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Every time the needle goes through the stopper is a chance to introduce bacteria
Clin Chest Med 40(1):2950 Peters U, Dixon AE, Forno E (2018) Obesity and asthma
Venter C, Meyer RW, Nwaru BI, Roduit C, Untersmayr E, Adel-Patient K, Agache I, Agostoni C, Akdis CA, Bischoff SC, du Toit G, Feeney M, Frei R, Garn H, Greenhawt M, Hoffmann-Sommergruber K, Lunjani N, Maslin K, Mills C, Muraro A, Pali-Schll I, Poulson LK, Reese I, Renz H, Roberts GC, Smith P, Smolinska S, Sokolowska M, Stanton C, Vlieg-Boerstra B, OMahony L
The pause is what keeps the protocol delivering across multiple cycles
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