That's true - changing needles after giving both insulin and TB skin tests is problematic, and is not done. The bottom line is: does the rubber in a stopper dull the needle. I think that the only way to tell would be a microscopic study of the needle itself, and I can't seem to find one.
The issue is not drawing up with a larger needle for efficiency reasons, but whether using a smaller gauge needle for both would dull the needle. The jury is still out.
Does anyone know of an article which describes any objective measures used to measure the sharpness of injection needles? Several of my nursing peers feel that the sharpness of a needle is compromised when pushed though a med vial stopper and then used to inject the patient. Therefore, they change the needle. I am not certain that this is necessary and would like some facts.