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Technically Speaking
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May 2021
Technically Speaking
A Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
IAC Executive Director Dr. Deborah Wexler writes Technically Speaking, a column featured in each issue of Vaccine Update for Healthcare Professionals, the monthly e-newsletter from the Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia. Technically Speaking columns cover practical topics in immunization delivery such as vaccine administration techniques, storage and handling, contraindications and precautions, and scheduling.
Subscribe to VEC's Vaccine Update for Healthcare Professionals to stay up to date on vaccine-related issues, including reviews of recently published journal articles, media recaps, and announcements about new resources and webinars. To subscribe, visit the Vaccine Update Newsletter Sign-up Form
The archive of past Technically Speaking columns is also available through links on the right side of this web page.
TECHNICALLY SPEAKING
Be Sure You Know the Anatomical Landmarks for Administering Intramuscular Injections in the Arm
Published May 2021
With tens of thousands of new vaccinators and millions of doses of COVID-19 vaccine being given each month, it is critical that vaccinators – both new and experienced – know how to precisely locate where intramuscular (IM) injections in the arm should be given.

For people age 3 years and older, a correctly placed IM injection is given in the upper arm, in the deltoid muscle, into its middle and thickest part, at a 90-degree angle to the skin. CDC has helpful instructional handouts for vaccinating children age 7 through 18 and adults that illustrate the anatomical landmarks for where to inject into the deltoid muscle.

For COVID-19 vaccinators, CDC highlights this same information on web pages specifically addressing vaccine administration of the three COVID-19 vaccines authorized for use in the U.S.:

One of the most common errors in IM injection is introducing the needle either too high on the shoulder or too low on the arm. Injections given too high (into the shoulder joint) or too low (into tendons and soft tissue) have the possibility of leading to serious shoulder or arm pain that can last several months. SIRVA (shoulder injury related to vaccine administration) is preventable by paying careful attention to the anatomical landmarks for correct placement in the deltoid.

The Immunization Action Coalition (IAC) has free print materials available on its website that teach vaccine administration techniques. Downloads of these IAC materials have skyrocketed since December 2020 when COVID-19 vaccinations began. Here are IAC’s most popular materials on this topic:

Additional IAC materials on vaccine administration

Additional CDC resources on vaccine administration

The archive of past Technically Speaking columns is also available through links on the right side of this web page.
 
This page was updated on May 27, 2021.
This page was reviewed on May 27, 2021.
2021 ISSUES >> view all issues
JUNE 2021
Saying Goodbye – and Leaving You with My "Top Ten" List of Places to Bookmark on Immunize.org
MAY 2021
Be sure you know the anatomical landmarks for administering intramuscular injections in the arm
MARCH 2021
IAC's newly updated "COVID-19 Vaccines" web page makes it easy to find important resources from CDC and others
FEBRUARY 2021
2021 Recommended U.S. Immunization Schedules for Children/Teens and for Adults Just Released – Laminated versions available for pre-order from IAC
JANUARY 2021
Don't Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early
2020 ISSUES >> view all issues
DECEMBER 2020
FDA issues EUA for Pfizer-BioNTech mRNA vaccine; CDC approves its use and provides clinical guidance
NOVEMBER 2020
Prevent Shoulder Injuries Caused by Missing the Deltoid Muscle When Injecting Vaccines!
OCTOBER 2020
ACIP Updates Recommendations on the Use of MenACWY and MenB Vaccines
SEPTEMBER 2020
Is It 0.25 mL or 0.5 mL? What Is the Correct Dose of Injectable Flu Vaccine for Children Younger Than 3?
JULY 2020
Choosing Proper Needle Length for Vaccination of Children and Adults: What Should You Consider?
JUNE 2020
Preventing Preventable Vaccine Administration Errors in Your Medical Setting
MAY 2020
IAC Launches New MenB Vaccination Honor Roll Recognizing Colleges and Universities That Require or Recommend the Vaccine to Protect Their Students
APRIL 2020
Our Society Deserves Vaccination: Two New Educational Pieces from IAC Explain the Science Supporting Vaccines and the Value of the Vaccine Injury Compensation Program
MARCH 2020
Now Available to Order! IAC's Laminated Versions of CDC's 2020 Immunization Schedules
FEBRUARY 2020
Sign up for IZ Express—the Best Way to Stay Current with Weekly U.S. Immunization News, Information, and Resources
JANUARY 2020
CDC Releases 2020 Version of Its Vaccine Storage and Handling Toolkit
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 1NH23IP922654) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.