Monday, February 23, 2009

Vaccine Administration

This is new information that I have just stumbled upon.

At 4 months of age my son was given 3 shots by a nurse that I did not particularly care for. At the time I felt that she was too rough with him and simply jabbed his thighs too hard. In fact, she even drew quite a bit of blood and he cried non-stop for 1/2 half hour afterward. My husband arrived just in time to see our son's reactions too. He was very upset wondering what had just happened to our little boy (he did not witness the injections, just the aftermath).

Fast forward to today. I came across this:

"Subcutaneous Injections

Subcutaneous injections usually are administered at a 45-degree angle into the thigh of infants aged <12 months and in the upper-outer triceps area of an infant, if necessary. A 5/8 inch, 23--25-gauge needle should be inserted into the subcutaneous tissue".

My son's nurse DID NOT administer his vaccines at an angle. She went straight in!

Also, this:

"Infants (persons aged<12> Among the majority of infants, the anterolateral aspect of the thigh provides the largest muscle mass and is therefore the recommended site for injection. For the majority of infants, a 7/8 --1-inch, 22--25-gauge needle is sufficient to penetrate muscle in the infant's thigh".


"Subcutaneous Site - Subcutaneous tissue can be found all over the body. The usual sites for vaccine administration are the thigh (for infants <12 months of age) and the upper outer triceps of the arm (for persons >12 months of age). If necessary, the upper outer triceps area can be used to administer subcutaneous injections to infants.

Subcutaneous Needle Gauge & Length - 5/8-inch, 23- to 25-gauge needle
Subcutaneous Technique - Follow standard medication administration guidelines for site assessment/selection and site preparation. To avoid reaching the muscle, pinch up the fatty tissue, insert the needle at a 45° angle and inject the vaccine into the tissue. Withdraw the needle and apply light pressure to the injection site for several seconds with a dry cotton ball or gauze.

Intramuscular (IM)
Intramuscular injections are administered into muscle tissue below the dermis and subcutaneous tissue.

Intramuscular Site - Although there are several IM injection sites on the body, the recommended IM sites for vaccine administration are the vastus lateralis muscle (anterolateral thigh) and the deltoid muscle (upper arm). The site depends on the age of the individual and the degree of muscle development.

Intramuscular Needle Gauge - 22- to 25-gauge needle
Intramuscular Needle Length - For all intramuscular injections, the needle should be long enough to reach the muscle mass and prevent vaccine from seeping into subcutaneous tissue, but not so long as to involve underlying nerves, blood vessels, or bone. The vaccinator should be familiar with the anatomy of the area into which the vaccine will be injected. Decision on needle size and site of
injection must be made for each person on the basis of the size of the muscle, the
thickness of adipose tissue at the injection site, the volume of the material to be
administered, injection technique, and the depth below the muscle surface into
which the material is to be injected.

Infants (Younger Than 12 Months)
For the majority of infants, the anterolateral aspect of the thigh is the
recommended site for injection because it provides a large muscle mass. The
muscles of the buttock have not been used for administration of vaccines in infants
and children because of concern about potential injury to the sciatic nerve, which
is well documented after injection of antimicrobial agents into the buttock. If the
gluteal muscle must be used, care should be taken to define the anatomic
landmarks. If the gluteal muscle is chosen, injection should be administered
lateral and superior to a line between the posterior superior iliac spine and the
greater trochanter or in the ventrogluteal site, the center of a triangle bounded by
the anterior superior iliac spine, the tubercle of the iliac crest, and the upper
border of the greater trochanter.

My infant DID have very low muscle tone in his legs. Was it wise to inject him in this area? I also don't recall the nurse evaluating his muscle mass before injecting him either. Was this why he screamed for a 1/2 hour? Did she not administer the vaccine correctly and leave my son permanently injured?

Injection technique is the most important factor to ensure efficient intramuscular
vaccine delivery. If the subcutaneous and muscle tissue are bunched to minimize
the chance of striking bone, a 1-inch needle is required to ensure intramuscular
administration in infants. For the majority of infants, a 1-inch, 22-25-gauge needle
is sufficient to penetrate muscle in an infant’s thigh. For newborn (first 28 days of
life) and premature infants, a 5/8-inch needle usually is adequate if the skin is
stretched flat between thumb and forefinger and the needle inserted at a 90-
degree angle to the skin.


Now, looking at my son's medical records and how he appears today, I come to the following conclusion - he has some sort of sciatic nerve damage. Incomplete sciatic nerve damage may be caused by exposure to toxic chemicals, or by an underlying disease, nutritional deficiencies, OR incorrect administration of a vaccine from what I am gathering.

"Sciatica is a form of peripheral neuropathy. It occurs when there is damage to the sciatic nerve, located in the back of the leg. This nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg and the sole of the foot. Incomplete damage to the sciatic nerve may appear identical to damage to one of the branches of the sciatic nerve (tibial nerve dysfunction or common peroneal nerve dysfunction)".


For information on tibial nerve dysfunction, click on the link below:

For information on common peroneal nerve dysfunction, click on the following link:


Anonymous said...

Sciatic nerve runs along the posterior aspect of the thigh. If your son was given a vaccine in the antero-lateral aspect of his thigh, then how could it have damaged the sciatic nerve? Surely the needle was not long enough to traverse the entire thickness of his thigh.

Dawn said...

Anonymous, I guess you failed to read the last two paragraphs of my post?

Anonymous said...

I am so sorry that your son has had to endure something like this. Although my husband is not an infant, he did go in to an allergist for some immunotherapy injections. The first injection they gve him was in his rear and then every week after in his arms. Now he is in the hospital and can not walk or sit because of the pain. I can only imagine what your little guy is going through. The neuro surgeon that saw my husband in the hospital said that this is irrepairable and will basically have to live with it. I am here searching the internet for more information on sciatic nerve damage due to injections and your site has helpped a alot. Thank you and I hope that your poor baby can find some relief to his pain.

Anonymous said...

If I were you I would be more worried about the ingredients of the vaccination you just allowed your child to have.