# Flu Shot



## BigBeautifulMe (Oct 23, 2008)

Every year I get a flu vaccine. Every year it's been in my arm, in the muscle. Yesterday I got one, and it was weird - it was really high up on my shoulder, and not in the muscle at all. Did I get someone incompetent, or has the vaccine administration changed? Could this be the difference between live flu vaccine and dead? (I think I usually get the dead kind since I have asthma). Anyone know?

Also, today I am sick as a dog.  I think it might be from the two kids I babysat Sunday who had colds, though, rather than from the flu shot. Don't know.


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## moore2me (Oct 24, 2008)

BigBeautifulMe said:


> Every year I get a flu vaccine. Every year it's been in my arm, in the muscle. Yesterday I got one, and it was weird - it was really high up on my shoulder, and not in the muscle at all. Did I get someone incompetent, or has the vaccine administration changed? Could this be the difference between live flu vaccine and dead? (I think I usually get the dead kind since I have asthma). Anyone know?
> 
> Also, today I am sick as a dog.  I think it might be from the two kids I babysat Sunday who had colds, though, rather than from the flu shot. Don't know.



Dear BigBeautifulMe,

The CDC has not changed the protocol for administering the adult flu vaccine. I have attached a link to their guidelines for 2008-2009. They recommend that the vaccine manufacturer's recs be followed for giving a shot - usually it is intramuscular and in the deltoid muscle of an adult.
(Table 2 of the document has some of this.)

They also specify a needle length of >1 inch (>25 mm) should be considered for persons in these age groups because needles of <1 inch might be of insufficient length to penetrate muscle tissue in certain adults and older children.

If you are concerned if your shot was not effective, I suggest you contact the CDC by phone or email and ask one of the experts there about your immunization quality.

http://www.cdc.gov/flu/professionals/acip/index.htm 

View attachment New Picture (1).jpg


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## Miss Vickie (Oct 24, 2008)

Oooh I hate giving deltoid injections. I think they hurt more than the hip ones, although I'm sure in a busy clinic it's much easier to get someone to roll up their sleeve than drop their drawers.  It sounds like it was in the deltoid muscle, but near the top, which is okay as long as it's in the muscle as M2M said.

Still though... ow.


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## BigBeautifulMe (Oct 24, 2008)

That's why I thought it wasn't in the muscle, Vickie. It didn't hurt a bit. Just a superficial prick - but none of the pain I remember when it gets into the muscle.


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## Miss Vickie (Oct 25, 2008)

BigBeautifulMe said:


> That's why I thought it wasn't in the muscle, Vickie. It didn't hurt a bit. Just a superficial prick - but none of the pain I remember when it gets into the muscle.



Well, some people are so good at giving injections that they don't hurt. (I am not one of these people). Also, some nurses grab the tissue on either side of the muscle and hold tight while giving the shot. Doing that blocks nerve impulses (Gate Pain Theory or some such) so no pain is perceived. Also, subcutaneous injections hurt, too; I gave a sub-q MMR vaccine the other day and it hurt like a mofo, but the intramuscular Tdap didn't hurt at all. Go figure. You may have just lucked out. I had one deltoid injection that didn't hurt, but I've never felt secure enough in my technique to do them very much.


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## BigBeautifulMe (Oct 25, 2008)

Thanks very much, Vickie! I feel better now. I don't know what I'd do without your sage advice around here.   :wubu:


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## Miss Vickie (Oct 25, 2008)

BigBeautifulMe said:


> Thanks very much, Vickie! I feel better now. I don't know what I'd do without your sage advice around here.   :wubu:



Aw, thank you! :blush: Just don't ask me to poke you with a pointy needle 'cause I totally suck at that.  I have lots of mad nursing skills, including drawing blood in patients whose veins are "too small" (including babies) but somehow I can't manage to give injections that don't hurt. Makes me sad, it does.


