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Immunizations - childhood vaccination programme - Management
How should I administer vaccines in a child or adult over 10 years of age?

  • Obtain written or verbal consent at the time of vaccination for people aged over 16 years. For younger people it is usual to get consent from a person with parental responsibility.
    • Adults over 18 years of age are presumed to be competent to consent to treatment provided they can comprehend and retain the information they are given, they believe it, and they can consider the facts and make an informed decision.
    • Young people of 16 and 17 years of age are also presumed to be competent using the same criteria as older adults.
    • Younger people can also give consent if they fully understand what is involved, but ideally someone with parental responsibility should also be involved.
    • Consent may be given in writing, orally, or implied by cooperation.
  • Check the vaccine is correct and has not expired. Wash the site with soap and water if it is visibly dirty.
  • For most people, administer the vaccine by intramuscular injection into the deltoid muscle using a 23-gauge needle (blue):
    • If the person has a bleeding disorder use the subcutaneous route (to reduce the risk of bleeding).
    • Use a 21-gauge needle (green) in women who weigh in excess of 90 kg.
  • Record the site of administration. If an additional vaccine is required on the same day, use separate limbs if possible or inject at sites at least 2.5 cm apart.
  • After administration, ensure any bleeding has stopped and check the person feels well (has no symptoms of anaphylaxis) before they leave.
    • Anaphylaxis is extremely rare, and usually becomes apparent within 10 minutes. By the time the site has been checked for bleeding and documentation has been completed, most reactions will have become apparent.
    • It is prudent to have a final assessment of the person before letting them leave the premises.

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