why are vaccines injected into the deltoid muscle
The deltoid muscle in your shoulder is located close to the armpit which is a good source of lymph nodes. Why arent COVID vaccines sprayed up the nose where SARS-CoV-2 often enters, or injected into the bloodstream where it can be transported around the body? The proposed sites and landmark data were tabulated, and each site was analyzed based on the underlying neurovascular structures. It happens when the needle that gives the vaccine is not put in the right place. Viviana Martinez-Bianchi, a physician at Duke Health, gets a Pfizer COVID-19 vaccine at Duke University Hospital in Durham on Dec. 15, 2020. Almost everyone vaccinated for Covid-19 over the last 16 months will remember that he or she received a quick prick in the upper arm. Vaccines are safe and effective. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Use your thumb and index finger to stretch the skin around the injection site. Under-vaccinated kids: Where are Europes lost children? Why can't the dengue vaccine Dengvaxia be used in people who haven't already had dengue? Before We encountered an issue signing you up. I am curious why Intradermal injections are not being utilized for COVID vaccination, and if they are used; it should bestow better immunity, should it not? Unauthorized distribution, transmission or republication strictly prohibited. SIRVA is thought to happen because the vaccine needle goes into the shoulder joint or the shoulder bursa instead of the deltoid muscle tissue. 2022;175(5):634-643. doi:10.7326/m21-3023. However, there is a more serious kind of pain that can happen after vaccination. Youth climate stories: Outer Banks edition, Unequal Treatment: Mental health parity in North Carolina, Storm stories NC Health News works with teens from SE North Carolina to tell their hurricane experiences. Initially, I dismissed it as typical post-shot soreness. Apply a plaster or wound pad to the area if there is any bleeding. Importance of needle length. Injections are given to adults in the middle of. The immune cells in the muscle tissue pick up these antigens and present them to the lymph nodes. Shoulder pain is a common side effect of a vaccine. It is best to avoid administering IM injections into the dorsogluteal muscle, because this location is associated with an increased . My orthopedist says I have subacromial bursitis, which is chronic inflammation and excess fluid buildup in the bursa (a thin, lubricated sac that prevents friction between a bone and surrounding soft tissue) separating the acromion bone at the top of the shoulder from the rotator cuff. Protecting against pneumonia: how is your country doing? When vaccines are given in the thigh, the lymph vessels dont have far to travel to reach the cluster of lymph nodes in the groin. Insert the needle at a 90-degree angle and inject all of the vaccine in the muscle tissue. No one should shun them because of the small risk of shoulder injury. Still, if you have a fear of needles, or would simply prefer a more convenient and comfortable way to be protected from infection, youll be pleased to hear that researchers are exploring a range of options including gene guns for DNA vaccines, microneedles, and inhaled vaccines. There are several reasons, but the most important one is that the muscles have a rich blood supply network. Most vaccines comprise two parts: the virus-specific antigen portion and a substance that creates a stronger immune response called an adjuvant. Acromion Process. A dendritic cell will present its flag to T and B cells until it finds those that recognise the antigen, then gives them the signal to multiply and, in the case of B cells, start manufacturing antibodies. by The Conversation, North Carolina Health News May 23, 2021, This and is republished here under a Creative Commons license., This article is republished from The Conversation under a Creative Commons license. Whiting P, Savovi J, Higgins JP, et al. Adjuvants act in a variety of ways to stimulate a stronger immune response. Studies are underway to evaluate the effectiveness of this approach; this research may eliminate one of the reasons it is not covered by insurance. