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. Where delivery or performance dates are stated by VWR these are estimates only and time is not of the essence; however, if VWR needs to change such dates it will do so only after providing information to the customer and having regards to the customer’s stated objectives. CADTH is not responsible for any errors, omissions, injury, loss, or damage arising from or relating to the use (or misuse) of any information, statements, or conclusions contained in or implied by the contents of this document or any of the source materials.

One randomized controlled trial was included in this report comparing skin preparation to no skin preparation prior to injection. No relevant cost-effectiveness studies or evidence-based guidelines were identified regarding preparing the skin for injection.This is the first RCT to specifically examine the effect of alcohol swab skin cleansing on the incidence of local skin reactions and infection in children undergoing vaccine injections. We found no evidence of a difference in the rate of local skin reactions and no cases of cellulitis or infectious abscess when alcohol swabs were and were not used” (pp997) 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 Liability Authorisation will be subject to the condition that the products are returned to VWR Customer Service Centre or to the manufacturer or other source and by the method advised by VWR. 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

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. Price on application’ (POA) quotations and all other quotations do not constitute offers and will be valid for 30 days from the date of the quotation, unless otherwise notified by VWR.The purpose of this report is to summarize the evidence regarding the clinical effectiveness and cost-effectiveness of skin preparation prior to injections. Evidence-based guidelines regarding preparing the skin for injection will also be sought. Authorisation to return products damaged during delivery must be requested within 3 days of delivery. VWR has the right to repair and return damaged products. These terms and conditions cover all sales of products and services by VWR International Ltd (VWR) in the United Kingdom and any information and advice given whether charged for or not, unless otherwise agreed by VWR in writing. These terms and conditions apply to the exclusion of any other terms submitted by the customer or which are implied by any trade, custom, practice or course of dealing. Customer Accounts