Injection Technique

There have been many studies that looked into the best techniques in giving injection to children to reduce pain. Most vaccines are injected directly into the muscle, while other vaccines must be injected in the fatty tissue under the skin. Those vaccines that are designed for muscular injection include the DTaP vaccine, the Hib conjugate vaccine, the pneumococcal conjugate vaccine, the meningococcal conjugate vaccine, the hepatitis B vaccine, the hepatitis A vaccine, and the HPV vaccine. Vaccines that must be given under the skin include the MMR vaccine, the pneumococcal polysaccharide vaccine, the meningococcal polysaccharide vaccine, and the chickenpox vaccine.

Where the meningococcal vaccine is administered depends on whether the vaccine is the conjugate type or the polysaccharide type. The conjugate vaccine is always given directly into the muscle, whereas the polysaccharide vaccine is given underneath the skin fold. Some vaccines can be given either into the muscle or under the skin. These vaccines include the pneumococcal polysaccharide vaccine and the killed polio vaccine. The nurse giving vaccines should be very familiar with the appropriate techniques for each individual vaccine.


The reason why some vaccines must be given directly into the muscle while others are given under the skin is because certain vaccines work better when they are injected into a particular layer of the tissue. If the vaccine is accidentally the wrong layer, it would not necessarily be harmful, but it may not work as well.

Location of Injection

You must wonder why some people get vaccinated in their buttocks while others receive the injection in their upper arms. If you had a baby recently, you would know that vaccines are usually injected into your baby's thighs. So how do doctors and nurses determine where to give the shots?

It turns out that there are options as to where vaccines can be safely injected into the body. As long as the needle stays away from major arteries and nerves, any site can be used for injection. In addition to avoiding blood vessels and nerves, the location must offer enough tissue so that the needle does not penetrate deep enough to hit bones.

It is generally accepted that the best place to give shots to babies less than a year old is the front of the thigh. There should be plenty of tissue so the needle cannot injure a nerve or blood vessel, and there is no major nerve that traverses through that part of the body.

For older children, the side of the upper arm is typically used for injection because once children are walking, injections in the thigh may cause more pain and interfere with normal ambulation. However, there are times when giving shots on the arm may be difficult or nearly impossible due to a fighting child resisting shots. In these circumstances, injection into the thigh or the buttocks may be necessary.


Since the number one reason why children fear going to the doctor is shots, it behooves doctors and parents to find out a way to give shots so that they are less painful. In 2007, a study sponsored by American and Canadian doctors looked into whether the speed of the injection mattered with pain perception in children. A standardized pain scale for children was used to determine the degree of pain sensation felt by these children.


In addition to giving the shots quickly, pinching the skin around the injection site has also been proven to help reduce pain associated with vaccination. If the nurse squeezes the skin of your child, it doesn't mean that she is hurting him. In fact, she is relieving the painful sensation of the injection.

Using the traditional, slower injection approach, the study found that a nurse took an average of eight seconds for each injection. Using the more rapid, needle-in-and-out technique, the nurse took less than one second for each injection. At the end of the study, the scientists found that children experienced significantly more pain with the long, drawn-out injection technique versus the rapid stab technique.

Most experienced nurses already know this, and they always accomplish the vaccination efficiently and quickly. So the next time a nurse quickly gives all the injections to your child, she or he is actually doing your child a favor by stabbing the skin quickly instead of digging in with the needle and taking it out slowly.


Many parents are concerned that the person giving the injections does not wear gloves. The act of giving an injection is not a sterile medical procedure, which means the use of gloves is not required. However, it must be done with clean hands, and the location where the skin is punctured by the needle must be cleaned with rubbing alcohol prior to the injection.


While wearing gloves is not mandatory for the person administering the shots, many people still decide to wear gloves to protect themselves from potential exposure to the small amount of bleeding that may occur with normal vaccination.

Syringe Disposal

The syringe used for vaccine administration is a source of danger, for both children and the adults giving the shots. The syringe must be disposed in the appropriate container immediately after the injection is given. If you see a syringe in the room or on the floor, you must notify the office staff immediately to reduce the risk of puncture injury and potential transmission of infection.

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