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
≥18 yrs: 0.5 mL adolescents, and adults
over triceps
Human papillomavirus (HPV) 0.5 mL IM Intramuscular (IM) injection
0.2 mL (0.1 mL in Intranasal Use a 22–25 gauge needle. Choose the injection site and needle length that
Influenza, live attenuated (LAIV)
each nostril) spray is appropriate to the person’s age and body mass.
Afluria: 0.25 mL needle
age length injection site
Influenza, inactivated (IIV); for ages Fluzone: 0.25 or 0.5 mL
IM
6–35 months Newborns (1st 28 days) ⅝"† Anterolateral thigh muscle
FluLaval; Fluarix:
0.5 mL Infants (1–12 mos) 1" Anterolateral thigh muscle

Influenza, inactivated (IIV), 3 yrs & old- 1–1¼" Anterolateral thigh muscle‡
0.5 mL Toddlers (1–2 years)
er; recombinant (RIV), 18 yrs & older; IM ⅝–1"† Deltoid muscle of arm
high-dose (HD-IIV) 65 yrs & older FluZone HD: 0.7 mL
Children ⅝–1" †
Deltoid muscle of arm‡
Measles, Mumps, Rubella (MMR) 0.5 mL Subcut (3–10 years) 1–1¼" Anterolateral thigh muscle
Meningococcal serogroups A, C, W, Y ⅝–1" †
Deltoid muscle of arm‡
0.5 mL IM Adolescents and teens
(MenACWY)
(11–18 years) 1–1½" Anterolateral thigh muscle
Meningococcal serogroup B (MenB) 0.5 mL IM
Adults 19 years or older
Pneumococcal conjugate (PCV) 0.5 mL IM
Female or male <130 lbs ⅝–1"† Deltoid muscle of arm
IM or
Pneumococcal polysaccharide (PPSV) 0.5 mL Female or male 130–152 lbs 1" Deltoid muscle of arm
Subcut
IM or Female 153–200 lbs
Polio, inactivated (IPV) 0.5 mL 1–1½" Deltoid muscle of arm
Subcut Male 153–260 lbs
Rotarix: 1.0 mL Female 200+ lbs
Rotavirus (RV) Oral 1½" Deltoid muscle of arm
Rotateq: 2.0 mL Male 260+ lbs
Varicella (VAR) 0.5 mL Subcut † 5/
A 8" needle may be used in newborns, preterm note: Always refer to the package insert
Zoster (Zos) Shingrix: 0.5* mL IM infants, and patients weighing less than 130 lbs included with each biologic for complete
(<60 kg) for IM injection in the deltoid muscle vaccine administration information. CDC’s
Combination Vaccines only if the skin stretched tight, the subcutaneous Advisory Committee on Immunization
DTaP-HepB-IPV (Pediarix) tissue is not bunched, and the injection is made
Practices (ACIP) recommendations for the
at a 90-degree angle to the skin.
DTaP-IPV/Hib (Pentacel) 0.5 mL IM ‡ particular vaccine should be reviewed as
DTaP-IPV (Kinrix; Quadracel) Preferred site
well. Access the ACIP recommendations at
MMRV (ProQuad) ≤12 yrs: 0.5 mL Subcut www.immunize.org/acip.

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

Immunization Action Coalition Saint Paul, Minnesota • 651- 647- 9009 • www.immunize.org • www.vaccineinformation.org
www.immunize.org/catg.d/p3085.pdf • Item #P3085 (8/20)