A “shot knot” is a localized swelling arising in the area of an injection or vaccination. It is an inflammatory reaction in the tissues that can also involve a bacterial infection. These knots vary in size and can be difficult and time consuming to resolve. Many factors can contribute to this reaction and include improper injection technique and contaminated equipment. Following is a list of suggestions for reducing these reactions.
Always use a new, sterile syringe and needle for each vaccination. Avoid the back of the neck for injections – this area has thicker skin and more of a fibrous sheath around the muscles. Accidental injections in the skin layers or muscle sheath will result in more reactions. A better injection site would be over the back or rib cage. Be sure the injection goes under the skin (subcutaneously). Injections made too shallow (into the skin layer itself) or too deep (into the muscle layer below or the sheath that encloses the muscle) will often result in an inflammatory reaction.
Procedure: Pick up a loose fold of skin forming a “tent”. Insert the needle through the skin into the space formed under the “tent” (being careful not to go too shallow or too deep). Retract the plunger before injecting to check for blood entering the needle hub (indicating a vein was entered by mistake). Slowly inject the vaccine. Remove and discard the needle (in an approved “Sharps Container”) and syringe. Gently massage the area after injection to facilitate spreading and absorption of the vaccine.