Proper Vaccine Administration

September 2010

Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
Proper Vaccine Administration
Published September 2010
Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit
It’s essential that all clinic staff members are well trained in proper vaccine administration technique. Unfortunately, vaccine administration errors are not uncommon and may result in having to recall patients and repeat doses. Avoiding vaccine administration errors will save your clinic time, money and potential embarrassment.
The Immunization Action Coalition (IAC) receives frequent inquiries from healthcare professionals regarding vaccine administration errors and what to do about them (e.g., “do I repeat the dose, and if so, when?”) The most common vaccine administration errors include:
Administering the wrong vaccine (e.g., DTaP vs. Tdap)
Using the wrong diluent when mixing a vaccine or administering diluent alone
Administering the wrong dose of vaccine for the patient’s age
Giving vaccine by the wrong route (e.g., intramuscularly, not subcutaneously)
Mixing two doses of vaccine into one syringe when they should be given in two separate syringes
Administering expired vaccine
Administering a dose of vaccine to the wrong patient
To prevent these errors from happening in your practice, make sure everyone is well trained and use a standardized system throughout the office. Resources are available to help train your staff and provide periodic refreshers during staff meetings:
Immunization Techniques: Best Practices with Infants, Children and Adults
This 25-minute DVD was recently updated by the California Department of Public Health, Immunization Branch, and is available for a nominal charge from IAC. It provides excellent training for new staff members and is a first-rate refresher for experienced staff.
How to Administer Intramuscular and Subcutaneous Injections
This two-page handout is available for download on the IAC website. It is IAC’s most frequently downloaded handout on this topic.
Administering Vaccines
Several CDC-reviewed handouts are also available on the IAC website.
E-mail the experts – If you cannot find answers to your vaccine administration questions, you can e-mail or


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