Administering Vaccines: Dose, Route, Site, and Needle Size

Vaccine Dose Route Injection Site and Needle Size

Pfizer-BioNTech Subcutaneous (Subcut) injection
∙age 5 to <12 yrs: 0.2 mL pediatric formulation (“orange cap”)
∙age ≥12 yrs: 0.3 mL adult/adolescent formulation for
Use a 23–25 gauge needle. Choose the injection site that is appropriate
COVID-19 primary and booster doses IM . to the person’s age and body mass.
Moderna; ≥18 yrs: 0.5 mL primary series*; 0.25 mL booster
age Needle injection site
Janssen: ≥18 yrs: 0.5 mL for primary & booster doses length
Diphtheria, Tetanus, Pertussis Fatty tissue over anterolat-
0.5 mL. . IM .. Infants (1–12 mos) ⅝"
(DTaP, DT, Tdap, Td) eral thigh muscle
Haemophilus influenzae type b (Hib) 0.5 mL IM Fatty tissue over anterolat-
Children 12 mos or older,
≤18 yrs: 0.5 mL ⅝" eral thigh muscle or fatty
adolescents, and adults
Hepatitis A (HepA) IM tissue over triceps
≥19 yrs: 1.0 mL
Intramuscular (IM) injection
Engerix-B; Recombivax HB Use a 22–25 gauge needle. Choose the injection site and needle length
Hepatitis B (HepB) ≤19 yrs: 0.5 mL
Persons 11–15 yrs may be given Recombivax HB that is appropriate to the person’s age and body mass.
≥20 yrs: 1.0 mL IM
(Merck)
1.0 mL adult formulation on a 2-dose schedule. Heplisav-B age needle injection site
≥18 yrs: 0.5 mL length
Human papillomavirus (HPV) 0.5 mL IM Newborns (1st 28 days) ⅝"1 Anterolateral thigh muscle
Intra- Infants (1–12 mos) 1" Anterolateral thigh muscle
0.2 mL (0.1 mL in each
Influenza, live attenuated (LAIV) nasal 1–1¼" Anterolateral thigh muscle2
nostril)
spray Toddlers (1–2 years)
⅝–1"1 Deltoid muscle of arm
Afluria: 0.25 mL
Children ⅝–1" 1
Deltoid muscle of arm2
Influenza, inactivated (IIV); for ages Fluzone: 0.25 or 0.5 mL
IM (3–10 years) 1–1¼" Anterolateral thigh muscle
6–35 months
Fluarix, Flucelvax, FluLaval:
0.5 mL Adolescents and teens ⅝–1"1 Deltoid muscle of arm2
Influenza, inactivated (IIV), ≥3 yrs; 0.5 mL (11–18 years) 1–1½" Anterolateral thigh muscle
recombinant (RIV), ≥18 yrs; IM
Adults 19 years or older
high-dose (HD-IIV) ≥65 yrs FluZone HD: 0.7 mL
Female or male <130 lbs ⅝–1"1 Deltoid muscle of arm
Measles, Mumps, Rubella (MMR) 0.5 mL Subcut
Female or male 130–152 lbs 1" Deltoid muscle of arm
Meningococcal serogroups A, C, W, Y
0.5 mL IM
(MenACWY) Female 153–200 lbs
1–1½" Deltoid muscle of arm
Male 153–260 lbs
Meningococcal serogroup B (MenB) 0.5 mL IM
Female 200+ lbs
Pneumococcal conjugate (PCV) 0.5 mL IM 1½" Deltoid muscle of arm
Male 260+ lbs
Pneumococcal polysaccharide IM or
0.5 mL Female or male, any weight 1½" Anterolateral thigh muscle
(PPSV) Subcut
IM or 1 5/ note: Always refer to the package insert
Polio, inactivated (IPV) 0.5 mL A 8" needle may be used in newborns, preterm
Subcut infants, and patients weighing less than 130 lbs included with each biologic for complete
Rotarix: 1.0 mL (<60 kg) for IM injection in the deltoid muscle vaccine administration information. CDC’s
Rotavirus (RV) Oral only if the skin stretched tight, the subcutaneous Advisory Committee on Immunization
Rotateq: 2.0 mL tissue is not bunched, and the injection is made Practices (ACIP) recommendations for the
Varicella (VAR) 0.5 mL Subcut at a 90-degree angle to the skin.
2 particular vaccine should be reviewed as
† Preferred site
Zoster (Zos) Shingrix: 0.5 mL IM well. Access the ACIP recommendations at
www.immunize.org/acip.
Combination Vaccines
DTaP-HepB-IPV (Pediarix)
DTaP-IPV/Hib (Pentacel)
0.5 mL IM
DTaP-IPV (Kinrix; Quadracel)
DTaP-IPV-Hib-HepB (Vaxelis)
MMRV (ProQuad) ≤12 yrs: 0.5 mL Subcut Intramuscular (IM) Subcutaneous (Subcut)
injection injection
HepA-HepB (Twinrix) ≥18 yrs: 1.0 mL IM
* If immunocompromised, Moderna 0.5 mL for
3-dose primary series, then 0.25 mL for booster
dose. Intranasal (NAS) 90° angle 45° angle
† administration skin
The Shingrix vial might contain more than skin
0.5 mL. Do not administer more than 0.5 mL. of Flumist (LAIV)
subcutaneous tissue subcutaneous tissue
vaccine
muscle muscle

Immunization Action Coalition Saint Paul, Minnesota • 651- 647- 9009 • www.immunize.org • www.vaccineinformation.org
www.immunize.org/catg.d/p3085.pdf • Item #P3085 (11/21)