Which Vaccines can be Given SQ?

When most folks think about getting a vaccine, they typically picture someone getting a shot.

It is important to remember that not all vaccines are shots though.

And even for those vaccines that are given as shots, not all of them are given intramuscularly (IM).

Some vaccines are also given orally, nasally, and subcutaneously.

Which Vaccines can be Given SQ?

Vaccines that are given by subcutaneous injection include:

  • MMR
  • ProQuad (MMR/V combination of MMR and chickenpox vaccines)
  • Pneumovax* (Pneumococcal vaccine)
  • IPV* (polio vaccine)
  • Varivax (chickenpox vaccine)
  • Zoster (shingles vaccine)

*The Pneumovax and IPV vaccines can be given either IM or Subcutaneously (SQ). And there are some other exceptions too. Kids with hemophilia can get the hepatitis A and B vaccines SQ, instead of IM.

Where to Give SQ Injections?

After asking how many shots they are going to get, kids often ask where they are going to get them?

While infants get their subcutaneous injections in the fatty tissue over their anterolateral thigh muscle, toddlers and older children get them in the fatty tissue over their anterolateral thigh muscle or triceps.

Older children get SQ injections in the the upper-outer triceps area.
Older children get SQ injections in the the upper-outer triceps area.

Be sure to use the correct needle size, length and gauge (typically 5/8″ and 23-25 gauge), and insert the needle with a quick thrust at a 45° angle to the skin (rapid injection technique), pinching up on the SQ tissue to avoid hitting the muscle, and instead injecting in the subcutaneous tissue between the skin and muscle.

Also keep in mind that it is not necessary to aspirate after injecting the needle and that multiple injections in the same extremity should be separated by at least one inch.

What to Know About SQ Vaccines

It is important to know which vaccines need to be given subcutaneously (SQ) and both how and where to give these shots.

More on SQ Vaccines

 

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