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Warning concerning accidental injection of Gudair sheep vaccine


Anastasia Tsirtsakis


24/11/2021 1:25:33 PM

SPONSORED: GPs have been reminded about the potential medical implications following unintended exposure to the Gudair vaccine.

Sheep getting vaccinated
Even a small amount of vaccine fluid can result in intense swelling and a persistent granulomatous inflammatory reaction.

GPs working in sheep producing areas around regional Australia are being encouraged to be on high alert for adverse events in patients who are exposed to Gudair – a vaccine administered to sheep, primarily at lamb marking.
 
Gudair, a vaccine containing inactivated mycobacterium paratuberculosis combined with a mineral oil adjuvant, is used to control Ovine Johne’s Disease (OJD), an incurable wasting disease.
 
Zoetis undertakes an extensive education program for all rural stores and veterinary clinics that stock Gudair, to promote the safe use of Gudair that involves correct vaccine handling and vaccination using a specialised safety vaccinator, with a safe work environment for competent and experienced personnel.
 
Nonetheless, accidental injection into humans can still occur and even a small amount of vaccine fluid can result in intense swelling and a persistent granulomatous inflammatory reaction.
 
For example, if injected into a finger joint or tendon sheath, the product may track along the tendon and as a result the swelling and inflammation may compromise blood supply and result in necrosis, and in rare cases can result in amputation.
 
To avoid severe side effects, people are advised to seek prompt medical attention.
 
Every case is different, and the correct medical advice is a matter for the treating doctor.
 
‘Doctors have found that the treatment of a human accidental self-injection case may require prompt surgical attention to remove the vaccine,’ a letter issued to regional doctors by Zoetis, the Australian distributor of Gudair, reads.
 
Zoetis is aware of the following treatment strategies being frequently recommended where needle stick injury has occurred.

Needle-stick injuries without known injection of vaccine

  • Doctors have recommended that the wound be allowed to bleed freely and that the wound or injection site not be squeezed or otherwise interfered with. Doctors have recommended that the wound then be cleaned thoroughly with warm water and then kept clean and dry
  • Doctors have also considered that, following appropriate immediate local cleansing, corticosteroids may decrease the severity of any local reaction
  • Doctors have frequently determined the patient’s tetanus immunisation status and administered a booster or primary series, as appropriate
  • Commonly, if there is no pain or swelling 24 hours post exposure, doctors have continued to monitor for at least a month and treat any clinical symptoms accordingly
If pain and swelling is present after 24 hours, doctors have considered that it is a case of accidental injection and have treated the injury as described below.
 
Needle-stick injuries with injection of vaccine
  • Doctors have observed that acute pain and inflammation is usually still evident 24 hours after the suspected injection occurred
  • In cases of self-injection, doctors have considered that prompt surgical attention has been required and, in those cases, the doctors have incised the wound to remove the vaccine, especially where there is involvement of finger pulp or tendon
    • In the case of a lesion that has progressed to necrosis or granulomatous ulceration, doctors have performed surgical debridement to remove residual vaccine material
  • Doctors have stated that meticulous technique has been required to stop inadvertent spread of the product during surgery 
Given the nature of this mineral oil-based vaccine, Zoetis recommends that any healthcare professional speak with a surgeon who has experience with the treatment.
 
Similarly, if a person is exposed to Silirum, a vaccine that contains inactivated mycobacteria and a mineral oil adjuvant, it is recommended that GPs follow the same guidance.
 
If presented with a case of accidental self-injection, GPs are advised to contact Zoetis on 1800 814 883 for further information.
 
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Gudair vaccine mycobacterium paratuberculosis


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Dr Ruth Sophie Ratner   25/11/2021 8:34:46 AM

As a city GP this sounds most unpleasant but it begs the question that if it is so horribly painful, what does the sheep feel?