann Intern Med. 1988;108(3):495.
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