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CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Evidence indicates that this cream does not interfere with the immune response to MMR (45). Using reduced doses administered at multiple vaccination visits that equal a full dose or using smaller divided doses is not recommended (4). The site provides the greatest thickness of gluteal muscles, is free from penetrating nerves and blood vessels, and has a thin layer of fat. The Needlestick Safety and Prevention Act (2) was enacted in 2000 to reduce the incidence of needlestick injury and the consequent risk for bloodborne diseases acquired from patients. A separate needle and syringe should be used for each injection. The site involves the gluteus medius and minimus muscle and is the safest injection site for adults and children. The deltoid should not be used. When possible, IM injections should be avoided in muscles that are emaciated or atrophied because these muscles absorb medication poorly.5, Aspiration before injection and slow injection of the medication are not supported by research for vaccine administration.2 The vastus lateralis and deltoid muscle are the only two sites recommended for vaccine administration because these sites do not contain large vessels that are within reach of the needle.2 For all other medications, there is no evidence to either support or abandon the practice of aspiration before administration. For intramuscular injections (use a 22- to 25-gauge needle for all ages): For subcutaneous injections (use a 23- to 25-gauge needle for all ages): Subcutaneous injections are administered at a 45-degree angle, usually into the thigh for infants younger than age 12 months and in the upper-outer triceps area of people age 12 months and older. 16. The total daily dose is 750 mg every four hours, or 3,000 mg per day. When choosing a needle size, the weight of the patient, age, amount of adipose tissue, medication viscosity, and injection site all influence the needle selection (Hunter, 2008; Perry et al., 2014; Workman, 1999). Response to vaccines recommended by the subcutaneous route is unlikely to be affected if the vaccines are administered by the intramuscular rather than subcutaneous route. Label all medications, medication containers, and other solutions. For adults, use a 1- to 1.5-inch needle. Name four techniques. Hands should be cleansed with an alcohol-based waterless antiseptic hand rub or washed with soap and water before preparing vaccines for administration and between each patient contact (1). Jet injectors prevent needlestick injuries to health-care providers (2) and can overcome improper, unsterile reuse and other drawbacks of needles and syringes in developing countries (9, 38-39). A vapocoolant spray (e.g., ethyl chloride) may also be used just before injection to decrease pain.