From the Guidelines
Yes, both the meningitis (MenACWY/MenB) and Tdap (Tetanus, Diphtheria, and Pertussis) vaccines are administered intramuscularly (IM). The meningitis vaccine is given as a single 0.5 mL dose injected into the deltoid muscle of the upper arm or, in young children, into the anterolateral thigh muscle, as stated in the study 1. The Tdap vaccine is also administered as a single 0.5 mL dose, injected into the deltoid muscle for individuals, as recommended in the study 1. For both vaccines, the intramuscular route is preferred because it provides better absorption and a more robust immune response compared to subcutaneous administration. Some key points to consider when administering these vaccines include:
- Using a 1-inch needle for most adults and a 5/8 to 1-inch needle for children, depending on their size
- Always following proper aseptic technique
- Choosing the appropriate injection site based on the patient's age and size
- Being aware of the potential for syncope after vaccination, especially among adolescents, as noted in the study 1. The most recent and highest quality study, 1, provides the most relevant guidance on the administration of these vaccines, and its recommendations should be prioritized in clinical practice.
From the Research
Administration Routes of Vaccines
- The administration routes of the meningitis (MenACWY/MenB) and Tdap (Tetanus, Diphtheria, and Pertussis) vaccines have been studied in various research papers 2, 3, 4, 5, 6.
Meningitis Vaccines
- The MenACWY-TT vaccine was administered intramuscularly in a study published in 2017, which showed that it was highly immunogenic for all four vaccine capsular groups and had an acceptable reactogenicity profile 3.
- Another study published in 2018 investigated the safety and immunogenicity of fractional dose intradermal injection of two quadrivalent conjugated meningococcal vaccines, including MenACWY-TT, and found that it was safe and effective 4.
Tdap Vaccines
- A study published in 1999 compared the subcutaneous and intramuscular injection routes for booster DT vaccination of adolescents and found that the intramuscular administration gave significantly less redness, swelling, itching, and pain 2.
- A study published in 2022 compared the effectiveness and safety of tetanus vaccine administration by intramuscular vs. subcutaneous route in anticoagulated patients and found that there were no differences between groups in any independent variable, but significant adjusted differences were observed in terms of safety, including pain, erythema, and swelling 5.
Comparison of Administration Routes
- A study published in 2003 compared the functional immune responses in humans after intranasal and intramuscular immunisations with outer membrane vesicle vaccines against group B meningococcal disease and found that the intramuscular vaccine induced a stronger immune response than the intranasal vaccine 6.
- The intramuscular route is commonly used for the administration of meningitis and Tdap vaccines, as it has been shown to be safe and effective in various studies 2, 3, 5, 6.