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## ThikJerseyChik (Oct 25, 2008)

I just got my flu shot on Friday, my arm is still sore. I didn't feel the needle go in at all, it was the burning/ache after the flu was injected in that hurt. OUCH!

It's sore around the injection site but all in all since my immune system is already compromised it's better than getting the full blown flu. YUCK!!! 

TJC


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## Miss Vickie (Oct 25, 2008)

True. It depends on how viscous the medication is, what the pH is, stuff like that. I'm told B12 injections are rough, as is Depo Provera.


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## moore2me (Oct 26, 2008)

It's true about the B12 shots. I give myself daily shots of Copaxone and have for years. Prior to that I gave myself insulin & hormone shots - no problemo. But then one doctor told me he wanted me to start taking monthly B12 shots. My nurse showed me how to give them to myself IM in my thigh. 

I got the prescription filled. THE NEEDLES WERE HUGE. I hated giving myself those shots. I dreaded it every month. I am pretty much a trooper about such things - but I hated those shots. After a a couple of years, I gave it up and started going to Kroger pharmacy in our town, they gave the shot for $15.00. Then, I started using the little patches - which are painless and do not hurt at all. Score one for the weinne in me.


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## Miss Vickie (Oct 26, 2008)

B12 patches are way cool, much nicer than the shots. One of the first shots I have as a nursing student was a B12 injection to a poor homeless alcoholic guy with a very skinny but. I think we were both equally traumatized!

I've lucked out that I do well with sublingual B12. My numbers are great so I haven't had to go with patches or shots or anything. *fingers crossed*


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## Pookie (Oct 29, 2008)

I got mine a couple weeks ago, really high up on my arm, like almost my shoulder and I didn't even notice it going in at all. Until the next day when I get a burning hard lump of owwiness!


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## AnnMarie (Oct 29, 2008)

I'm not sure if someone said it, I haven't read through... but I get a flu shot every year and I ask for it high up on my shoulder and I ask them to rub it in post injection BECAUSE my arm is so fat, above the muscle, that if they don't shoot it high in my arm there is no chance of a good vaccination. 

The higher they put it, the less fat there is (relatively speaking of course) and I usually don't get the huge hot spot if I have them follow this protocol. If They do a regular mid-upper arm injection and don't do any "rub in"... I get a giant hot spot for about a week following the injection. It just sits there in my fat.


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## moore2me (Oct 30, 2008)

Dear Ann Marie & Pookie, 

I hate to break it to you and the others here about "oweiness" but almost all the flu vaccine suppliers recommend that their vaccines be injected *intramuscularly*. For adults, this is usually in the deltoid muscle of the arm. For those of us that have fat arms (myself included, this may involve using longer needles ). In my earlier posts I included a link to the CDC's recommendations and it is always a intramuscular dose. Sorry. 

View attachment Deltoideus.1.jpg


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## Pookie (Oct 30, 2008)

Oh I see, I guess I finally got to the stage where my arms are too fat and had to have it higher up lol  last years was done lower.


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## AnnMarie (Oct 30, 2008)

missaf said:


> I think AM is saying she likes the shot higher up in her deltoid so that the injection needle goes through less fat.



You got it! I know full well the injection needs to be in muscle. 

The higher up they go, it's more likely to get in the muscle because it's going through less fat. Lower and it's all fat - needles are too tiny.


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## moore2me (Oct 30, 2008)

Dear AM, 

I didn't mean to be "snitty" at your post. Sorry if I came across that way. Bad lizard lady from Tokyo. It will be much better after Halloween night is over.


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## Dromond (Oct 31, 2008)

I got my flu shot today. I can tell they hit the muscle. *ouch*

As for B-12 shots, I take them twice a month and dread it each time. The needles look like they were developed by the Defense Department. I shoot it into my quads and boy does it hurt. The blast of energy I get from the shot is really wonderful, though. I have a couple of days of a near manic state, and I get a lot done that I'm otherwise reluctant to try. This last shot left me with enough energy to scrub the kitchen floor by hand.


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