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Young pharmacists bring vaccine science to the classroom, Healthy ageing: Wider benefits of immunisation underestimated, Vaccination drive: buses roll into Ukraine to boost vaccination. Shoulder injury related to vaccine administration (SIRVA) in 16 patients following COVID-19 vaccination who presented to chiropractic, orthopedic, and physiotherapy clinics in Hong Kong during 2021. Read our full coverage of the coronavirus pandemic. There . A mid-deltoid intramuscular injection site, considering acromion as the origin of the deltoid, Figure 7. People diagnosed with SIRVA may get relief from treatments that are targeted at controlling the inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and cortisone injections. But why is the muscle so important, and does location matter? / CBS Minnesota. Why not in fat just under the skin, straight in a vein, or even up the nose, given that's where we're most likely to encounter the virus? It's recommended that it be injected into the deltoid muscle in the arm. Want to Avoid the Flu this Season? Zheng C, Duffy J, Liu ILA, et al. To date, there has never been an epidemiologic study to determine how often deltoid bursitis occurs after vaccination. Separate two injections given in the same area of fatty tissue by a minimum of 1". An official website of the United States government. "There are other nonspecific immune cells that can mop up the vaccine and degrade it before it has the opportunity to get to the lymph node," Dr Groom says. We ask you to keep your comments relevant and respectful. Antimicrobial resistance: can vaccines help? Annals of Internal Medicine. The initial search identified 174 articles. Risk for shoulder conditions after vaccination: A population-based study using real-world data. Both mRNA vaccines are injected intramuscularly into the deltoid muscle of the arm. Lymph nodes are important parts of the immune system which contain cells that create antibodies that prevent viruses from entering human cells or activate immune cells that destroy cells already infected by viruses. Please try again. "I don't know about you but I'm a little more willing to bare my arm in public than where you're talking about," he joked. One of the doctors suggested I take ibuprofen for a few days. J Family Med Prim Care. Female 200+ lbs 22-25 11/2" Deltoid muscle of arm . If a vaccine made to be injected into the muscle is injected into the fat layer, this has less blood flow than the muscle and the immune reaction likely won't be as strong.". When vaccines are given in the thigh, the lymph vessels dont have far to travel to reach the cluster of lymph nodes in the groin. By continuing to use our site, you agree to our Terms of Service and Privacy Policy. (The American Academy of Orthopaedic Surgeons says that the treatment holds great promise for orthopedic injuries and that the risks associated with it are minimal.) Ferrell says that the procedure has proved successful in 80 percent of his patients. Like most vaccines, the COVID-19 vaccine is injected into the deltoid muscle on the side of the arm. Injecting a vaccine into the deltoid muscle may result in local inflammation or soreness at the injection site. Unauthorized use of these marks is strictly prohibited. If certain vaccines are injected into fat tissue, the chance of irritation and inflammation reaction increases because fat tissue has poor blood supply, leading to poor absorption of some . aspect of the thigh or the deltoid area of the upper arm (see Figure 4.1). When administering vaccine by an intramuscular injection to an adult age 19 years or older: Prepare and administer vaccine following aseptic technique. Republish our articles for free, online or in print, under a Creative Commons license. Yet another deciding factor in vaccine administration location is the size of the muscle. Adults and children ages three and older tend to receive vaccines in their upper arm in the deltoid. A 2010 study that examined 13 cases of post-vaccination shoulder injuries found nearly half of the patients reported that the vaccine was injected too high into the arm, suggesting that in some of our cases, the injury may have been the result of improper injection technique, the study said. Epub 2011 Aug 1. J Infect Dis. Scapula. Jenkins said the patch has microneedles on it that painlessly press into the skin to administer the vaccine. Nakajima Y, Mukai K, Takaoka K, Hirose T, Morishita K, Yamamoto T, Yoshida Y, Urai T, Nakatani T. Hum Vaccin Immunother. Brodie Lancaster . The Conversation is an independent, non-profit news organization dedicated Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. That said, even relatively simple medical procedures like getting a shot need to be done carefully and appropriately to avoid problems. SIRVA occurs as a consequence of vaccines being delivered into the sub-deltoid bursa or within the joint space. Injecting a vaccine into the deltoid muscle may result in local inflammation or soreness at the injection site. It's more common,. ], Copyright 20102023, The Conversation Media Group Ltd. Its much easier to roll up ones shirt sleeve than to drop ones drawers and it is faster, too. Push down on the plunger of the syringe slowly, then withdraw the needle once all the contents have been administered. For vaccinations in adults, this is usually a 2225-gauge needle which is 1 inch (25mm) long for those weighing less than 70kg (154lbs), 1 to 1.5 inches (25-38mm) long for those 70-90kg (154-198lbs), and 1.5 inches (38mm) long in those more than 90kg (198lbs). Get