CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Immunizations - childhood vaccination programme - Management
Basis for recommendation
These recommendations are based on good clinical practice and are consistent with recommendations given in the 'Green Book' [DH, 2006d].
- Getting consent before vaccination fulfils both a clinical function (to foster trust and cooperation with parents or guardians) and a legal function, namely to ensure that a person's right to autonomy has been addressed in order to prevent a charge of battery [Vaccine Administration Task Force, 2001].
- The site of administration depends on the child's age:
- The anterolateral aspect of the thigh is appropriate in children less than 1 year of age as the deltoid muscle is not considered to be well-enough developed for intramuscular injection (over the age of 1 year, either the deltoid muscle or the anterior aspect of the thigh can be used for administration, but the deltoid is generally more convenient).
- The gluteal muscle should be avoided. The needle may not penetrate through adipose tissue into the muscle, and this may cause a poor immunological response to the vaccine. In addition, there is a risk of damage to underlying structures such as the sciatic nerve.
© NHS Institute for Innovation and Improvement