Technically Speaking: Prevent Shoulder Injuries Caused by Missing the Deltoid Muscle When Injecting Vaccines
Published on in Vaccine Update for Healthcare Providers
It’s essential that you know how to choose the proper site on the arm when administering vaccines. A correctly placed injection not only will optimize the protection afforded by the vaccine, it also will help you avoid the risk of shoulder or arm injury resulting from an injection placed too high or too low in the arm.
Knowing exactly where to inject a vaccine is critical whether you’re “catching up” children, teens and adults on their missed vaccinations during the COVID-19 pandemic, getting patients vaccinated against influenza, or administering COVID-19 vaccines in the near future.
The websites of the Centers for Disease Control and Prevention (CDC), the Immunization Action Coalition (IAC), and the California Department of Health Immunization Program are rich with practical tools and resources on how to identify the correct spot for administering vaccines. For example, the two CDC videos listed below have a combined total of more than 500,000 views, and the IAC materials listed are among the top downloads accessed on our website. Be sure to check out these and the other great materials shown below.
Watch these brief videos from CDC
- Video: Intramuscular (IM) Injection: Sites [5:07]
- Video: Subcutaneous (SC or Subcut) Injection: Sites [3:26]
Refer to these instructions from IAC
- Print piece: How to Administer Intramuscular and Subcutaneous Vaccine Injections
- Print piece: How to Administer Intramuscular and Subcutaneous Vaccine Injections to Adults
Use these job aids from the California Department of Public Health Vaccines For Children program (EZIZ)
- Poster: Anatomic Sites for Immunization
- Video: Immunization Techniques: Best Practices with Infants, Children, and Adults [25:15]
Additional resources
- CDC Epidemiology and Prevention of Vaccine-Preventable Diseases (“The Pink Book”), Chapter 6: Vaccine Administration
- General Best Practice Guidelines for Immunization: Best Practices Guidance of ACIP, Section 6: Vaccine Administration
- IAC’s “Clinic Tools: Administering Vaccines” gateway page provides links to dozens of resources from IAC, CDC, EZIZ and others
- IAC’s “Handouts: Administering Vaccines” gateway page links to more than 20 print pieces on vaccine administration
- EZIZ Vaccine Administration Job Aids
Contributed by: Deborah Wexler, MD
Categories: Vaccine Update November 2020, Technically Speaking
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.