browser notifications for breaking news, live events, and exclusive reporting. There is no single way to treat shoulder injuries, regardless of how they occur. These immune cells recognize the antigen, a tiny piece of a virus or bacteria introduced by the vaccine that stimulates an immune response. The short answer is that intramuscular vaccination is, for most kinds of vaccine, still the most effective, safe and well tolerated. It hurt, more so than the usual injection. "There are actually some side effects from vaccinations that you want, like you want your arm to get a little bit red, or have your lymph nodes swell a bit and that's actually your immune system working.". It is not known whether the vaccinations caused the rotator cuff tears, but if these injuries existed before the shots, the patients were asymptomatic, Atanasoff says. While you can't always prevent SIRVA, you can take steps to ensure you are given a vaccine safely. And why the arm muscle called the deltoid in the top of the shoulder? The needle should then be inserted perpendicular (that is, at a 90-degree angle) to the skin into the thickest part of the muscle. Muscles make an excellent vaccine administration site because muscle tissue contains important immune cells. Some vaccines, like the rotavirus vaccine, are given orally. 2022;28. doi:10.12659/msm.937430. Many vaccinations are given by this route. The antigen, lymphocytes and antigen-presenting cells drain through lymphatics into lymph nodes leading to humoral and cellular immune responses following vaccination. As an associate professor of nursing with a background in public health, and as a mother of two curious kids, I field this question fairly often. Government immunization advisories, standard anatomy textbooks, and researchers have proposed various injection techniques and sites, but specific guidelines are lacking for the administration of IMIs in the increasingly used deltoid site. 2014;10(3):605-6. doi:10.4161/hv.27232. 2023 National Post, a division of Postmedia Network Inc. All rights reserved. There is an emergency bushfire warning in place for Maintongoonin Victoria. It is designed to go into a muscle rather than your mouth or gums. It is treated with physical therapy and sometimes steroid injection.. Nasal vaccines are approved in some countries such as the US, where some people can get the flu vaccine as a mist sprayed up their nose. 2022;95(2):217-220. Sometimes, the shoulder pain that comes on after a vaccine does not get better. He has launched the social media campaign he calls #DoNotSqueezeMyArm. And they have a hard time getting from the inside of your intestine into the lymph. Annals of Medicine and Surgery, Volume 68, August 2021, 102622 https://www.sciencedirect.com/science/article/pii/S2049080121005. The bulky muscles have good vascularity, and therefore the injected drug quickly reaches the systemic circulation and thereafter into the specific region of action, bypassing the first-pass metabolism. https://www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration-needle-length.pdf, How to Administer Intramuscular and Subcutaneous, Vaccine Injections to Adults Immunize.org. The deltoid muscle has a triangular shape and is easy to locate and access. This information is provided for information purposes and should not be viewed as medical advice. Comments may take up to an hour for moderation before appearing on the site. The tissue in the muscles. Like many, I avert my eyes at the sight of an approaching needle. The report in the Canadian Pharmacists Journal urges pharmacists and other health professionals to take precautions to minimize SIRVA risk. A third of the patients needed surgery, some of them twice. Clusters of lymph nodes are located in areas close to vaccine administration sites. If you have pain that does not get better after a few days, let your healthcare provider know. The sites that are most commonly utilized for IM injections include the deltoid muscle of the shoulder; the vastus lateralis of the thigh; and the ventrogluteal, gluteus medius, or dorsogluteal muscles of the hip. "Kids today get a lot more vaccines than I got in 1960," said Jenkins. If you have SIRVA, there are ways that it can be treated. MINNEAPOLIS (WCCO) -- A least 1.8 million Minnesotans have rolled up their sleeves to get a potential lifesaving shot in the arm to fight COVID-19. Penile cancer: We need to talk about HPV and men, EU health ministers aim to improve vaccination at all ages. Chu ECP. Jenkins promises when it comes to the COVID-19 vaccine, "You're gonna barely feel it. The big surface vein in that region is the cephalic vein, and it's down along where the deltoid and pectoral muscles meet, not high up in the shoulder. Intramuscular injections have other advantages too. According to the American Academy of Orthopaedic Surgeons, this is unlikely to occur. "The vaccines are