Should Gloves Be Worn When Giving Allergy Shots?

A common question patients ask is whether nurses and or other medical staff be wearing gloves when giving allergy shots (or other forms of immunization).
According to the CDC:

"Gloves are not required when administering vaccinations, unless persons administering vaccinations are likely to come into contact with potentially infectious body fluids or have open lesions on their hands." [link]

As such, the practice of wearing gloves is left up to the discretion of the person administering the shot.

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Some offices/hospitals may have a policy in place that makes it mandatory, but technically it is not required.

Of course, many individuals will point out a conflicting policy based on "Universal Precautions" which can potentially be interpreted as mandatory use of barrier protection (like gloves) whenever there is the possibility of bloodborne pathogen transference (which some may interpret as risk is always present).

However, if one actually reads the Universal Precautions put out by the CDC as it relates to blood drawing (considered higher risk than immunizations),

"In universal precautions, all blood is assumed to be potentially infective for bloodborne pathogens, but in certain settings (e.g., volunteer blood-donation centers) the prevalence of infection with some bloodborne pathogens (e.g., HIV, HBV) is known to be very low. Some institutions have relaxed recommendations for using gloves for phlebotomy procedures by skilled phlebotomists in settings where the prevalence of bloodborne pathogens is known to be very low. Institutions that judge that routine gloving for all phlebotomies is not necessary should periodically reevaluate their policy. Gloves should always be available to health-care workers who wish to use them for phlebotomy." [link]

Not quite the "mandatory" use of gloves some people stipulate when quoting Universal Precautions policy.


References:
General Recommendations on Immunization. CDC 2/8/02

Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings. CDC 6/24/88

Should Gloves Be Worn When Giving Allergy Shots?

A common question patients ask is whether nurses and or other medical staff be wearing gloves when giving allergy shots (or other forms of immunization).

According to the CDC:

"Gloves are not required when administering vaccinations, unless persons administering vaccinations are likely to come into contact with potentially infectious body fluids or have open lesions on their hands." [link]

 As such, the practice of wearing gloves is left up to the discretion of the person administering the shot.

Some offices/hospitals may have a policy in place that makes it mandatory, but technically it is not required.

Of course, many individuals will point out a conflicting policy based on "Universal Precautions" which can potentially be interpreted as mandatory use of barrier protection (like gloves) whenever there is the possibility of bloodborne pathogen transference (which some may interpret as risk is always present).

However, if one actually reads the Universal Precautions put out by the CDC as it relates to blood drawing (considered higher risk than immunizations),

"In universal precautions, all blood is assumed to be potentially infective for bloodborne pathogens, but in certain settings (e.g., volunteer blood-donation centers) the prevalence of infection with some bloodborne pathogens (e.g., HIV, HBV) is known to be very low. Some institutions have relaxed recommendations for using gloves for phlebotomy procedures by skilled phlebotomists in settings where the prevalence of bloodborne pathogens is known to be very low. Institutions that judge that routine gloving for all phlebotomies is not necessary should periodically reevaluate their policy. Gloves should always be available to health-care workers who wish to use them for phlebotomy." [link]

Not quite the "mandatory" use of gloves some people stipulate when quoting Universal Precautions policy.


References:
General Recommendations on Immunization. CDC 2/8/02

Perspectives in Disease Prevention and Health Promotion Update: Universal Precautions for Prevention of Transmission of Human Immunodeficiency Virus, Hepatitis B Virus, and Other Bloodborne Pathogens in Health-Care Settings. CDC 6/24/88

Allergies May Prevent Heart Attacks???

Research has been published suggesting an inverse relationship between serum IgE and heart attacks in the US population independent of coronary risk factors.

No kidding...

This conclusion was reached based analyzing 4002 participants between 2005-2006. They also detected that of the 7 "data-driven, prespecified allergen clusters," house dust mite was the only allergen cluster for which serum IgE is associated with reduced risk for heart attack.

For those wondering, serum IgE is a rough measure of how allergic a patient is generally speaking without any specification of what the patient may be allergic to. It is obtained by bloodwork (RAST or immunoCAP).

The higher the IgE levels, the more allergic a patient is generally speaking. However, one must keep in mind that it may still be possible to be allergic even if IgE is low or vice versa.

Also, although there appears to be a relationship between IgE and heart attacks, it is doubtful it reaches clinical significance for any given patient. Rather, such conclusions may apply to a general population. This study was also retrospective and as such, it would be nice if a new study now looked at a group of allergic patients and see how many suffer heart attacks in the future.

Such un-intuitive relationships just goes to show how complex the human body is where one thing doesn't cause one problem, but rather one thing may affect multiple different aspects of human health.

Now why would IgE and/or allergies in general influence heart attack risk?

Well heart attacks are due to vascular disease (blockage of the coronary artery). Vascular disease is thought to be influenced by how much inflammation is present in the body. The more inflammation present, the higher the risk of vascular disease which in turn increases heart attack rates.

One factor thought to influence the degree of inflammation present in the body is the immune system, and allergies is one part of the immune system.

As such, allergies could be a reflection of what the immune system is doing which in turn influences the degree of inflammation present in the body which in turn affects vascular disease which plays a role in heart attacks.

Reference:
Relation between objective measures of atopy and myocardial infarction in the United States. Journal of Allergy and Clinical Immunology. In Press Aug 27, 2012.