Which vaccines are given intramuscularly?

• A. DTaP, DT, Hib, hepA, hepB, HPV, IIV, MCV, PCV, rabies, Td, Tdap, RZV (Shingrix), and sometimes IPV or PPSV
• B. Measles, mumps, rubella, and varicella vaccines are given intramuscularly
• C. All vaccines are given intramuscularly
• D. Some vaccines are given intramuscularly, others by other routes.

Answer: (A)

Intramuscular delivery is used for many routine vaccines because muscle tissue provides good absorption and helps generate a strong immune response with the adjuvants used in these products. The vaccines listed are those typically given by the IM route: DTaP, DT, Hib, Hepatitis A and B, HPV, the inactivated influenza vaccine, meningococcal conjugate vaccines, pneumococcal conjugate vaccines, rabies, tetanus/diphtheria/pertussis combinations, and the shingles vaccine Shingrix. IPV (polio) is sometimes given IM, and PPSV (pneumococcal polysaccharide) is usually IM in adults.

Some vaccines are given by other routes—for example, measles, mumps, rubella, and varicella vaccines are administered subcutaneously, not intramuscularly. That’s why they aren’t listed among the intramuscular vaccines. While it’s true that some vaccines can be given by more than one route depending on age or product, the best-fit answer is the explicit list of vaccines commonly administered via the IM route.