Deltoid Intramuscular Injection Guidelines

Volume Recommendations

The Centers for Disease Control and Prevention recommends a standard vaccine volume of 0.5 mL for most intramuscular vaccines administered in the deltoid for adults 1, 2, 3, 4
For children aged ≥36 months, a volume of 0.5 mL is recommended for intramuscular preparations 4
For children aged 6-35 months, a volume of 0.25 mL is recommended for certain vaccine formulations 4

The Centers for Disease Control and Prevention recommends using needles of 1 to 1½ inches in length and 22-25 gauge for deltoid injections in adults 1, 2, 3
For children, needles of 7/8 to 1¼ inches in length and 22-25 gauge are recommended, based on muscle size 1, 2
The American Academy of Pediatrics recommends that injections should be administered at a 90-degree angle into the deltoid muscle 3

Aspiration before injection is not required based on current evidence from the Centers for Disease Control and Prevention, though some practitioners continue this practice 2, 3
The Centers for Disease Control and Prevention recommends against using volumes exceeding 1 mL in the deltoid, as larger volumes may cause discomfort 1, 2
The Centers for Disease Control and Prevention advises against administering vaccines containing adjuvants subcutaneously or intradermally, as they can cause local irritation and granuloma formation 2, 3

The American Academy of Pediatrics recommends observing patients for 15 minutes after vaccination, especially adolescents and young adults, due to syncope risk 6