How to administer intramuscular and subcutaneous vaccine ...

How to Administer Intramuscular and Subcutaneous Vaccine Injections

Administration by the Intramuscular (IM) Route

Administer by IM route only

? COVID-19

? Dengue

? Diphtheria-tetanus-pertussis (DTaP, Tdap)

? Diphtheria-tetanus (DT, Td)

? Haemophilus influenzae type b (Hib)

? Hepatitis A (HepA)

? Hepatitis B (HepB)

? Human papillomavirus (HPV)

? Inactivated influenza vaccine (IIV)

? Meningococcal serogroups A,C,W, Y

(MenACWY)

? Meningococcal serogroup B (MenB)

? Respiratory Syncytial Virus (RSV &

RSV-mAb)

? Pneumococcal conjugate (PCV)

? Zoster (RZV)

Administer by IM or

Subcutaneous (Subcut) route

? Inactivated polio vaccine (IPV)

? Measles, mumps, and rubella (MMR II

[Merck] only)

? Pneumococcal polysaccharide (PPSV23)

? Varicella (VAR)

90¡ã angle

PATIENT AGE

INJECTION SITE

NEEDLE SIZE

Newborn (0¨C28 days)

Anterolateral thigh muscle

?"* (22¨C25 gauge)

Infant (1¨C12 mos)

Anterolateral thigh muscle

1" (22¨C25 gauge)

Anterolateral thigh muscle

1¨C1?" (22¨C25 gauge)

Alternate site: Deltoid muscle of arm if

muscle mass is adequate

?*¨C1" (22¨C25 gauge)

Deltoid muscle (upper arm)

?*¨C1" (22¨C25 gauge)

Alternate site: Anterolateral thigh muscle

1¨C1?" (22¨C25 gauge)

Deltoid muscle (upper arm)

??¨C1" (22¨C25 gauge)

Toddler (1¨C2 years)

Children (3¨C10 years)

Children and adults

(11 years and older)

Alternate site: Anterolateral thigh muscle

?

?

1 ¨C1?" (22¨C25 gauge)

* A ?" needle usually is adequate for neonates (first

weighing 153¨C200 lbs (70¨C90 kg) and men weighing

28 days of life), preterm infants, and children ages

153¨C260 lbs (70¨C118 kg); a 1?" needle is recom1 through 18 years if the skin is stretched flat

mended in women weighing more than 200 lbs

between the thumb and forefinger and the needle

(91 kg) or men weighing more than 260 lbs (118 kg).

is inserted at a 90¡ã angle to the skin.

?A

 1" needle may be used for an IM injection in the

? A ?" needle may be used in patients weighing less

anterolateral thigh muscle of an adult of any weight if

than 130 lbs ( ................
................

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