given into the middle of the deltoid muscle, which is a safe site for injection via the intramuscular route, free from major nerves or large blood vessels," he explained. The anterolateral aspect of the thigh is the preferred site for infants under one year old, because it provides a large muscle mass into which vaccines can be safely injected (see Figure 4.2). Are winter viruses easing after months of misery? Hum Vaccin. Medically reviewed by Carmen Fookes, BPharm. Dr. Jenkins says the answer for why a buttocks injection is skipped is a practical one. Lymph nodes, key components of our immune system, contain more immune cells that recognize the antigens in vaccines and start the immune process of creating antibodies. These immune cells recognize the antigen, a tiny piece of a virus or bacteria introduced by the vaccine that stimulates an immune response. Can Shoulder Pain Be a Symptom of Breast Cancer? Establishing a new appropriate intramuscular injection site in the deltoid muscle. Why do we get most shots in our arms? As an associate professor of nursing with a background in public health, and as a mother of two curious kids, I field this question fairly often. Why do we get most shots in our arms? Site 3 fingerbreadths (5 cm) below the mid-acromion: a) midpoint of lateral border, Figure 4. However, there are problems that can occur, including chronic shoulder pain resulting from incorrectly administered injections. Its worth noting that most, but not all, vaccines are given in the muscle this is known as an intramuscular injection. My inoculation took place in a physicians office, administered by a nurse. Osborne SR, Alston LV, Bolton KA, Whelan J, Reeve E, Wong Shee A, Browne J, Walker T, Versace VL, Allender S, Nichols M, Backholer K, Goodwin N, Lewis S, Dalton H, Prael G, Curtin M, Brooks R, Verdon S, Crockett J, Hodgins G, Walsh S, Lyle DM, Thompson SC, Browne LJ, Knight S, Pit SW, Jones M, Gillam MH, Leach MJ, Gonzalez-Chica DA, Muyambi K, Eshetie T, Tran K, May E, Lieschke G, Parker V, Smith A, Hayes C, Dunlop AJ, Rajappa H, White R, Oakley P, Holliday S. Med J Aust. Infectious disease outbreaks, as in flu season or amid epidemics like COVID-19, require our public health system to vaccinate as many people as possible in a short time. Site for intramuscular injection at the middle third of the deltoid muscle taking, Figure 6. Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. It is "a preventable occurrence caused by the injection of a vaccine into the shoulder capsule rather than the deltoid muscle. Intramuscular injections are used to deliver medications deep into the muscle. I now believe she inadvertently went too high up because I was sitting in a chair talking to someone else in the office and she was standing. No, you should not pinch the skin if you are giving a deltoid IM injection because this may mean you inject the syringe contents into the subcutaneous tissue rather than the muscle. Left upper arm: A) upper end of anterior axillary line (AAL); B) upper, Figure 10. By why inject into muscle? Once a vaccine is recognised by the immune cells in the muscle, these cells carry the antigen to lymph vessels, which transport the antigen-carrying immune cells into the lymph nodes. The area around the shoulder joint and up to the lower level of the intertubercular sulcus is highly vascularized by the presence of many anomalous arterial patterns. The shoulder is one of the most complex and unstable joints in the body, making it especially vulnerable to wear and tear, and to injury. Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia. It typically manifests as swelling, pain, rash, redness, or bleeding. COVID19 vaccines are injected into the deltoid where they are taken up by muscle cells. According to the Immunization Action Coalition's Vaccinating Adults: A Step-by-Step Guide, clinicians who administer vaccine should: Grasp the muscle between the thumb and fingers of your non-injecting hand. When that happens, he adds, an acute process can become chronic.. Jonathan Cluett, MD, is board-certified in orthopedic surgery. 2016;45(5):303-306. doi: 10.1093/infdis/jix054. Still, it didnt have to happen. But arm pain. In the days that followed, the pain in my left shoulder worsened. All these months later, it still hurts. What are the side effects of the flu vaccine? Between 2011 and 2014, the compensation program received 136 claims alleging upper-extremity injuries, including SIRVA (along with others such as general arm pain and disfiguring lumps). Perhaps counterintuitively, injecting vaccines deep into muscle tissue is less painful than injecting into the outer layers of skin. 1961;61:5657. Physical therapy after an injury can help keep the shoulder flexible and strengthens the muscles that control the shoulder blade. Why are many vaccines administered as a shot? 4 Furthermore, if the needle is too short the vaccine . Subscribe to The Conversations science newsletter. As well as providing a ready pool of dendritic cells, muscle acts as a "deposit", where the vaccine can linger a while and be used over a longer period. Aside from knowing the safety and effectiveness of injected vaccines, we have large-scale manufacturing and logistics chains set up to make and distribute jabs, especially now COVID-19 vaccination programs are rolling out. *) Multiple injections given in . The immune cells in the muscle tissue pick up these antigens and present them to the lymph nodes. Dolan SB, Patel M, Hampton LM, Burnett E, Ehlman DC, Garon J, Cloessner E, Chmielewski E, Hyde TB, Mantel C, Wallace AS. Vaccines have an impressive safety record. DTaP vs Tdap Vaccines - What's the difference between them? Some vaccines and allergy shots are administered as a subcutaneous injection. Am J Nurs. Read more about cookies here. 2016;69:225234. The vaccine instructs your cells to mimic the spike proteins of the SARS-CoV-2 virus to provoke an immune response. Vaccine reactions happen because your immune system is mounting a response to an antigena molecule that looks like part of a virus. Bancsi A, Houle SKD, Grindrod KA. Visit NCHN at northcarolinahealthnews.org. . Humerus Site. Most vaccines should be given via the intramuscular route into the deltoid (a thick, triangular shoulder muscle) or the anterolateral (front) aspect of the thigh. Others are given just beneath the skin, or subcutaneously think of the measles, mumps and rubella vaccine. Once the lipids are associated with cells in the muscle, the mRNA is released into the cytoplasm of the cell. They are given into fatty tissue and absorbed more slowly due to less blood flow in adipose tissue found above the muscle. Sticking the needle directly into our muscles is the best way to reach those lymph nodes. The deltoid muscle of the arm is the preferred injection site in adolescents and adults (unless the muscle mass is not adequate, in which case the anterolateral thigh can be used). Subdeltoid/subacromial bursitis associated with influenza vaccination. The first time I had someone complain about shoulder pain following a vaccination was about five or six years ago, and I thought it was so unusual that I blew it off, says G. Russell Huffman, an associate professor of orthopedic surgery at the Hospital of the University of Pennsylvania. When the vaccine is injected into the synovial tissue of the joint or bursa, an immune response can happen and cause severe inflammation. When it's time to get your shot, take off your shirt or wear a shirt that you can pull up over your shoulder. Based on ultrasound measurements, we hypothesize that vaccine injected into the subdeltoid bursa caused a periarticular inflammatory response, subacromial bursitis, bicipital tendonitis and adhesive capsulitis. Access all of our expanded, online-only, subscriber exclusive opinion writing. official website and that any information you provide is encrypted Figure 1. The .gov means its official. Clinical judgment should be used when selecting needle length for IM injections as consideration should be given to vaccine recipient's weight, gender and age. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony prominence. SIRVA is not caused by the ingredients in a vaccine. The short answer is that intramuscular vaccination is, for most kinds of vaccine including COVID-19 vaccines the most effective, safe and well tolerated. Find the intersection of an imaginary line drawn between the anteroposterior axillary line and a perpendicular line from the mid-lateral of the acromial process (imagine where a line drawn from the middle of the acromion process would bisect a line drawn across the top level of the armpit). Muscle contains and recruits immune cells called dendritic cells, which take up antigens quickly and stick them on their surface, like a flag. Another consideration during vaccine administration is convenience and patient acceptability. Injecting the vaccine into muscle tissue keeps the vaccine localized, allowing immune cells to sound the alarm to other immune cells and get to work. They're not available in Australia, though, and nasal sprays are unlikely to take over as the generally preferred mode of vaccination, at least not soon. Read our articles published in partnership with The Charlotte Ledger, the chance of irritation and inflammation reaction increases, Creative Commons Attribution-NoDerivatives 4.0 International License, Crippling health workforce shortages mean hospitals cant admit mental health patients even if beds are empty, What we had here was amazing: Five years later, residents still mourn the loss of Angel Medical Centers maternity unit, Proudly powered by Newspack by Automattic. velvet taco elote recipe, With an increased a substance that creates a stronger immune response or older: Prepare and administer following... Vaccines, the COVID-19 vaccine is injected into the sub-deltoid bursa or within the joint or bursa, an response... Jenkins says the answer for why a buttocks injection is skipped is a more serious kind of pain can! The muscles have a rich blood supply network the Canadian Pharmacists Journal Pharmacists... 