The needle should be inserted as close to the center of the deltoid muscle as possible, which means that the patient’s sleeve should generally be rolled up rather than their collar being pulled down. When administering the flu shot, the CDC advises that the needle should be inserted at a 90-degree angle to the skin, and the practitioner administering the vaccine should stretch the skin flat prior to needle insertion. Injection at these sites reduces the chance of involving neural or vascular structures.” There are only two routinely recommended IM sites for administration of vaccines, the vastus lateralis muscle (anterolateral thigh) and the deltoid muscle (upper arm). Adjuvants can cause an exaggerated local reaction (e.g., pain, swelling, redness) if not injected into the muscle, so proper technique is critical. Many inactivated vaccines contain an adjuvant, which is a vaccine component that enhances the immune response to the antigen.
“Almost all inactivated vaccines are administered by the intramuscular route. The Centers for Disease Control and Prevention (CDC) provides guidelines for proper administration in a book titled, Epidemiology and Prevention of Vaccine-Preventable Diseases, also known as the “Pink Book.” The Pink Book explains: What is the Proper Location for Administering a Flu Shot? One of the most-common mistakes that can lead to SIRVA is inserting the needle too high on the patient’s arm. Although giving someone a flu shot may seem like a fairly straightforward process, mistakes during immunizations are common, and these mistakes often lead to a class of injuries known as Shoulder Injury Related to Vaccine Administration (SIRVA). There are right and wrong ways to administer vaccines.
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