Selecting the proper needle length when
vaccinating your patients is critical vaccine must reach the
desired tissue site for optimal immune response to
occur. To determine the proper needle length to use in each
situation, you must consider the following factors:
- the route of injection whether it is intramuscular or
subcutaneous
- the anatomic site of the injection
- age must also be considered
- weight will also need to be taken into account
Below is a summary of the guidance for choosing the proper needle
length for intramuscular and subcutaneous injections based on CDC’s
General Best
Practice Guidelines for Immunization
(Vaccine Administration).
FOR INFANTS, CHILDREN, AND
TEENS
Intramuscular (IM) injections: Injection site and needle size
- For newborns (028 days): Use anterolateral thigh muscle,
⅝"
needle, 2225 gauge
Note: For neonates (first 28 days of life) and preterm infants, a
⅝" needle is recommended if the skin is stretched flat between the
thumb and forefinger
and the needle is inserted at a 90° angle to the skin.
- For infants (112 months): Use anterolateral thigh muscle, 1"
needle, 2225 gauge
- For toddlers (12 years): There are two options for injection
site and needle length:
- Anterolateral thigh muscle – use 1"1¼" needle, 2225 gauge
- Deltoid muscle – if muscle mass adequate, use
⅝"1" needle,
2225 gauge
- For children (310 years): There are two options for injection
site and needle length:
- Deltoid muscle – use ⅝"–1" needle, 2225 gauge
- Anterolateral thigh muscle – use 1"1¼" needle, 2225 gauge
- For preteens and teens (1118 years): There are two options for
injection site and needle length:
- Deltoid muscle – use ⅝"1" needle, 2225 gauge
- Anterolateral thigh muscle – use 1"1½" needle, 2225 gauge
Subcutaneous (Subcut) injections: Injection site and needle size
- For infants (1112 months): Inject at a 45° angle into fatty
tissue overlying the anterolateral thigh muscle use ⅝" needle,
2325 gauge
- For children and teens (118 years): Inject at a 45° angle into
fatty tissue overlying the triceps or anterolateral thigh muscle –
use ⅝" needle,
2325 gauge
FOR ADULTS
Intramuscular (IM) injections
The deltoid muscle is most often used as the site for IM injections
in adults. Needle length is usually 1"1½", 2225 gauge, but a
longer or shorter needle
may be needed depending on the patient's weight.
Note: An alternate site for IM injection in adults is the
anterolateral thigh muscle. The needle length and gauge are the
same as when the deltoid muscle is
used, i.e., 1"–1½" length, 22–25 gauge.
You should choose needle length based on the weight of your adult
patients, as follows:
- Adults weighing less than 130 lbs (60 kg): Use of a 1" needle is
recommended. However, a ⅝" needle may be used for IM injection in
the deltoid
muscle if the fatty tissue overlying the deltoid muscle is
flattened (i.e., not bunched between thumb and fingers during the
injection) and the needle is
inserted at a 90° angle to the skin.
- Adults weighing 130152 lbs (6070 kg): Use of a 1" needle is
recommended.
- Women weighing 152200 lbs (7090 kg) and men weighing 152260
lbs (70118 kg): Use of a 1"1½" needle is recommended.
- Women weighing more than 200 lbs (90 kg) or men weighing more
than 260 lbs (118 kg): Use of a 1½" needle is recommended.
Subcutaneous (Subcut) injections
- Inject at a 45° angle into fatty tissue overlying the triceps
muscle – a ⅝" needle, 2325 gauge is recommended.
MORE RESOURCES
Administering Vaccines: Dose, Route, Site, and Needle Size
Administering Vaccines to Adults: Dose, Route, Site, and Needle
Size
How to Administer Intramuscular and Subcutaneous Vaccine Injections
How to Administer Intramuscular and Subcutaneous Vaccine Injections
to Adults
IAC’s Handouts: Administering Vaccines
gateway page
IAC’s Clinic Tools: Administering Vaccines
gateway page
CDC Vaccine Administration
gateway page
CDC Vaccine Administration Resource Library
with instructive videos on vaccine
administration
CDC
Epidemiology and Prevention of Vaccine-Preventable Diseases
(“The Pink Book"), Chapter 6, Vaccine Administration: Route and
Site
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This page was updated on July
21, 2020. |
This page was reviewed on July
21, 2020 |
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