Intramuscular (IM) Injection Technique

All vaccinators must be competent in intramuscular (IM) injection technique.  

How to give an intramuscular (IM) injection

  1. Land mark the injection site in the deltoid muscle:

Two finger widths down from the acromion process; the bottom edge is at an imaginary line drawn from the axilla

Injection site: 5cms below acromion process

The recommended site is in the middle of the triangle. To avoid causing an injury, do not inject too high or too low. Vaccinators should landmark the injection site and use correct injection technique to prevent shoulder injuries.

  1. At the injection site spread the skin taut between the thumb and forefinger with the non-dominant hand.

Do NOT bunch up the skin as this leads to administering the vaccine into subcutaneous tissue inadvertently.

  1. Use the dominant hand to inject the medication.

This ensures control of the needle and syringe during the procedure.

  1. Hold the syringe firmly between thumb and forefinger, with heel of hand resting on the thumb of the non-dominant hand.

This ensures a 90-degree angle is achieved and the correct site is targeted

  1. Insert the needle smoothly and swiftly.
  2. Inject at a 90-degree angle, to ensure the medication reaches the muscle. Inject medication over 1-2 seconds.
  3. After removing the needle, use gentle pressure with a cotton ball or gauze. Do not massage the injection site.
  4. If there is a leakage at the injection site after withdrawal of needle: apply light pressure with gauze.

Swift needle entry, slow injection of medication, swift needle withdrawal = less pain

Please note that this short video is intended for demonstration of correct IM injection technique into the deltoid muscle only as per the recommendations of the National Immunisation Advisory Committee (NIAC).

It is not intended to demonstrate other aspects of practice such as hand hygiene, sharps disposal and location of items and other consumables. Please refer to the relevant HSE Policies, Protocols and Guidelines for these details.

National Immunisation Advisory Committee (NIAC) Recommendations

It is not necessary to use gloves for vaccine injections, unless contact with potentially infectious body fluids is possible, or unless the health care worker has an infected lesion on the hand.

If gloves are worn they should be changed for each patient.

If the skin at the injection site is visibly dirty it should be cleaned with soap and water.

There is no need to use a disinfectant e.g. alcohol swabs. If an alcohol swab is used, injection should be delayed for ≥30 seconds, to ensure the alcohol will have evaporated.

Read more about NIAC recommendations.

Additional resources

We encourage vaccination leads in clinics to remind vaccinators of the requirement for competency in the correct IM injection technique and of the training and supporting materials that are available:

COVID-19 vaccines should be given IM only

This page was updated on 7 March 2022