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YOU CALL THE SHOTS

Vaccinating Adolescents

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Vaccination can be a stressful experience. Adolescents may experience 

fear and anxiety. If healthcare providers don't address these fears, 

they can have long-term effects. For example, adolescents may avoid 

needed health care throughout their lifetime. Your practices can improve 

adolescents’ experiences and attitudes about of vaccination. Consider 

strategies to manage pain and potential acute reactions.

Distract adolescents to reduce stress and ease pain.

 Interact with adolescents throughout the appointment.

 Use clinician-led distraction techniques (e.g., point out interesting things in the room 

and ask the patient to describe what they see, tell an age-appropriate story).

 Use patient-led distraction techniques (e.g., games, videos, music, books).

 Remind adolescents to stay focused on the distraction strategy if their attention 

wanders to the vaccination.

 Suggest adolescents engage in slow, deep breathing or exhalation during vaccination.

 Avoid telling adolescents “It won’t hurt.”

Administer vaccines using best practices.

 Select the correct needle size for adolescents (22–25-gauge 5/8–1 inch [16–25 mm] needle). 

 Consider using topical anesthetics on the skin upon arrival at the clinic, if requested.

 Identify the injection site (preferred site: deltoid muscle in the upper arm).

 Have adolescents sit upright or lie down during injection. 

If sitting, ask them to: 

 Sit in a straight-backed chair

 Rest their feet flat on the floor

 Relax their forearms and place hands on their upper thighs

 Relax their shoulders 

 When administering multiple vaccine injections to adolescents sequentially, inject the most 

painful vaccine last to reduce pain at the time of injection.*

 Administer vaccine using a rapid injection technique without aspiration.

*COVID-19 and other vaccines may now be administered without regard to timing because the benefits of coadministration 

are generally expected to outweigh potential and unknown risks. This includes simultaneous administration of COVID-19 and 

other vaccines on the same day, as well as co-administration within 14 days.
05/14/2021 CS 322033-E

Vaccinating Adolescents

U.S. D

Heal

Cente

Cont

Observe and manage potential syncope (fainting).

Syncope after vaccination is most common among adolescents and young adults. To 

prevent injuries:

 Keep adolescents seated for 15 minutes after vaccination to help prevent injuries 

that could occur from a fall while fainting.†

 Be aware of symptoms that precede fainting (e.g., weakness, dizziness, pallor). 

Provide supportive care and take appropriate measures to prevent injuries if such 

symptoms occur.

 If an adolescent does faint, observe them until they regain consciousness so further 

treatment can be determined. 

Educate adolescents and their parents about pain management 

after a vaccination.

 Adolescents might experience side effects that should go away within a few days:

 At the injection site: pain, redness, and/or swelling

 Throughout the rest of the body: tiredness, headache, muscle pain, chills, fever, and/or nausea

 Minimize mild side effects:

 Apply a clean, cool, damp washcloth to reduce redness, soreness, and/or swelling.

 Use or exercise the arm.

 Drink plenty of fluids and wear light, loose-fitting clothing.

 Provide parents information regarding non-aspirin-containing pain relievers. Aspirin is not 

recommended for children and adolescents.

Resources for more information:

 Before, During, and After Shots:

https://www.cdc.gov/vaccines/parents/visit/before-duringafter-shots.html

 Fainting (Syncope) after Vaccination: 

https://www.cdc.gov/vaccinesafety/concerns/fainting.html

 Vaccine Administration: Needle Gauge and Length:

https://www.cdc.gov/vaccines/hcp/admin/downloads/

vaccine-administration-needle-length.pdf

 Vaccine Administration: Intramuscular (IM) Injection 

Children 7 through 18 years of age: https://www.cdc.gov/

vaccines/hcp/admin/downloads/IM-Injection-children.pdf

 Epidemiology and Prevention of Vaccine-Preventable 

Diseases, Vaccine Administration chapter: 

https://www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html 

 You Call the Shots, Vaccine Administration: 

https://www2.cdc.gov/vaccines/ed/vaxadmin/va/ce.asp 

†Some patients should be observed for adverse reactions for 30 minutes following vaccination with a COVID-19 vaccine. 

For more information, see: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html