1.4 Administration of vaccines

Please note: due to continuous updates being made to the Immunisation Handbook, the page number on the electronic version will not always match the hard copy version.


The location of each separate injection given should be recorded, so that if a local adverse event occurs, the implicated vaccine(s) can be identified.

Infants <12 months of age

The suitable sites for this age group are the anterolateral thighs and the ventrogluteal areas. Two vaccines can be given into the same anterolateral thigh, separated by at least 2.5 cm. However, only 1 vaccine should be given into each ventrogluteal area.

When 3 or 4 IM vaccines are to be given at the same visit, the options are:

• 2 injections can be administered in the same anterolateral thigh, separated by at least 2.5 cm (see Figure 1.4.11); further IM vaccines can be given in this way in the other thigh, or
• 1 injection can be given into each anterolateral thigh and 1 injection can be administered into each ventrogluteal area.

Figure 1.4.11: Recommended technique for giving multiple vaccine injections to an infant <12 months of age into the anterolateral thigh

Children ≥12 months of age, adolescents and adults

A single injection can be given into each deltoid muscle.

When 3 or 4 IM vaccines are to be given to a child at the same visit, the options will depend on the muscle mass of the child’s deltoid.

If the deltoid mass is adequate:

• a further injection can be given into each deltoid muscle (separated by 2.5 cm from the initial vaccine).

If the deltoid muscle mass is small:

• further injections can be given into either the anterolateral thighs (2.5 cm apart if 2 vaccines are given in the same thigh), or
• give 1 injection into each ventrogluteal area.

For younger children, the cuddle or straddle position (Figures 1.4.3 and 1.4.4) are suitable for accessing multiple limbs during the one vaccination encounter.


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