Vaccines

Intramuscular

• 90 degree

• 22-25 gauge needle

• Deltoid, Adults: 1 inch

• Anterolateral thigh, Adults: 1 ½ inch

• Thigh (lat) for babies

Subcutaneous

• 45 degrees

• 23-25 gauge needle

• 5/8 ich

Intradermal

• 30 gauge

• ½ inch

• 5-15 degree

• PPD (Purified Protein Derivative), TB, and Mantonx

Documenting

Write down horizontally

• Date, Brand, Dosage, Manufacturer, Lot #, Expiration Date, Location (e.g., Right Deltoid, IM), Sign Off with Initials (AP)

COVID-19

• IM

• Moderna, Pfizer, Janssen

• COVID-19 (respiratory virus)

• Breathing in droplets or aerosols from an infected person.

• 1 dose annually (updated vaccine)

DTaP, DT, Tdap, Td

• IM

• Adacel, Boostrix

• Diphtheria – throat infection; Tetanus – muscle spasms (“lockjaw”); Pertussis – whooping cough

• Diphtheria & pertussis: coughing/sneezing.

• Tetanus: soil, dust, or animal feces entering a wound.

• 1 dose of Tdap as an adult, then Td or Tdap every 10 years

Hepatitis A

• IM

• Havrix, Vaqta

• 2 doses (6 months apart)

• Contaminated food/water (fecal-oral)

Hepatitis B

• IM

• Blood, body fluids, sex, needles, childbirth

• 2 doses (Heplisav-B, 1 month apart)

• or 3 doses (Engerix-B/Recombivax-B at 0, 1, and 6 months)

• Recombivax-B, Heplisav-B, Engerix-B

Human Papillomavirus

• IM

• Gardasil 9

• 3 doses (0, 2, and 6 months) if starting at age 15 or older

• Skin-to-skin sexual contact

•  Prevents cervical and other cancers and genital warts.

Influenza — Seasonal Flu

• IM

• Fluad, Fluzone

• Respiratory droplets

• 1 dose every year

MMR — Measles, Mumps, Rubella

• SQ

• Prioriz, MMR2

• Airborne droplets

• 1 dose if not immune; 2 doses (4 weeks apart) for certain high-risk adults

Men B — Meningococcal B

• IM

• Bexsero, Trumenba

• Saliva, kissing, sharing drinks

• 2 doses (Bexsero) or 3 doses (Trumenba for certain high-risk people)

PPSV — Pneumococcal Polysaccharide

• IM or SQ

• Pneumovax 23

• Respiratory droplets

• Usually 1 dose for adults who need it (often age 65+ or certain medical conditions)

• Helps prevent pneumonia, meningitis, and bloodstream infections.

Polio — IPV

• IM or SQ

• Ipol

• Contaminated food/water

• 1 lifetime series if never vaccinated (3 doses) or 1 booster for certain at-risk adults

• Can cause paralysis.

Varicella - VAR

• SQ or IM

• Varivax

• Chickenpox

• Airborne droplets or contact with blisters

• 2 doses (4–8 weeks apart) if no evidence of immunity

• Virus stays dormant and can later cause shingles.

Tuberculosis — PPD (Purified Protein Derivative), Mantonx

• ID

• Tubersol

• Not a vaccine

• Airborne

• Read 48–72 hours after placement.