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Many pediatric vaccines are administered via the intramuscular (IM) route, and the CDC recommends selection of needle length according to patient age). IM vaccines can increase immunogenicity and minimize local injection-site reactions compared with vaccines given at subcutaneous or intradermal levels, but overpenetration can be painful and cause bone or periosteal damage. To determine optimal needle length for IM injection, investigators used MRI or CT to measure thickness of subcutaneous fat and muscle layers of normal thighs and shoulders in 250 patients (age range, 2 months to 18 years).
Current CDC recommendations for 1-inch and 1¼-inch needle lengths for vaccination in thigh muscles in children aged 1 year and older could result in ove…