How to Administer Intramuscular and Subcutaneous Vaccine

1. Intramuscular (IM) Injections  (Injections to Adults)

Administer these vaccines via the IM route

• Haemophilus influenzae type b (Hib)
• Hepatitis A (HepA)
• Hepatitis B (HepB)
• Human papillomavirus (HPV)
• Influenza vaccine, injectable (IIV)
• Influenza vaccine, recombinant (RIV3; RIV4)
• Meningococcal conjugate (MenACWY)
• Meningococcal serogroup B (MenB)
• Pneumococcal conjugate (PCV13)
• Pneumococcal polysaccharide (PPSV23) –may also be given Subcut
• Polio (IPV) – may also be given Subcut
• Tetanus, diphtheria (Td), or with pertussis (Tdap)
• Zoster, recombinant (RZV; Shingrix)

Injection site:
Give in the central and thickest portion of the deltoid muscle – above the level of the armpit and approximately 2–3 fingerbreadths (~2") below the acromion process. To avoid causing an injury, do not inject too high (near the acromion process) or too low. 

Needle size: 22–25 gauge, 1–1½" needle 

Note: A ⅝" needle is sufficient in adults weighing less than 130 lbs  (<60 kg) for IM injection in the deltoid muscle only if the subcutaneous tissue is not bunched and the injection is made at a 90° angle; 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 (70–90 kg) and men weighing 153–260 lbs (70–118 kg); a 1½" needle is recommended in women weighing more than 200 lbs (91 kg) or men weighing more than 260 lbs (more than 118 kg).

2. Subcutaneous (Subcut) Injections (Injections to Adults)

Administer these vaccines via the Subcut route

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

Injection site:
Give in fatty tissue over the triceps. See the diagram.

Needle size: 23–25 gauge, 5/8" needle

Needle insertion:

• Pinch the tissue to prevent injection into the muscle. Insert the needle at a 45° angle to the skin.
• Separate two injections are given in the same area of fatty tissue by a minimum of 1".

Practice injection with our injection practice pad. Besides the intramuscular & subcutaneous injection pad, we also have iv injection pads for customers.

Related Articles:
Why and How to Start IVS on Fake Arm Instead of Hand?

Your email address will not be published.Required fields are marked. *