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Covid Vaccine Given Too High On Arm

Updated | Posted

 

would-you-get-your-covid-vaccine-at-a-pharmacy.jpg.47d899b2cbb14a329c0118490dbb8059.jpgThe bruise was the injection site administered by a pharmacy tech at Walgreens.  Can't remember how far away my arm was from the side, so it's possible that the bursa was irritated.  Appears to be 3 cm below the lower edge of the acromion, though I think it should be 5-6 cm to avoid the bursa.  Any nurses care to comment?  I know that you would get your vaccines at the hospital, but would you go back to a Walgreens for shots?

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I've never gotten an injection from Walgreens. 

CrunchRN, ADN, RN

Specializes in Clinical Research, Outpt Women's Health. Has 25 years experience.

That is high up.

Are you saying your arm is hurting more than you expected?

I've received shots from walgreens because they offer preservative free, and tri and quad and egg free, etc.  

Maybe next time point to exactly where you want the shot, that could help.

I’m just a little sketched out by getting vaccines from major retailers, and the higher up vaccination placement just adds to the anxiety. No idea if the bursa was irritated or not. Arm just feels weaker even 10 days out. 

Realistically, I know that short of having a massive bruise or immobile arm, there isn’t anything that I can do. Arguing over 3-4 cm below the acromion vs 5-6cm wouldn’t get me anywhere with a doctor visit. 

I’ll just have to get my second vaccine(all future vaccines) at a hospital from now on. Nothing else I can really do. 

Mine (second one) was given at the hospital by an RN and was still way too high so don't know if going to hospital will solve the issue. 

CommunityRNBSN, BSN, RN

Specializes in Community health. Has 3 years experience.

I do not think it’s a Walgreens problem. In order to vaccinate 400 million people, LOTS of people are being drafted to vaccinate. At our clinic (an FQHC), if you have any sort of license that allows you to vaccinate, you’re up. Here are the syringes, get out there and get moving. So, no, everyone is not an expert vaccinator. Should we be doing more training and shadowing?  Sure, there are a lot of things that would be happening if we weren’t in the middle of a pandemic. My point is— don’t blame Walgreens. Going to a clinic or hospital wouldn’t guarantee a better outcome for shots.  In future if you’re anxious, you can always ask the tech to point with her finger where she’s going to inject. 

CABGpatch_RN, BSN

Specializes in Critical Care. Has 20 years experience.

Nurse vaccinator here.  I would go lower, but for what it's worth I don't think the picture above depicts an injection too high.  Wishing you nothing but the best.

https://healthjade.net/deltoid-muscle/

Edited by CABGpatch_RN
typo

CABGpatch_RN, BSN

Specializes in Critical Care. Has 20 years experience.

btw, yes.  Get your vaccine wherever it is available to you.  Including the retail pharmacies.

sideshowstarlet, BSN, RN

Specializes in Med-Surg, Developmental Disorders. Has 8 years experience.

I agree with the prior poster who said you should get the vaccination wherever and whenever it is available to you. I am surprised that you have had to wait this long for a first shot. In my area, frontline workers like EMTs were getting their first and even second shots before Walgreens even started administering them. Wishing you a smooth second shot and good health! 

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

The images below show correct deltoid locations for injections ---  first post picture site appears to be 2 fingerbreaths below shoulder tip--- acceptable location.

image.png.2579a0f530cef48cece0b609f1226b03.png

 

image.thumb.png.4acdda49cb12814bfb3919416df5d48c.png

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NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

This  picture shows hand position I used to administer deltoid IM .

image.png.7b951d578a79968846faa509547855fd.png

On 3/27/2021 at 12:15 AM, CABGpatch_RN said:

Nurse vaccinator here.  I would go lower, but for what it's worth I don't think the picture above depicts an injection too high.  Wishing you nothing but the best.

https://healthjade.net/deltoid-muscle/

Can't u give vaccines in the anterolateral thigh? Like in the vastus lateralis? I always dislike receiving injections in my little delt! 

sideshowstarlet, BSN, RN

Specializes in Med-Surg, Developmental Disorders. Has 8 years experience.

On 3/27/2021 at 3:41 PM, scuba-girl said:

Can't u give vaccines in the anterolateral thigh? Like in the vastus lateralis? I always dislike receiving injections in my little delt! 

You can technically administer it anywhere, as long as it gets in the muscle. When I help out with vaccine administration, people are vaccinated from their cars, so the deltoid is generally more convenient for giving the shot. 

CABGpatch_RN, BSN

Specializes in Critical Care. Has 20 years experience.

On 3/27/2021 at 3:41 PM, scuba-girl said:

Can't u give vaccines in the anterolateral thigh? Like in the vastus lateralis? I always dislike receiving injections in my little delt! 

I suppose we could, but maybe in a super private setting.  Definitely not where I am currently vaccinating. 

I have gotten some great influenza vaccinations at pharmacies and I've known medical assistants in clinics to give them wrong. I don't think the venue matters that much.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 19 years experience.

This is a really cool and professional discussion. I know another poster mention the vastus lateralis and my personal preference is the ventrogluteal. I have on occasion given my vaccines to myself using this site, but only when I really don't trust the vaccinator.

Marie Bailey, MSN

Has 13 years experience.

That looks like a perfectly appropriate injection site to me. 2-3 finger breadths below the acromion process, aiming for the center of the muscle = adequate. If you’re skinny, maybe you need a 5/8” needle instead of a 1”. It also helps to bunch up the muscle while administering. Also , it’s never necessary to aspirate with a deltoid IM. Other than that, needles might leave you sore with a bruise (b/c they’re needles), but it’s better than going too low & inadvertently administering it SQ; this could result in reduced serum antibodies. 
Wanna see my pet peeve? See photo on right. Too low!

99844CE3-9BAD-4D69-99B7-517FF3F4ADC3.jpeg

Edited by Marie Bailey