I have been on Avonex since 4/97! I can honestly say that I am a 'little' overweight so the size of the needle doesn't bother me a bit. Also I was an RN so I had no trouble giving myself a shot. I did have some flu like problems at first but I take 2 Aleve an hour before each shot and I don't have any problems. I don't know what would happen if I didn't take that Aleve but it is usually the only Aleve I take a week so I don't worry about it. My MRIs look the same now as they did in 1997 so I'm sticking with my Avonex.