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Flu shots have been administered intramuscularly (IM) in the upper arm in adults and in the thigh in children aged over six months. Children under six months can not be vaccinated yet. There is also now a new intradermal (ID) injection for flu for adults ages 18 - 64.

The typical IM syringe needle is a 25.4 mm (1 or 1 1/2 inch) long needle and it is usually 22-25 Gauge size. It really isn't very big as medical intramuscular injection needles go.

The ID syringe needle is tiny in comparison (90% smaller) and is very useful for the needle-averse patient due to small size, less pain on injection, and the needle is not readily visible in the special micro-injection system.

ID needles are short, injected only 1.5 mm deep (0.039 inches) and are thin (30 gauge).

The amount of vaccine in an adult dose of the IM H1N1/09 flu shot is 0.5 mL (one half cc), which is a very small amount (approximately 1/10 of a teaspoon). But the micro dose of ID vaccine is only 0.1 mL.

The IM vaccine's dose of antigen is 45 mcg while the ID contains antigen in a dose of 27 mcg for as good or better immunization. The skin has special immune system cells available that help the ID vaccine work better.

In trials 96% of clinicians administering the vaccines would recommend the ID vaccine.

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Q: How big is the flu shot?
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