The vaccines that are recommended for routine immunization by the Centers for Disease Control and Prevention (CDC) in all children from birth through age 6 years are discussed below. [1] For more detailed information, including exceptions and other considerations, see the CDC’s full vaccines and immunizations guidelines. Show
The vaccines listed below are administered via intramuscular (IM) injection unless otherwise stated. IM administration in the anterolateral thigh muscle is preferred in neonates, infants, and small children. IM administer in the deltoid muscle is preferred in young children (eg, aged 4-6 years) who are of normal weight. Hepatitis B vaccine (HepB)
Rotavirus vaccine (RV)
Diphtheria, tetanus, acellular pertussis vaccine (DTaP)
Haemophilus influenza type b vaccine (Hib)
Pneumococcal vaccine 13-valent (PCV13)
In 2015, the Advisory Committee on Immunization Practices provided recommendations on the pneumococcal polysaccharide vaccine (PPSV23) and the pneumococcal conjugate vaccine (PCV13), summarized as follows: [3]
Inactivated poliovirus vaccine (IPV)
Influenza vaccines
ACIP recommends return of intranasal flu vaccine in the United States for the 2018-2019 season
Measles, mumps, and rubella vaccine (MMR)
Varicella virus vaccine
Hepatitis A vaccine (HepA)
The following clinical practice guidelines were released in 2015 by Help Eliminate Pain in Kids: [8]
What is the most appropriate site of injection for children under 3?For the majority of infants, the anterolateral aspect of the thigh is the recommended site for injection because it provides comparatively larger muscle mass than the deltoid (Figure 2) (23).
Which site for IM injection is not used in children under 3 years of age?Infants (up to 2 years of age)
Do not use the inner thigh or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section.
Which muscle is used for the IM injection in infants and children younger than 3 years?The anterolateral thigh is the preferred site for IM injection in infants under 12 months of age. Medications are injected into the bulkiest part of the vastus lateralis thigh muscle, which is the junction of the upper and middle thirds of this muscle.
Which is the ideal site for injecting an intramuscular medication in children less than 3 years of age?The anterolateral aspect of the thigh, or vastus lateralis muscle, is the preferred IM site for neonates and infants.
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