Vaccine Administration:
Intramuscular (IM) Injection
Children 7 through 18 years of age
Administer these vaccines by IM injection:
Haemophilus influenzae type b (Hib) Influenza vaccine, inactivated (IIV) Pneumococcal conjugate (PCV13)
Hepatitis A (HepA) Influenza vaccine, recombinant Pneumococcal polysaccharide
Hepatitis B (HepB) (RIV4 [18 years of age and older]) (PPSV23)*
Hepatitis A and hepatitis B (HepA- Inactivated polio vaccine (IPV)* Tetanus and diphtheria toxoid (Td)
HepB [18 years of age and older]) Meningococcal conjugate Tetanus toxoid, reduced diphtheria
Human papillomavirus (HPV (MenACWY) toxoid, and acellular pertussis (Tdap)
vaccine) Meningococcal serogroup B (MenB)
*May also be administered by subcutaneous injection
To ensure vaccines are safe and effective, it’s important to prepare and administer them correctly:
Follow aseptic technique. Perform hand hygiene before vaccine preparation, between
Use a new needle and syringe for each injection. patients, when changing gloves (if worn), and any time hands
become soiled.‡
‡Gloves are not required unless the person administering the vaccine is likely to come in contact with potentially infectious body fluids or has open lesions on
the hands. If worn, perform hand hygiene and change gloves between patients.
1. Use the correct syringe and needle. Deltoid Muscle
Administer vaccine using either a 1-mL or 3-mL syringe. 5/8 in (16 mm) 1 in (25 mm)
Use a 22- to 25-gauge needle.
If the skin is stretched tightly and
Use the correct needle length (5/8- to 1.5-inch needle).* the subcutaneous tissues are not
*The anterolateral thigh may be used. For children:
• 7 through 10 years of age, use a 1- to 1.25-inch (25–32 mm) needle bunched
• 11 through 18 years of age, use a 1- to 1.5-inch (25–38 mm) needle
2. Identify the injection site.
Preferred site: Deltoid muscle in the upper arm
Use anatomical landmarks to determine the injection site. The deltoid muscle is a
Scapula
large, rounded, triangular shape. Find the acromion process, which is the bony point
at the end of the shoulder. The injection site will be below the bone and above the
Acromion
axillary fold/armpit. process Injection
site
3. Administer the vaccine correctly. Deltoid
muscle
Inject the vaccine into the middle and thickest part of the muscle. Insert the needle at
Axillary
a 90-degree angle and inject all of the vaccine in the muscle tissue. fold/
If administering more than one vaccine in the same arm, separate the injection sites armpit
by 1 inch if possible. Humerus
U.S. D
For additional information, go to CDC's
Heal
vaccine administration resource library at Cente
www.cdc.gov/vaccines/hcp/admin/resource-library.html. Contr
11/16/20
