Administering Vaccines: Dose, Route, Site, and Needle Size

Vaccine Dose Route Injection Site and Needle Size

COVID-19 For product and dosage information for COVID-19 vaccine Subcutaneous (Subcut) injection
primary series and booster doses for both immunocompetent and immu- IM .
nocompromised adults, see CDC’s “COVID-19 Vaccine Interim COVID-19 Use a 23–25 gauge needle. Choose the injection site that is appropriate to
Immunization Schedule for Persons 6 Months of Age and Older.”* the person’s age and body mass.
Dengue (DENV4CYD) 0.5 mL. Subcut NE E DLE
AG E INJ EC TION SI T E
LE NG TH
Diphtheria, Tetanus, Pertussis
0.5 mL. IM .. Fatty tissue over antero-lateral
(DTaP, DT, Tdap, Td) Infants (1–12 mos) ⅝"
thigh muscle
Haemophilus influenzae type b (Hib) 0.5 mL IM
≤18 yrs: 0.5 mL Fatty tissue over antero-lateral
Hepatitis A (HepA) IM Children 12 mos or older,
⅝" thigh muscle or fatty tissue
≥19 yrs: 1.0 mL adolescents, and adults
over triceps
Engerix-B; Recombivax HB
Hepatitis B (HepB) ≤19 yrs: 0.5 mL Intramuscular (IM) injection
People 11–15 yrs may be given Recombivax ≥20 yrs: 1.0 mL IM Use a 22–25 gauge needle. Choose the injection site and needle length that
HB(Merck) 1.0 mL adult formulation on a
2-dose schedule. Heplisav-B; PreHevbrio is appropriate to the person’s age and body mass.
≥18 yrs: 0.5 mL
NE E DLE
AG E INJ EC TION SI T E
Human papillomavirus (HPV) 0.5 mL IM LE NG TH
Intranasal Newborns (1st 28 days) ⅝" 1
Anterolateral thigh muscle
Influenza, live attenuated (LAIV4) 0.2 mL (0.1 mL in each nostril)
spray
Infants (1–12 mos) 1" Anterolateral thigh muscle
Afluria: 0.25 mL
Influenza, inactivated (IIV4); 6 thru 35 mos 1–1¼" Anterolateral thigh muscle3
• Egg-based IIV4: Afluria, Fluzone, Fluzone: 0.25 or 0.5 mL Toddlers (1–2 yrs)
IM ⅝ –1"
2
Deltoid muscle of arm
Fluarix, FluLaval
Fluarix, Flucelvax, FluLaval:
• Cell-culture based (ccIIV4): Flucelvax ⅝ –1"
2
Deltoid muscle of arm3
0.5 mL Children
Influenza, inactivated (IIV4) and (3–10 yrs) 1–1¼" Anterolateral thigh muscle
• Cell-culture based (ccIIV4), 3+ yrs; ⅝ –1"
2
Deltoid muscle of arm3
0.5 mL Adolescents and teens
• Recombinant (RIV4, Flublok), 18+ yrs; IM
• Adjuvanted (aIIV4, Fluad) 65+ yrs (11–18 yrs) 1–1½" Anterolateral thigh muscle
Influenza, high-dose (IIV4-HD) 65+ yrs 0.7 mL Biological sex and weight of
MMR II (Merck) IM or Subcut
patient 19 yrs or older
Measles, Mumps, Rubella (MMR) 0.5 mL 2
Priorix (GSK) Subcut Female or male <130 lbs ⅝ –1" Deltoid muscle of arm
Meningococcal serogroups A, C, W, Y Female or male 130–152 lbs 1" Deltoid muscle of arm
0.5 mL IM
(MenACWY)
Female 153–200 lbs
1–1½" Deltoid muscle of arm
Meningococcal serogroup B (MenB) 0.5 mL IM Male 153–260 lbs
Mpox (Jynneos) 0.5 mL Subcut† Female more than 200 lbs
1½" Deltoid muscle of arm
Pneumococcal conjugate (PCV) 0.5 mL IM Male more than 260 lbs
1 –1½"
2
Pneumococcal polysaccharide (PPSV23) 0.5 mL IM or Subcut Female or male, any weight Anterolateral thigh muscle
Polio, inactivated (IPV) 0.5 mL IM or Subcut 1 If skin is stretched tightly and subcutaneous NOTE: Always refer to the package
Respiratory Syncytial Virus (RSV) vaccine 0.5 mL IM tissues are not bunched. insert included with each biologic for
2 Alternate needle lengths may be used if the complete vaccine administration
0.5 mL, 1 mL, or 2 mL based skin is stretched tightly and subcutaneous
RSV preventive antibody (RSV-mAb) IM information. CDC’s Advisory Committee
on weight and/or age tissues are not bunched, as follows: a) a ⅝" on Immunization Practices (ACIP)
Rotarix: 1.0 mL needle in toddlers, children, and patients recommendations for the particular
Rotavirus (RV) Oral
Rotateq: 2.0 mL weighing less than 130 lbs (less than 60 kg) vaccine should be reviewed as well.
for IM injection in the deltoid muscle only, or Access the ACIP recommendations at
Varicella (VAR) 0.5 mL IM or Subcut b) a 1" needle for administration in the thigh www.immunize.org/acip.
‡
Zoster (Zos) Shingrix: 0.5 mL IM muscle for adults of any weight.
3 Preferred site
Combination Vaccines
DTaP-HepB-IPV (Pediarix) Intranasal (NAS)
DTaP-IPV/Hib (Pentacel)
0.5 mL IM administration
DTaP-IPV (Kinrix; Quadracel)
DTaP-IPV-Hib-HepB (Vaxelis) of Flumist (LAIV)
vaccine
MMRV (ProQuad) 0.5 mL IM or Subcut
HepA-HepB (Twinrix) 1.0 mL IM
45° angle
* www.cdc.gov/vaccines/covid-19/downloads/COVID-19- immunization-schedule-ages-6months-older.pdf
†
Administer mpox vaccine (Jynneos) 0.5 mL Subcut or, in adults, 0.1 mL intradermally. Subcut is the route 90° angle skin
indicated on the package insert. Intradermal administration to adults is permitted under FDA emergency
use authorization (see www.fda.gov/media/160774/download). skin Subcutaneous subcutaneous tissue
‡
The Shingrix (RZV) vial may contain more than 0.5 mL. subcutaneous tissue (Subcut) injection
Do not administer more than 0.5 mL.
Intramuscular (IM)
injection muscle

muscle

www.immunize.org/catg.d/p3085.pdf
FOR PROFESSIONALS www.immunize.org / FOR THE PUBLIC www.vaccineinformation.org Item #P3085 (10/23/2023)
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