Pre-injection Alco Swabs, Pack of 100

Product Information

VWR may at any time, without limiting any other rights and remedies that it may have, set off any amount owing to it by the customer under the contract against any amount payable by VWR to the customer (whether under the contract or a separate agreement). Delivery

the total liability of VWR for any loss or damage suffered by a customer in connection with the supply of the products under this contract is limited to the invoice price of the products in relation to which loss or damage is claimed. Inclusion criteria: Healthy children aged zero to 18 years who qualified for vaccination in accordance with the Ontario Immunization Schedule were eligible. Follow-up telephone surveys were available for 99% (168/170) on Day 1, 99% (168/170) on Day 5, and 94% (160/170) on Day 14 postvaccination VWR shall under no circumstances whatsoever be liable to the customer (whether in contract, tort (including negligence), breach of statutory duty or otherwise), for any loss of profit, or any indirect or consequential loss arising in connection with the supply of products under this contract; and In view of the wide range of uses of chemicals and apparatus, the customer will be solely responsible for determining the suitability and specification of products, services, information and advice for its purposes.The reporting of the RCT was considered well done overall, with a clear description of the objective, patient eligibility criteria, inventions and controls. The outcomes were described; however, most of the outcomes were reported by the parents of the patients (except cellulitis and infectious abscesses which were diagnosed by a pediatrician) rather than an objective assessment of the outcome by a health professional. This subjective approach to reporting outcomes may bias the outcomes; though the authors noted that this would not introduce differential reporting between groups. As patients and the parents were blinded to the treatment group, they would unlikely be influenced differently between groups in their outcome reporting (i.e., the assessment of outcomes is equally flawed across groups). The study reported that approximately 20% of diaries were not returned by parents which may impact the validity and interpretation of results. Furthermore, the authors undertook a post-hoc analysis for both groups regarding the duration of local skin reaction and this analysis was considered justifiable as this outcome was unspecified before the data was seen. 8

VWR shall provide services to the customer in accordance with the specification agreed between them from time to time. Such services will be provided with all reasonable care and skill.

Evidence from the randomized-controlled trial suggested that alcohol swabbing does not reduce local skin reactions prior to vaccination. The study had reasonable attempts at blinding where possible and described the main outcomes, recruitment process and overall results. There were no statistically significant differences between the alcohol swab group and control group for delayed pain, redness, swelling and warmth to touch while there were no reported cases of cellulitis and infectious abscesses. Post-hoc analysis showed that the duration of pain was statistically significantly higher in the alcohol swab group compared to the control group although the clinical significance of this outcome not discussed by the authors. The study was underpowered to detect differences in the primary outcome of skin infection and instead focused on the differences of local skin reaction between groups. Therefore, the study did not answer the primary outcome and a larger sample size is needed to detect whether alcohol swabbing does reduce the risk of infection. While the authors report that this is one of the first studies to report on the effectiveness of alcohol swabbing prior to vaccinations, it is difficult to draw definitive conclusions from a single trial. 8 Additionally, the study was described as being partially blinded with the all participants, parents and pediatricians (administering the injections) being blinded, though the clinic-based research assistant who performed the skin preparation for both intervention and control groups was not blinded. The choice of unblinding the clinic-based research assistant who performed skin preparation was considered justifiable as it may not have been possible to blind the individual performing this task. As this was the only unblinded person in this study, the risk of bias was. Nevertheless, the same clinic-based research assistant who performed the skin preparation also interviewed the parents post-vaccination for the results. This may bias the study results as the clinic-based research assistant’s knowledge of treatment group allocation for each patient may have affected the reporting of results. Additionally, the randomization and allocation were clearly defined in the study protocol and both groups were followed up for the same amount of time. This reduces selection bias and the influence of confounding variables in the study and strengthens the internal validity (the extent to which the study supports a claim about cause and effect) of the study. 8

If VWR’s performance of the services is prevented or delayed by any act or omission of the customer, VWR shall without limiting its other rights or remedies, have the right to suspend performance of the services until the customer remedies the position and VWR shall not be liable for any losses or costs arising from such delay. Health, Safety and LiabilityVarious health organizations including the WHO, 1 United Kingdom’s Department of Health, 4 and Australia’s Department of Health 5 have stated that if the skin is visibly clean, disinfecting the skin (or alcohol swabbing) is not necessary and does not reduce infection. To the contrary, the Public Health Agency of Canada 6 advises the practice of cleaning the skin with a suitable antiseptic solution prior to vaccination or injection. Hence, there is ongoing debate whether the continued use of alcohol swabbing is clinically necessary and effective for routine injections or vaccinations.