Reduce the Risk of Pain or Injury From IM Vaccinations

You can help minimize pain and prevent injury from intramuscular (IM) vaccines when working in COVID-19 vaccine clinics.

It's common for patients to have arm soreness or discomfort for a couple days after getting any IM vaccine (COVID-19, Tdap, etc).

But shoulder injury or other serious issues can occur if a vaccine isn't given properly.

Advise those scheduled for a vaccine to wear a sleeveless shirt...or one with sleeves that can easily be rolled up...to completely expose their shoulder for the injection.

Pulling the shirt down over their shoulder can increase the risk of injecting too high and causing shoulder injury.

If you're trained to give vaccines, focus on proper technique.

Give IM vaccines in the central, thickest part of the deltoid in patients over age 3.

Aim for about 2 inches...or 2 to 3 finger widths...below the bony part of the shoulder, and inject at a 90-degree angle.

Sit or kneel to vaccinate a seated patient...but adjust if needed. For example, in a drive-thru clinic, you may need to open a vehicle door, or use a stool to get to eye level if a patient's seated in a truck.

Ensure patients get clinician counseling on managing arm soreness or discomfort. Not resting the arm...applying a cool compress...and taking acetaminophen or an NSAID (ibuprofen, etc) if needed may help.

Find more tips in our Vaccine Administration checklist.

And if you aren't already an immunizer, consider getting trained to administer vaccines. Our Pharmacy Technicians University's PTU Elite: Immunizations program will help you meet requirements...and be confident and prepared.

Key References

  • https://ismp.org/resources/prevent-shoulder-injuries-during-covid-19-vaccinations (3-4-21)
  • Can Fam Physician 2019;65(1):40-2
  • www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html (3-4-21)
  • www.immunize.org/technically-speaking/20181023.asp (3-4-21)
  • www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html (3-4-21)
Hospital Pharmacy Technician's Letter. March 2021, No. 370302



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