Japanese Encephalitis Vaccine Administration Guidelines

General Administration Guidelines

The Centers for Disease Control and Prevention recommends that the inactivated Japanese encephalitis vaccine (JE-VC) must be administered intramuscularly (IM), not subcutaneously, for all age groups 1, 2

For children 2-35 months, the American Academy of Pediatrics recommends an intramuscular dose of 0.25 mL per injection, given on days 0 and 28, with the anterolateral thigh as the preferred injection site 1, 2, 3, 4
For children 3-17 years, the American Academy of Pediatrics recommends an intramuscular dose of 0.5 mL per injection, given on days 0 and 28, with the deltoid muscle as the preferred injection site 1, 2, 3, 4
For adults 18-65 years, the Centers for Disease Control and Prevention recommends an intramuscular dose of 0.5 mL per injection, given on days 0 and 7-28, with the deltoid muscle as the preferred injection site 1, 2, 6
For adults >65 years, the Centers for Disease Control and Prevention recommends an intramuscular dose of 0.5 mL per injection, given on days 0 and 28, with the deltoid muscle as the preferred injection site 1, 2

The Centers for Disease Control and Prevention notes that the current JE-VC requires intramuscular administration, which is a crucial difference from the discontinued mouse brain-derived vaccine (JE-MB) that was administered subcutaneously 6, 7, 8

The Centers for Disease Control and Prevention recommends a needle angle of 90 degrees for intramuscular injections, with a needle size of 1-1½ inch, 22-25 gauge for deltoid injection in adults and adolescents, and 7/8-1 inch, 22-25 gauge for anterolateral thigh injection in infants 5

The Centers for Disease Control and Prevention recommends shaking the syringe well before administration to obtain a white, opaque, homogeneous suspension, and expelling and discarding half the volume from the 0.5 mL prefilled syringe for the 0.25 mL dose in young children 1, 2

The Centers for Disease Control and Prevention recommends completing the 2-dose series at least 1 week before potential JE virus exposure 1, 2, 3

The Centers for Disease Control and Prevention recommends that JE-VC can be given simultaneously with hepatitis A vaccine and rabies vaccine without interference, using separate syringes and different anatomical sites (>1 inch apart if possible) 1, 2, 10