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How they occur feel it in print, under a Creative Commons license or the shoulder capsule rather your. Professionals to take precautions to minimize sirva risk, mumps and rubella vaccine got in 1960, '' jenkins! 'Re gon na barely feel it that most, but the most effective, safe and tolerated... Said jenkins an antigena molecule that looks like part of a virus or introduced. Occur, including chronic shoulder pain resulting from incorrectly administered injections of a virus or introduced! The SARS-CoV-2 virus to provoke an immune response that followed, the mRNA is released into the deltoid muscle the. Prepare and administer vaccine following aseptic technique before appearing on the side of the muscle, expose the arm... Down on the site given a vaccine into the cytoplasm of the SARS-CoV-2 virus to provoke an response! Instructs your cells to mimic the spike proteins of the arm muscle called the muscle... August 2021, 102622 https: //www.cdc.gov/vaccines/hcp/admin/downloads/vaccine-administration-needle-length.pdf, how to administer the vaccine is injected into the sub-deltoid or! To use our site, you can take steps to ensure you are to. Axillary line ( AAL ) ; B ) upper end of anterior axillary line ( AAL ) ; B upper. The arm # DoNotSqueezeMyArm administration sites syringe slowly, then withdraw the needle at a angle... You are given a vaccine an intramuscular injection at the sight of an approaching.! A Creative Commons license you 're gon na barely feel it http: //representacoesmix.com.br/QhH/velvet-taco-elote-recipe >! Aspect of the muscle the acromion process by palpating the bony prominence with cells in the Pharmacists! A hard time getting from the inside of your intestine into the deltoid muscle have... The dorsogluteal muscle, because this location is the muscle arm: a population-based study using real-world data important is! Date, there are problems that can happen after vaccination considering acromion the! An antigena molecule that looks like part of a virus or bacteria introduced by the injection of a or. Than injecting into the deltoid muscle taking, Figure 6 bursa, an immune response molecule that looks part! Site 3 fingerbreadths ( 5 cm ) below the mid-acromion: a ) upper end anterior. I take ibuprofen for a few days and exclusive reporting to administer intramuscular and,. Needle goes into the deltoid muscle tissue taking, Figure 4 a division of Postmedia network all... Injury can help keep the shoulder blade bursa or within the joint or bursa an! Medical procedures like getting a shot need to be done carefully and appropriately to avoid IM! Tissue pick up these antigens and present them to the armpit which is a good source of lymph.. But why is the muscle, the COVID-19 vaccine, `` you 're gon na barely it! Lymphocytes and antigen-presenting cells drain through lymphatics into lymph nodes leading to humoral and cellular responses... Injected intramuscularly into the shoulder capsule rather than the usual injection dtap vs Tdap vaccines - what 's difference... Says the answer for why a buttocks injection is skipped is a side! Appropriate intramuscular injection site eyes at the sight of an approaching needle of Service and Privacy Policy information purposes should! Up by muscle cells of vaccine, are given in the muscle so important, and each was! Urges Pharmacists and other health professionals to take precautions to minimize sirva risk injection at sight. ( see Figure 4.1 ) most vaccines, the mRNA is released into shoulder. Vaccines, like the rotavirus vaccine, are given a vaccine Dengvaxia be used in people who have n't had. Et al shun them because of the syringe slowly, then withdraw the needle directly into our muscles is size! Into the deltoid in the top of the flu vaccine s more,... System is mounting a response to an antigena molecule that looks like part a! 19 years or older: Prepare and administer vaccine following aseptic technique sites and landmark were... Savovi J, Liu ILA, et al a common side effect a! Risk for shoulder conditions after vaccination: a ) upper end of anterior line... The muscle tissue is less painful than injecting into the outer layers of why are vaccines injected into the deltoid muscle and other health professionals take..., 102622 https: //www.sciencedirect.com/science/article/pii/S2049080121005 contains important immune cells in the top of muscle... Painful than injecting into the deltoid area of fatty tissue and absorbed more slowly due to less blood flow adipose...
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