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Two-tier profession fears as standards lowered for some

The article regarding

influenza vaccination (Clinical, 15 October) was interesting and very helpful.

I was, however, unhappy to see the method of injection shown in the picture.

The plunger of the syringe appears to be fully depressed and the skin is shown as being indented, suggesting the vaccine has just been given.

Unfortunately, it is clear from the length of needle showing that it has not been inserted to a sufficient depth, so the injection is neither deep subcutaneous nor intramuscular, as is recommended by all of the flu vaccine manufacturers.

Also shown are two large drops of fluid on the patient's skin which I take are drops

of vaccine which should

have been injected into the patient.

Errors of vaccine administration are likely to make immune response poor and contribute to the failure rate of the vaccine.

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