Dosage
Check the vaccine package insert for the appropriate dosage. The most common vaccine utilized by TotalWellness is inactivated influenza vaccine (IIV) with a dosage of 0.5mL for children between the ages of 3 – 18 years old.

Needle Size & Injection Site
Utilize a 5/8 – 1 inch needle. Administer shot in the child’s deltoid muscle (upper arm) or alternatively, in the anterolateral thigh muscle; depending on the size of the child. Small children should have the shot in their thigh muscle and/or do not inject the entire needle when administering the vaccination.

First Flu Shot
If this is the child’s first flu shot, have the parent follow up with the child’s doctor to determine if a second dose is necessary.

• A second dose of influenza vaccine is recommended 4 weeks or more after the first dose for children age 6 months through 8 years if they have not or don’t know if they have received 2 doses in prior years (not necessarily in the same season).
• A second dose is needed for a 9-year-old child who received one dose in the current season when they were age 8 years, if they have not or don’t know if they have received 2 doses in prior years.

TotalWellness does not return to locations to administer 2nd doses.

Anaphylactic Response
In case of life-threatening anaphylaxis, follow the procedure below:

1. Maintain airway, breathing and circulation;
2. Activate emergency medical services by calling 911;
3. Epinephrine use:
   1. Epinephrine 1:1000, 0.01mL–0.3mL injected IM for individuals < 66 pounds OR
   2. Epinephrine 1:1000, 0.3mL–0.5 mL injected IM for individuals > 66 pounds;
4. Dose may be repeated for severe, persistent anaphylaxis every five to ten minutes, but patient should not receive more than 3 doses; and
5. Advise patient to follow-up with further medical attention as biphaxic anaphylaxis may occur.