Before Vaccination:

Vaccination should follow the recommendations as laid out in The Green Book Chapter 4.

You should:

• Select the correct product and dose for the recipient.
• Check the vaccine is within expiry date.
• Check the colour and composition of the vaccine matches the description in the product’s SPC, which can be found on the electronic Medicines Compendium. 
• Ensure there are no contraindications to administration.
• Check the recipient/carer is fully informed about the vaccine and has given relevant consent.
• Check the recipient/carer is aware of possible adverse reactions due to vaccination, such as pyrexia, sore arm and allergic reactions.

Always check the PGD and the vaccine's licence for each product to check the recommended route of administration as they may vary.

If an individual is receiving two or more injections in the same visit, they should be given in separate sites and preferably in different limbs. If they’re given in the same limb, they should be administered at least 2.5 cm apart. The site of all injections should be recorded in the individual’s records.

Techniques

In community pharmacy the flu vaccine is generally administered intramuscularly (IM) into the deltoid muscle. 

Image source: Green Book Chapter 4

The needle should pierce the skin at a 90° angle with the skin stretched at the site of injection.

Image source: The Green Book Chapter 4

1. Hold the syringe like a pen or dart between your thumb and forefinger.
2. Locate the injection site, then use your non-dominant hand to stretch the skin above. This helps displace the subcutaneous layer and reduces nerve sensitivity.
3. Insert the needle swiftly and smoothly at a 90° angle, leaving a small portion visible to ensure proper depth into the muscle.
4. Depress the plunger slowly—about 1 second per 0.1ml—then withdraw the needle in a controlled motion.
5. Dispose of the needle immediately into a sharps container.
6. Ask the patient to gently press the site with cotton wool.

You can find a video of this technique produced by ECG here:

Subcutaneous (SC) injections are delivered into the arm with the needle at a 45° angle to the skin and the skin should be pinched at the site of administration before delivering the injection.

Image source: The Green Book Chapter 4

You can find a video of this technique produced by ECG here: