We have a nurse in one of our clinics who gave separate doses of hepatitis A and hepatitis B vaccine in the gluteus of our adult patients. Are the doses considered invalid? If so, when can a valid dose be administered?

Although the gluteus muscle is not a recommended site for vaccination, in general, a dose given there can be considered valid. The exceptions to this general rule are hepatitis B and rabies vaccines. Hepatitis B vaccine is not considered valid if administered by any route other than intramuscular, or, if given to an adult, if given in any site except the deltoid or anterolateral thigh. So, the hepatitis A vaccine may be counted as valid, but the hepatitis B vaccine should not be counted in this situation. The hepatitis B vaccine can be repeated immediately. See the vaccine administration section of CDC’s “General Best Practices for Immunization” for details, available at www.cdc.gov/vaccines/hcp/imz-best-practices/vaccine-administration.html.