anatomic sites for immunizations IMM-685 - sdiz.org

1 Subcutaneous shots ininfants and toddlers aregiven either in the upperarm or in the fatty area ofthe thigh. The tissue is pinched up between thethumb and index 25 gauge,5/8 entire needle at 45 injections tochildren and adults areusually given in the upperarm. The deltoid muscle isfound about 3 fingers belowthe acromion, above the levelof the 23 25 gauge, 1 entire needle at 90 angle. A 11/2 needle may beneeded for large in the upper tissue on the back of theupper arm is pinched up between the thumb andindex 25 gauge,5/8 entire needle at 45 shots ininfants and toddlers areusually given in theanterolateral thigh. Thevastus lateralis muscle is onthe outside of the leg in themid- to 23 25 gauge, 1 entire needle at 90 Schwarzenegger, Governor State of CaliforniaKimberly Belsh , Secretary Health and Human Services AgencySandra Shewry, Director Department of Health ServicesImmunization Branch 850 Marina Bay Parkway, Building P Richmond, CA 94804 IMM-685 (10/05) site :Vastus Lateralis Example oftwo IM sites Example oftwo IM sitesSite:DeltoidVaccines given subcutaneously (SC): Inactivated Polio Vaccine* Measles-Mumps-Rubella Pneumococcal Polysaccharide* Varicella*Can also be given IM90 45 Safe Effective CaringOSite:Outer Aspect Example of two SC sitesSite:Outer Aspect Example of two SC sitesSUBCUTANEOUS (SC) INTRAMUSCULAR (IM) Subcutaneous(SC) Needle Size:25 gaugeNeedle Length.

2 5/8 Infant/Toddler Subcutaneous ShotAge: 0 36 monthsAge: 3 years AdultChild/Adult Subcutaneous ShotAge: 0 36 monthsAge: 3 years AdultInfant/Toddler Intramuscular ShotChild/Adult Intramuscular ShotVaccines given intramuscularly (IM):Intramuscular(IM) Needle Size:23 25 gaugeNeedle Length:1 Diphtheria-Tetanus-Pertussis Haemophilus influenzae, type b Hepatitis A Hepatitis B Influenza Meningococcal Conjugate Pneumococcal ConjugateMedical Illustrations by Lynne Larson, All rights reserved. This chart is based on extensive review of the scien-tific literature including recommendations of the Advisory Committee on immunization Practices (MMWR 1994; 43RR-1, 1-38) and theAmerican Academy of Pediatrics (Red Book 2000). The purpose of this chart is to present the most customarily recommended vaccineinjection sites and needle sizes.

3 For alternatives or additional information, please refer to the vaccine manufacturer s package insertand the cited references. Devices illustrated are available with engineered sharps injury prevention mechanisms. Produced by the immunization Branch, California Department of Health by the immunization Branch, California Department of Health Services.