As Registered Nurses we are veterans of administering many hundreds, if not thousands, of intramuscular injections. So, we have the appropriate knowledge to raise a significant concern with the current, possibly faulty, practice of covid vaccine administration, and to suggest that this is a factor in the litany of injuries and deaths reported via the Yellow Card pharmacovigilance system.
After the standard nursing school practice on oranges, one of us (NM) had an unfortunate experience with his first human recipient. On a medical ward, he drew up the drug from the vial in the treatment room, under a staff nurse’s supervision. He then carried a foil tray with loaded syringe to the patient’s bedside, the contents shaking due to his nervousness. He wiped the injection spot on the man’s upper arm with an alcohol swab and then, with a motion like throwing a dart, smoothly entered the muscle.
As taught, NM pulled back slightly on the plunger. This process, called aspiration, was aimed at creating a negative pressure in the chamber of the syringe to see if the needle had inadvertently entered a blood vessel. Unfortunately, the fluid in the syringe began to change from clear to red indicating that the needle had entered a blood vessel. “Withdraw the needle,” instructed the staff nurse. NM did so, and the poor patient wondered what was happening. After reassuring the patient, the nurse prepared and injected another shot. Afterwards, she told NM that he had been incredibly unlucky to have entered a blood vessel. The chances of this happening are like an artillery gun firing at the thin line of an enemy trench from five miles away… and hitting the target.
For a good explanation of why aspiration in intramuscular injection is so important see nurse educator and popular covid commentator Dr. John Campbell on this YouTube video (at approximately eight minutes). You have to make sure the injected fluid is in the muscle tissue as opposed to the bloodstream because the substance is intended for gradual release (typically over two or three hours, but much longer for some drugs) from the capillaries of thick muscle tissue. If inadvertently going directly into the bloodstream, the drug could cause shock or more serious injury. This may be just as important when injecting a vaccine, yet the covid vaccines are being given without this safety procedure.
During the unprecedented rapid mass vaccination programme for COVID-19, approximately 13 billion jabs have been administered worldwide and continue to be administered at a rate of 1.88 million daily. One of us (RW) is the recipient of two doses of a Covid vaccine and, not being squeamish, watched closely on both occasions the needle puncturing his arm and the contents being introduced without aspiration. Surprised by this, he asked a senior colleague involved in the Covid vaccine rollout whether those administering the vaccines were being trained to aspirate. He replied with a clear negative.
Indeed, the recent guidance as promulgated in an Elsevier Clinical Skills Today update of November 2022 – specific to influenza vaccines but mentioning Covid vaccines in that light – states that “aspiration before injection and slow injection of the medication are not supported by research for vaccine administration”, adding that for other intramuscular medication “there is no evidence to either support or abandon the practice of aspiration before administration”. This approach is supported in a systematic review of IM injection techniques.
We suspect expedience here – the rush to inject whole populations as quickly as possible. The risk of direct entry to the bloodstream is undeniable. COVID-19 vaccines, particularly the mRNA type, are specifically designed to work within the muscle cells where they are administered. Purportedly, mRNA vaccines are using the protein synthesising system of muscle cells to produce COVID-19 spike particles, which then raise antibodies to the spike protein, thus conveying immunity against infection by the virus. According to the CDC:
The Pfizer and Moderna vaccines work by introducing mRNA (messenger RNA) into your muscle cells. The cells make copies of the spike protein and the mRNA is quickly degraded (within a few days). The cell breaks the mRNA up into small harmless particles.
So, what are the risks if the Covid vaccines, especially the Pfizer or Moderna mRNA based vaccines, are introduced directly into the bloodstream? Simply, they do not start to work where they are supposed to work. Instead, they take a journey through the 60,000 miles of the cardiovascular system (you read that correctly). In other words, the vaccine can end up anywhere in the body which means that it can end up somewhere specific – the heart – where it potentially causes damage up to an including sudden death.
Every tissue of the body has a microcirculation of capillaries, the radius of which is the same as the diameter of a red blood cell (~8 microns or 0.008 millimetres) and these are easily blocked and damaged. This does not usually lead to immediate problems as many tissues have alternative routes whereby blood can circulate (anastomoses). The heart does have such entities, but they generally develop if there is gradual damage to the heart, such as atherosclerosis. They are not good at responding to rapid events such as sudden blockage of a blood vessel.
It is well within the bounds of possibility that if an mRNA vaccine reaches the microcirculation of the heart, it enters the myocardium (heart muscle) and starts using the muscle cells to manufacture Covid spike proteins. After all, in the wake of the Covid vaccine rollout, precisely the same technology has been used to introduce mRNA into the myocardium with the aim of instructing the heart muscle to repair itself following a heart attack. A Covid mRNA vaccine lodging in the myocardium could trigger either a local immune reaction leading to a local inflammatory response (myocarditis and/or pericarditis) which is an essential part of the immune response. We already know that this is happening as an acknowledged adverse effect of the Covid vaccines. Alternatively, a blood clotting cascade could be triggered that could occlude these vessels leading to a heart attack and death.
What we present above is theoretical. We do not know if this is what is happening, but it is of some concern that nobody knows. (If they do, they’re not telling us.) Our argument is hypothetical, but it’s possible that inadequate safety in vaccination practice may be a factor in injuries and deaths. The extent of harm caused by injection into the bloodstream is unknown, but unlikely to be zero. Although the risk of hitting a blood vessel is small, the sheer scale of the vaccination regime means that the number affected could be in the tens of thousands. Referring to the hasty rollout of the COVID-19 vaccines, Paul Thacker wrote in the BMJ of November 2nd 2021 that “speed may have come at the cost of data integrity and patient safety”.
We would extend that concern to the point of delivery.
Professor Roger Watson and Dr. Niall McCrae are Registered Nurses.
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