# Presentation: 637988

## Vaccine Administration

**Epidemiology and Prevention of Vaccine-Preventable Diseases**
**National Immunization Program**
**Centers for Disease Control and Prevention**

**Revised January 2007**

## Importance of Proper Vaccine Administration Technique

**Promote optimal antibody response**
**Reduce risk of local adverse reactions**

## Subcutaneous Injection

**Injection into the fatty tissue below the dermis and above the muscle**
**Usual sites are thigh and upper outer triceps area of the arm**

## Subcutaneous Needle

**Gauge****	****	****23 to 25**
**Length****	****	****5/8 inch**
**Needle inserted at a 45****o**** angle****	**

## Intramuscular Sites

**Site selection depends on**
**person’s age**
**muscle development**
**Use deltoid muscle for older children, adults (toddlers only if adequate muscle mass)**
**Use anatomical landmarks to locate site**

## Intramuscular Needle

**Gauge: 22 to 25**
**Length:   Newborn****	****	****	**** 5/8 inch**
**	****	****   ****Infant****	****	****                    1 inch**
**   ****Older Children  5/8* to 11⁄4 inch**
**	****	****	****   ****Adolescent/adult   1 to 11⁄2 inch**

***5/8 inch needle is adequate only for the deltoid muscle of older children if the skin is stretched flat and the needle inserted at a 90****o**** angle to the skin**

## Infection Control

**Hand hygiene**
**recommended between patients**
**alcohol-based waterless antiseptic can be used**
**Gloves**
**not required by OSHA unless **
**potential for exposure to blood or body fluids **
**open lesions on the hands or **
**agency policy**

## Infection Control

**Equipment disposal**
**never detach, recap or cut a used needle**
**place in puncture-proof container**
**dispose as infectious medical waste**
**use safety needles or needle-free devices whenever available to reduce risk of injury**

## Other Vaccine Administration Issues

**Not necessary to change needles between drawing or reconstituting vaccine and administration unless needle is contaminated or bent**
**NEVER mix vaccines in the same syringe unless approved for mixing by the FDA**

## Other Vaccine Administration Issues

**Injection sites in same limb should be separated by at least 1 inch if possible**
**Aspiration**
**not required**
**no reports of injury from failure to aspirate**
**can result in wastage of vaccine**

## Latex Allergy

**Most often a contact-type allergy**
**Person with anaphylactic allergy to latex generally should not receive vaccines supplied in vials or syringes that contain rubber**
**Persons with latex allergies that are not anaphylactic can be vaccinated**

## Injection Pain

**Pain is subjective and influenced by:**
**person’s age**
**anxiety level**
**previous healthcare experiences**
**culture**
**Pain management**
**medical (e.g., anesthetics)**
**non-medical (e.g., diversionary techniques)**

## Vaccine Administration Errors

**Administration of the wrong formulation**
**Wrong diluent**
**Incorrect route of administration**

## National Immunization ProgramContact Information

**Telephone****	****	****800.CDC.INFO**** **
**Email****	****	****	****nipinfo@cdc.gov**** **
**Website****	****	****www.cdc.gov/nip**