Administering Vaccines:

Dose, Route, Site, and Needle Size

Vaccine Dose Route Injection Site and Needle Size
Diphtheria, Tetanus, Pertussis Subcutaneous (Subcut) injection
0.5 mL. . IM ..
(DTaP, DT, Tdap, Td) Use a 23–25 gauge needle. Choose the injection site that is appropriate to
Haemophilus influenzae type b (Hib) 0.5 mL IM the person’s age and body mass.
≤18 yrs: 0.5 mL age Needle injection site
Hepatitis A (HepA) IM length
≥19 yrs: 1.0 mL
Fatty tissue over anterolateral
Engerix-B; Recombivax HB Infants (1–12 mos) ⅝"
thigh muscle
Hepatitis B (HepB) ≤19 yrs: 0.5 mL
Persons 11–15 yrs may be given Recombivax HB (Merck) >20 yrs: 1.0 mL IM Fatty tissue over anterolateral
Children 12 mos or older,
1.0 mL adult formulation on a 2-dose schedule. Heplisav-B ⅝" thigh muscle or fatty tissue
adolescents, and adults
≥18 yrs: 0.5 mL over triceps
Human papillomavirus (HPV) 0.5 mL IM Intramuscular (IM) injection
0.2 mL (0.1 mL in Intrana- Use a 22–25 gauge needle. Choose the injection site and needle length that
Influenza, live attenuated (LAIV) is appropriate to the person’s age and body mass.
each nostril) sal spray
Fluzone: 0.25 mL age needle injection site
Influenza, inactivated (IIV); for ages length
FluLaval; Fluarix: IM
6–35 months
0.5 mL Newborns (1st 28 days) ⅝" Anterolateral thigh muscle
Influenza, inactivated (IIV), for ages 3 Infants (1–12 mos) 1" Anterolateral thigh muscle
years & older; recombinant (RIV), for 0.5 mL IM 1–1¼" Anterolateral thigh muscle
ages 18 years and older Toddlers (1–2 years)
⅝–1" Deltoid muscle of arm
Measles, Mumps, Rubella (MMR) 0.5 mL Subcut
Children ⅝–1"* Deltoid muscle of arm
Meningococcal serogroups A, C, W, Y
0.5 mL IM (3–10 years) 1–1¼" Anterolateral thigh muscle
(MenACWY)
Meningococcal serogroup B (MenB) 0.5 mL IM Adolescents and teens ⅝–1"* Deltoid muscle of arm
Pneumococcal conjugate (PCV) 0.5 mL IM (11–18 years) 1–1½" Anterolateral thigh muscle
IM or Adults 19 years or older
Pneumococcal polysaccharide (PPSV) 0.5 mL
Subcut
Female or male <130 lbs ⅝–1"* Deltoid muscle of arm
IM or
Polio, inactivated (IPV) 0.5 mL Female or male 130–152 lbs 1" Deltoid muscle of arm
Subcut
Rotarix: 1.0 mL Female 153–200 lbs
1–1½" Deltoid muscle of arm
Rotavirus (RV) Oral Male 153–260 lbs
Rotateq: 2.0 mL
Female 200+ lbs
Varicella (Var) 0.5 mL Subcut 1½" Deltoid muscle of arm
Male 260+ lbs
Shingrix: 0.5* mL IM
Zoster (Zos)
Zostavax: 0.65 mL Subcut * A 5/8" needle may be used for patients note: Always refer to the package insert included
Combination Vaccines weighing less than 130 lbs (<60 kg) for with each biologic for complete vaccine administration
IM injection in the deltoid muscle only information. CDC’s Advisory Committee on Immunization
DTaP-HepB-IPV (Pediarix) if the skin stretched tight, the subcuta- Practices (ACIP) recommendations for the particular
DTaP-IPV/Hib (Pentacel) 0.5 mL IM neous tissue is not bunched, and the
vaccine should be reviewed as well. Access the ACIP
DTaP-IPV (Kinrix; Quadracel) injection is made at a 90-degree angle.
recommendations at www.immunize.org/acip.
MMRV (ProQuad) ≤12 yrs: 0.5 mL Subcut
HepA-HepB (Twinrix) ≥18 yrs: 1.0 mL IM
* The vial might contain more than 0.5 mL. Do not administer more than 0.5 mL.

Intramuscular (IM) injection Subcutaneous (Subcut) injection Intranasal (NAS) administration

of Flumist (LAIV) vaccine

90° angle 45° angle

skin skin
subcutaneous tissue subcutaneous tissue

muscle muscle

Technical content reviewed by the Centers for Disease Control and Prevention

Immunization Action Coalition Saint Paul, Minnesota • 651- 647- 9009 • www.immunize.org • www.vaccineinformation.org
www.immunize.org/catg.d/p3085.pdf • Item #P3085 (10/18)