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ORNAC Standards

This document provides guidance on administering intramuscular (IM) and subcutaneous (Subcut) vaccine injections to adults. It lists which vaccines should be given via each route. For IM injections into the deltoid muscle, it recommends a needle length based on weight and injection technique at a 90 degree angle. For Subcut injections into the fatty tissue over the triceps, it recommends a 5/8 inch needle inserted at a 45 degree angle and pinching the tissue.

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167 views1 page

ORNAC Standards

This document provides guidance on administering intramuscular (IM) and subcutaneous (Subcut) vaccine injections to adults. It lists which vaccines should be given via each route. For IM injections into the deltoid muscle, it recommends a needle length based on weight and injection technique at a 90 degree angle. For Subcut injections into the fatty tissue over the triceps, it recommends a 5/8 inch needle inserted at a 45 degree angle and pinching the tissue.

Uploaded by

Summer ReNee
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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How to Administer Intramuscular and Subcutaneous

Vaccine Injections to Adults


Intramuscular (IM) Injections
Administer these vaccines via IM route
• Haemophilus influenzae type b (Hib)
• Hepatitis A (HepA)
• Hepatitis B (HepB)
• Human papillomavirus (HPV) acromion process
• Influenza vaccine, injectable (IIV) • (bony prominence above deltoid)
• Influenza vaccine, recombinant (RIV3; RIV4)
level of armpit
• Meningococcal conjugate (MenACWY) IM injection site
• Meningococcal serogroup B (MenB) (shaded area = deltoid muscle)
• Pneumococcal conjugate (PCV13)
• Pneumococcal polysaccharide (PPSV23) – elbow
may also be given Subcut
• Polio (IPV) – may also be given Subcut
• Tetanus, diphtheria (Td), or with pertussis (Tdap)
• Zoster, recombinant (RZV; Shingrix)
90° angle
Injection site
skin
Give in the central and thickest portion of the deltoid
muscle – above the level of the armpit and approximately subcutaneous tissue
2–3 fingerbreadths (~2") below the acromion process.
muscle
See the diagram. To avoid causing an injury, do not inject
too high (near the acromion process) or too low.
Note: A ⅝" needle is sufficient in adults weighing less than 130 lbs
Needle size
(<60 kg) for IM injection in the deltoid muscle only if the subcutane-
22–25 gauge, 1–1½" needle (see note at right) ous tissue is not bunched and the injection is made at a 90° angle;
Needle insertion a 1" needle is sufficient in adults weighing 130–152 lbs (60–70 kg);
a 1–1½" needle is recommended in women weighing 153–200 lbs
• Use a needle long enough to reach deep into the muscle.
(70–90 kg) and men weighing 153–260 lbs (70–118 kg); a 1½" needle
• Insert the needle at a 90° angle to the skin with a quick is recommended in women weighing more than 200 lbs (91 kg) or
thrust. men weighing more than 260 lbs (more than 118 kg).
• Separate two injections given in the same deltoid muscle
by a minimum of 1".

Subcutaneous (Subcut) Injections Administer these vaccines via Subcut route


• Measles, mumps, rubella (MMR)
• Pneumococcal polysaccharide (PPSV23) –
may also be given IM
• Polio (IPV) – may also be given IM
acromion process
• Varicella (Var; chickenpox)
• Zoster, live (ZVL; Zostavax)

Subcut injection site


Injection site
(shaded area)
Give in fatty tissue over the triceps. See the diagram.

elbow
Needle size
23–25 gauge, 5/8" needle
45° angle
Needle insertion
skin • Pinch up on the tissue to prevent injection into the
muscle. Insert the needle at a 45° angle to the skin.
subcutaneous tissue • Separate two injections given in the same area of fatty
muscle tissue by a minimum of 1".

Saint Paul, Minnesota • 651- 647- 9009 • www.immunize.org • www.vaccineinformation.org


www.immunize.org/catg.d/p2020a.pdf • Item #P2020a (1/18)

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