Tag: shots

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

 

Which Vaccines Can Be Given IM?

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 IM?

Vaccines that are given by intramuscular injection include:

  • DTaP, Pediarix, Pentacel, Kinrix, Quadracel (DTaP containing vaccines)
  • hepatitis A
  • hepatitis B
  • Hib containing vaccines (Hib, Pentacel, Comvax, Kinrix, Quadracel)
  • Gardasil9 (HPV vaccines)
  • flu shots
  • Menactra, Menveo, Bexsero, Trunembra (Meningococcal vaccines)
  • Prevnar13, Pneumovax* (Pneumococcal vaccines)
  • IPV* (polio vaccine)
  • Boostrix, Adacel (Tdap vaccines)

*The Pneumovax and IPV vaccines can be given either IM or Subcutaneously (SQ).

There are exceptions though. Kids with hemophilia can get IPV and the hepatitis A and B vaccines SQ, instead of IM.

Where to Give IM Injections?

The upper arm is the best place to give shots to older kids.
The upper arm is the best place to give shots to older kids.

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

While newborns, infants, and younger toddlers get their IM injections in their anterolateral thigh muscle, older children typically get them in their anterolateral thigh muscle or in the deltoid muscle of their arm.

Be sure to use the correct needle size, length and gauge, and insert the needle with a quick thrust at a 90° angle to the skin (rapid injection technique). 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 IM Vaccines

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

More on IM Vaccines

Making Shots Hurt Less

Vaccines are one of the greatest achievements in public health.

Holding your child, if possible, can make getting shots less painful.
Holding your child, if possible, can make getting shots less painful.

Vaccines work. Vaccines are safe, with many benefits and few risks. Vaccines are necessary.

The great majority of us understand all of those things, but there is still one thing about most vaccines that most of us don’t like.

Shots can hurt.

Fortunately, there are many things we can learn to do to reduce the pain and anxiety that can be associated with getting vaccines.

Making Shots Hurt Less

Did you know that you can also do things that make getting a shot more stressful than it has to be?

“A smile goes a long way, especially between parents and their children. Children often take their parents’ moods into account when experiencing the world around them. Hugs, cuddles, soft whispers, and a calm, reassuring attitude will help ease children through the vaccination process. Remain upbeat and relaxed before, during, and especially after shots. Let your child know everything is ok.”

CDC on 9 Things to Make Shots Less Stressful… For You and Your Baby

In addition to staying happy and calm, you can help your child by:

  • preparing them in advance so they know what to expect, but be honest and avoid telling them that “it won’t hurt” when you know that it will, at least a little bit
  • making sure your pediatrician uses combination vaccines to decrease the number of shots that your child has to get at each visit
  • not delaying or skipping any vaccines, so that your child doesn’t have to get shots over multiple visits or get caught up on a lot of shots when they are older
  • distracting them right before and during their shots
  • holding them, if possible, while they get their shots (why wouldn’t you be able to hold your child? If you don’t hold your child well, it will just prolong the whole thing and could lead to a needle getting batted away or a needle-stick injury…)
  • if nursing, breastfeed during the shots, or if that isn’t possible, right after the shots are given
  • considering the use of a numbing cream (they can give you a prescription if they don’t have any in the office, and just bring it to your next visit) if your child is really anxious about getting their shots

What’s the best way to help your child? It is probably to have someone that who is confident and has experience giving kids vaccines.

What should you avoid?

Don’t give your child a pain reliever before their shots. One study said that it might decrease the immune response to the vaccine, it probably won’t decrease the pain from the vaccine, and your child might not need it. Do give a pain or fever reliever afterwards if necessary though.

You also shouldn’t joke about taking your child to the doctor for a shot if they misbehave, or that the doctor is going to use a really big needle, etc.

What about commercial tools, like the Buzzy or Shot Blocker? While some people swear by them, they likely “work” as a sort of distraction.

What to Know About Making Shots Hurt Less

While needles and shots can be painful, there are ways to reduce the pain and anxiety that are associated with vaccines, so that your kids can get vaccinated and protected with minimal stress.

More on Making Shots Hurt Less