Anatomy of a Flu Shot

October 23rd, 2018

Nurses are at the front lines of our annual battle against the flu, giving thousands of flu shots to protect JPS patients and our community from influenza. They see firsthand how getting the flu can be miserable and even turn into serious health problems that can require a hospital stay.

If you’ve never had a flu shot, or are anxious about injections, you might be apprehensive about what it involves. We asked Shelly Howard, RN, Clinical Manager, an experienced JPS Health Network nurse, to walk us through the process for how nurses administer the vaccination to adults. In coming weeks, we will talk to a nurse about ways to make the experience easier for adults and children.


Before the shot


Just like patients, nurses want the shot to be as quick and pain-free as possible, Howard said.

JPS Health Network

“Most patients are scared of the shot itself,” she said. “Some people just have a fear of needles and they want to know that you are going to be quick. They will ask you, ‘are you good at this?’ I always reassure them that yes, we are really good at this; we have done this multiple times. I try to put them at ease and make it really quick. A lot of times, they will tell you, ‘oh, wow, that was really, really fast.’ ”

Nurses first assess the patient’s arm to determine if there is any dense tissue. That helps them choose which needle size to use for the injection.

JPS uses two kinds of needles, which are attached to syringes that are pre-filled with individual doses by the vaccine manufacturer. For most adults, a standard needle that is 1 inch in length is used. For adults who have denser muscle in their arms a needle that is 1.5 inches long because the flu vaccine is required to be a deep muscle injection.

Patients are asked which arm they would like to receive the vaccine. It is common for patients to experience soreness in their arm, similar to a pulled muscle, for a day or two day after the shot. Many patients choose to have it in their non-dominant arm (the arm that they don’t write with.) Some patients prefer to get the shot in their dominant arm. That’s because even though the arm might be sore, moving, stretching and reaching throughout the day helps work the vaccine into the muscle more quickly.

To locate the correct place for the injection, nurses measure about three fingers from the top of the shoulder, in the thickest part of the deltoid muscle.

“The third finger is where you inject because that’s where you have enough muscle tissue to make sure you won’t hit bone,” Howard said.


During the shot

The skin is cleaned with an alcohol wipe to help ensure that no bacteria enters the injection site. Once the alcohol dries, the nurse gathers the patient’s deltoid muscle between her fingers and holds it somewhat tightly.

“The reason I pinch the skins to help with the pain of the actual injection itself and to make sure I stay within the right area for administration,” Howard said. “By pinching their arm it takes their mind off the actual poke.”

The needle goes straight in, like using a dart, at a 90 degree angle. The faster the needle punctures the skin, the less it hurts.


After the shot

It’s not mandatory, but some nurses choose to apply firm pressure or rub the injection site after the shot to help reduce the discomfort that can happen afterwards.

Patients should feel free to ask questions about possible side effects, such as fever or aches. Although most side effects will go away on their own, but if they are serious or persistent, patients should contact their primary care provider or come to the JPS Urgent Care Center.


Flu Shots at JPS:

The flu vaccine is recommended every year for adults and children 6 months and older to reduce the risk of developing flu-related illness.

You can receive your flu vaccine during special walk-in hours at JPS Medical Homes throughout Tarrant County. You can also get a flu shot during a medical appointment at JPS and at appointments with a clinical pharmacist. For those without insurance or who wish to pay out-of-pocket, the cost is $25.

Walk-In Flu Shot Clinics: 3 – 5 p.m. Monday – Thursday, and 8 a.m. to 5 p.m. on Friday at JPS Medical Homes.

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