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Ask the AIPO Experts
Clinical answers to vaccine questions
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Intramuscular vaccine injection sites, spacing and needle sizes
 General considerations:
- If 2 vaccines are to be administered in a single limb, they should be spaced one inch apart. Injecting Pertussis and Pneumococcal vaccines in opposite extremities helps prevent large localized reactions.
- An intramuscular injection is made at a 90-degree angle and the tissue is not bunched.
- For vaccines (MMR, MMRV, MPSV4, PPSV23, IPV and Varicella) given subcutaneously, the injection is made at a 45-degree angle.
RESOURCES:
ACIP Vaccine Administration Guidelines for Immunization | CDC
Administering Vaccines: Dose, Route, Site, and Needle Size Job Aid
Contact the Arizona Immunization Program Office (AIPO) for Assistance
The AIPO has clinical staff available to assist with your immunization questions. Contact the following individuals (or your county health department) for assistance:
Main Desk: 602-364-3630, ask for a nurse consultation.
Michelina Stazzone, DNP, RN, CPNP Michelina.stazzone@azdhs.gov, 480-259-5342
Shannon Clark, BSN, RN Shannon.Clark@azdhs.gov, 480-261-5557
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