Proper vaccine administration is critical for preventing vaccine-related injuries. Mistakes are easy to make, and while they may seem relatively minor, they can have serious and long-term consequences.
The primary risk associated with mistakes during vaccine administration is a class of injuries referred to as shoulder injuries related to vaccine administration (SIRVA). There are several types of SIRVA, including:
- Adhesive Capsulitis (frozen shoulder)
- Brachial Neuritis
- Rotator Cuff Tears
- Shoulder Bursitis
- Tendonitis
These injuries can have effects that last anywhere from months to years. They can also prove incredibly expensive. Fortunately for vaccine recipients and their families, these injuries are covered under the National Vaccine Injury Compensation Program (VICP) in many cases. When SIRVA are covered under the VICP, vaccine recipients and their families can hire a vaccine injury lawyer to handle their claim at no cost.
Publicly-Available Resources for Proper Vaccine Administration
Even so, SIRVA can—and should—be avoided. Doctors, pharmacists, nurses and other vaccine administrators can prevent SIRVA by following the correct process for administering vaccines. The Centers for Disease Control and Prevention (CDC) and National Center for Immunization and Respiratory Diseases (NCIRD) have published guidance for proper vaccine administration, and by following this guidance, vaccine administrators can avoid mistakes that have the potential to result in SIRVA.
The CDC’s and NCIRD’s guidance is publicly available online. For example, Vaccinating Adults: A Step-by-Step Guide is a 142-page reference manual written “in an easy-to-use format” to help healthcare providers ensure proper vaccine administration in all settings. Resources such as Immunize.org’s Administering Vaccines: Dose, Route, Site, and Needle Size are also publicly available and designed to help ensure that vaccine administrators have easy access to the information they need to avoid causing potentially serious injuries.
The Basics of Proper Vaccine Administration
Administering a vaccine is not as simple as sticking a needle into someone’s arm. There are several safety considerations involved, and different needles, different doses and different administration procedures are used in different cases. As a result, vaccine administrators must be well-versed in the proper vaccine administration protocols, and they must devote adequate time and attention to each individual patient to ensure that they are not putting patients at risk for injury.
Here is an overview of the basics of proper vaccine administration:
1. Dose
Some vaccines have different dosage requirements for patients of different ages. For example, the proper dose of the Hepatitis A (HepA) vaccine for individuals aged 18 or under is 0.5 milliliters, while the proper dose for adults aged 19 and older is 1.0 milliliters. With the Hepatitis B (HepB) vaccine, the proper dosage depends not only on the patient’s age but also on which formulation of the vaccine the patient receives.
2. Needle Length
The appropriate needle length for administering a vaccine also depends on the patient’s age and, for adults, the patient’s weight. The current recommendations according to Immunize.org for intramuscular (IM) injections are as follows:
- Newborns (28 Days and Under) – 5/8”
- Infants (Under 12 Months) – 1”
- Toddlers (1 to 2 Years) – 5/8” to 1 1/4″ depending on the injection site
- Children (3 to 10 Years) – 5/8” to 1 1/4″ depending on the injection site
- Adolescents (11 to 18 Years) – 5/8” to 1 1/2″ depending on the injection site
- Adults Under 130 Pounds – 5/8” to 1”
- Adults 130 to 152 Pounds – 1”
- Adult Females 153 to 200 Pounds – 1” to 1 1/2″
- Adult Females More Than 200 Pounds – 1 1/2″
- Adult Males 153 to 260 Pounds – 1” to 1 1/2″
- Adult Males More Than 260 Pounds – 1 1/2″
3. Injection Method and Needle Gauge
There are two main injection methods for vaccines: subcutaneous (subcut) and intramuscular (IM). According to Immunize.org, subcutaneous injections should be administered with a 23 to 25-gauge needle, while intramuscular injections should be administered with a 22 to 25-gauge needle.
While most vaccines should be administered using intramuscular injections, there are a few exceptions. Additionally, some vaccines can be administered either subcutaneously or intramuscularly. As a result, vaccine administrators need to know which method they should be using, and they should follow the procedures for that specific method of injection.
4. Injection Angle
Another key difference between subcutaneous and intramuscular vaccine injections is the angle at which the needle is inserted below the skin. While subcutaneous injections should be administered at an angle of 45 degrees (so that the needle does not penetrate the muscle below the subcutaneous tissue), intramuscular injections should be administered at an angle of 90 degrees.
5. Injection Site
One of the most common vaccine administration errors that leads to SIRVA is failure to choose the correct injection site. Intramuscular injections should be administered into the deltoid muscle, which is located on the outside of the arm just below the shoulder. During intramuscular injections, the patient’s shoulder should be fully exposed so that the proper injection site is easily accessible. Asking a patient to pull down his or her shirt can result in the needle being inserted too high on the shoulder while asking a patient to roll up his or her sleeve can result in the needle being inserted too low on the arm.
For subcutaneous vaccine injections, the proper administration site is different. Subcutaneous injections should be administered in the back of the arm, about halfway between the shoulder and the elbow. Administering subcutaneous injections in the deltoid region or in other areas of the arm risks causing muscle damage which can lead to SIRVA.
To clarify, these are not all of the considerations involved. Refrigeration, use of diluents, sanitization and various other safety practices must be considered as well.
Do You Have a Claim for SIRVA? Find Out from a Vaccine Injury Lawyer
If you or a loved one has been diagnosed with a shoulder injury related to vaccine administration (SIRVA), your family may have a claim under the National Vaccine Injury Compensation Program (VICP). To discuss your legal rights with vaccine injury lawyer Leah V. Durant, please call 202-800-1711 or request a free initial consultation online today.
Leah Durant Bio
Experienced litigation attorney Leah Durant focuses on representing clients in complex vaccine litigation matters. Leah Durant is the owner and principal attorney of the Law Offices of Leah V. Durant, PLLC, a litigation firm based in Washington, DC. Leah Durant and her staff represent clients and their families who suffer from vaccine-related injuries, adverse vaccine reactions and vaccine-related deaths. The Law Offices of Leah V. Durant, PLLC is dedicated to assisting individuals in recovering the highest level of compensation as quickly and efficiently as possible. To learn more, contact vaccine attorney Leah Durant today.
Categories: Shoulder Injury Related to Vaccine Administration or SIRVA
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