Administering Vaccines:

Dose, Route, Site, and Needle Size

Vaccine Dose Route Injection Site and Needle Size
Diphtheria, Tetanus, Pertussis Subcutaneous (Subcut) injection
0.5 mL. . IM ..
(DTaP, DT, Tdap, Td) Use a 23–25 gauge needle. Choose the injection site that is appropriate to
Haemophilus influenzae type b (Hib) 0.5 mL IM the person’s age and body mass.
≤18 yrs: 0.5 mL age Needle injection site
Hepatitis A (HepA) IM length
≥19 yrs: 1.0 mL
Fatty tissue over anterolateral
Engerix-B; Recombivax HB Infants (1–12 mos) ⅝"
thigh muscle
Hepatitis B (HepB) ≤19 yrs: 0.5 mL
Persons 11–15 yrs may be given Recombivax HB (Merck) >20 yrs: 1.0 mL IM Fatty tissue over anterolateral
1.0 mL adult formulation on a 2-dose schedule. Children 12 mos or older,
Heplisav-B ⅝" thigh muscle or fatty tissue
≥18 yrs: 0.5 mL adolescents, and adults
over triceps
Human papillomavirus (HPV) 0.5 mL IM Intramuscular (IM) injection
0.2 mL (0.1 mL in Intranasal Use a 22–25 gauge needle. Choose the injection site and needle length that
Influenza, live attenuated (LAIV)
each nostril) spray is appropriate to the person’s age and body mass.
Afluria: 0.25 mL needle
age length injection site
Influenza, inactivated (IIV); for ages Fluzone: 0.25 or 0.5 mL
IM
6–35 months Newborns (1st 28 days) ⅝"* Anterolateral thigh muscle
FluLaval; Fluarix:
0.5 mL Infants (1–12 mos) 1" Anterolateral thigh muscle
Influenza, inactivated (IIV), for ages 3 1–1¼" Anterolateral thigh muscle**
years & older; recombinant (RIV), for 0.5 mL IM Toddlers (1–2 years)
ages 18 years and older ⅝–1"* Deltoid muscle of arm

Measles, Mumps, Rubella (MMR) 0.5 mL Subcut Children ⅝–1"* Deltoid muscle of arm**
(3–10 years) 1–1¼" Anterolateral thigh muscle
Meningococcal serogroups A, C, W, Y
0.5 mL IM
(MenACWY) ⅝–1"* Deltoid muscle of arm**
Adolescents and teens
Meningococcal serogroup B (MenB) 0.5 mL IM (11–18 years) 1–1½" Anterolateral thigh muscle
Pneumococcal conjugate (PCV) 0.5 mL IM Adults 19 years or older
IM or Female or male <130 lbs ⅝–1"* Deltoid muscle of arm
Pneumococcal polysaccharide (PPSV) 0.5 mL
Subcut
Female or male 130–152 lbs 1" Deltoid muscle of arm
IM or
Polio, inactivated (IPV) 0.5 mL Female 153–200 lbs
Subcut 1–1½" Deltoid muscle of arm
Male 153–260 lbs
Rotarix: 1.0 mL
Rotavirus (RV) Oral Female 200+ lbs
Rotateq: 2.0 mL 1½" Deltoid muscle of arm
Male 260+ lbs
Varicella (VAR) 0.5 mL Subcut
Shingrix: 0.5* mL IM * A 5/8" needle may be used in newborns, preterm note: Always refer to the package insert
Zoster (Zos) infants, and patients weighing less than 130 lbs included with each biologic for complete
Zostavax: 0.65 mL Subcut (<60 kg) for IM injection in the deltoid muscle vaccine administration information. CDC’s
Combination Vaccines only if the skin stretched tight, the subcutaneous
Advisory Committee on Immunization
tissue is not bunched, and the injection is made
DTaP-HepB-IPV (Pediarix) at a 90-degree angle to the skin.
Practices (ACIP) recommendations for the
DTaP-IPV/Hib (Pentacel) 0.5 mL IM ** Preferred site particular vaccine should be reviewed as
DTaP-IPV (Kinrix; Quadracel) well. Access the ACIP recommendations at
www.immunize.org/acip.
MMRV (ProQuad) ≤12 yrs: 0.5 mL Subcut
HepA-HepB (Twinrix) ≥18 yrs: 1.0 mL IM
* The vial might contain more than 0.5 mL. Do not administer more than 0.5 mL.

Intramuscular (IM) injection Subcutaneous (Subcut) injection Intranasal (NAS) administration

of Flumist (LAIV) vaccine

90° angle 45° angle

skin skin
subcutaneous tissue subcutaneous tissue

muscle muscle

Technical content reviewed by the Centers for Disease Control and Prevention

Immunization Action Coalition Saint Paul, Minnesota • 651- 647- 9009 • www.immunize.org • www.vaccineinformation.org
www.immunize.org/catg.d/p3085.pdf • Item #P3085 (8/19)