How Can (and Should) Vaccine Administrators Improve the Immunization Experience?

Getting vaccinated should be a simple and straightforward process. There are clear procedures that vaccine administrators can (and should) follow when providing immunizations, and following these procedures can greatly reduce the risk of vaccine-related injuries. Vaccine administrators also can (and should) take steps to help reduce vaccination anxiety for both children and adults when necessary. Yet, many people still have a negative immunization experience, and some find themselves in need of an experienced vaccine injury attorney.

Addressing Vaccination Anxiety

The National Center for Immunization and Respiratory Diseases (NCIRD) and Centers for Disease Control and Prevention (CDC) have published several resources for providers and parents focused on addressing vaccination anxiety. While these resources focus on vaccination anxiety in children, many of the tips in these resources are relevant for adult vaccine recipients as well.

For example, to help reduce vaccination anxiety, the NCIRD and CDC recommend:

  • Offering a pre-registration option to minimize time in the waiting room
  • Setting up vaccination areas so that they are comfortable and private
  • Keeping needles out of sight until the provider is prepared to administer the vaccine
  • Consider applying topical analgesia or advising patients or parents to apply topical analgesia 30 to 60 minutes before their appointment
  • Avoiding words such as “shot” or “sting” that may induce fear, while also avoiding false assurances, such as “It won’t hurt a bit”
  • Instructing vaccine recipients on coping strategies, such as deep breathing, as necessary
  • Following proper vaccine administration procedures to minimize pain, including not aspirating before the injection, injecting the needle quickly and administering the most painful vaccine last when administering multiple immunizations

Again, these are just examples. Experienced providers should be familiar with these tactics (among others), and should be able to make informed decisions about what will be most effective for each individual vaccine recipient. While it may not be possible to fully eliminate a vaccine recipient’s anxiety and provide a truly “comfortable” experience, vaccine administrators should generally do what they can with the time and resources they have available.

Understanding the Risk of Shoulder Injuries Related to Vaccine Administration (SIRVA)

Along with taking steps to help reduce vaccine recipients’ anxiety as necessary, vaccine administrators should also ensure that they are doing everything necessary to mitigate the risk of shoulder injuries related to vaccine administration (SIRVA). Unlike other types of vaccine-related medical conditions, SIRVA do not result from adverse reactions to vaccines, but rather from errors during the vaccination process.

All vaccinations present risks for SIRVA, and all forms of SIRVA present risks for vaccine recipients diagnosed with these vaccine-related injuries. For example, some of the most common effects of SIRVA include:

  • Severe pain
  • Limited mobility
  • Limited range of motion
  • Loss of muscle control
  • Loss of sensation

Shoulder injuries related to vaccine administration can have other effects as well; and, in all cases, treatment can be very costly. As a result, it is important that vaccine administrators take appropriate precautions to prevent these injuries each time they inject a vaccine.

5 Ways Vaccine Administrators Can (and Should) Mitigate the Risk of SIRVA

What can (and should) vaccine administrators do to mitigate the risk of SIRVA? The steps to properly administer a vaccine differ for intramuscular and subcutaneous injections. For intramuscular injections—including the flu shot, human papillomavirus (HPV) vaccine, tetanus vaccines, and hepatitis A and B vaccines—properly administering a vaccination involves:

1. Choosing the Correct Needle Length

The correct needle length for intramuscular injections varies for children and adults of different weights. For small children, vaccine administrators should typically use a needle that is 5/8” in length. A 1” needle is appropriate for larger children, women up to 200 pounds and men up to 260 pounds, while a 1.5” needle is recommended for heavier adults.

2. Identifying the Injection Site

The correct location for administration of an intramuscular vaccine injection is the deltoid muscle in the upper arm. The CDC advises: “Find the acromion process, which is the bony point at the end of the shoulder. The injection site will be approximately 2 inches below the bone and above the axillary fold/armpit.”

3. Inserting the Needle at the Correct Angle

For intramuscular vaccine injections, the needle should be inserted at a 90-degree angle to the skin. This ensures that the needle will penetrate to the correct depth (assuming the vaccine administrator chooses the correct needle length), which is critical for mitigating the risk of SIRVA. The tip of the needle should reach into the muscle tissue, and this is where the vaccine should be injected.

4. Properly Administering Multiple Vaccines

When administering multiple vaccines (intramuscular or subcutaneous), vaccine administrators should insert the various needles at least one inch apart, “if possible.” Inserting multiple needles too close together can increase the risk of trauma resulting in a shoulder injury related to vaccine administration. If it is not possible to inject multiple vaccines in the same arm at least one inch apart, the vaccine administrator can inject vaccines into both arms, or recommend a follow-up appointment if necessary.

5. Using Aseptic Technique Throughout the Vaccine Administration Process

Using aseptic technique when administering vaccines helps to prevent contamination and infections, both of which can lead to SIRVA. As the CDC explains, aseptic technique involves appropriately storing vaccines prior to administration, practicing appropriate hand hygiene, preparing vaccines for injection in a designated medical area, checking expiration dates, and ensuring that vaccine administrators have all of the clinical supplies they need to administer the vaccine without leaving and returning.

Are You Entitled to Financial Compensation for SIRVA? Schedule a Free Consultation with Vaccine Injury Attorney Leah V. Durant

Individuals diagnosed with SIRVA are entitled to financial compensation under the National Vaccine Injury Compensation Program (VICP) in many cases. At the Law offices of Leah V. Durant, PLLC, we represent vaccine recipients and families in VICP claims nationwide. If you would like to learn about filing a claim for SIRVA, please call 202-800-1711 or contact us online to arrange a free consultation with vaccine injury attorney Leah V. Durant.


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.