Ventrogluteal area—a suitable site for intramuscular vaccination of infants and toddlers

Buttock vaccination has lower reactogenicity and similar immunogenicity to the two other recommended paediatric vaccination sites (deltoid and anterolateral thigh). Safety concerns about buttock injection derived from injections with neurotoxic agents, like penicillin but not vaccines, have become entrenched. However, the ventrogluteal area is considered safe for intramuscular injection.This study outlines the development of the ventrogluteal area as a suitable site for intramuscular vaccination of infants and toddlers. Measurement was made in 642 children, aged 2–18 months and age-specific templates were prepared. These were used in an untrasonographic study of 57 children aged 2–18 months to determine the tissue composition of the ventrogluteal area compared with the recommended anterolateral thigh vaccination site.The ventrogluteal area was found to be clearly defined by the template and suitable for intramuscular injection. Subsequent vaccination studies with the area showed that it was:
• safe and had a high level of parental acceptability;
• associated with lower reactogenicity with pertussis vaccines and equivalent immunogenicity with hepatitis B vaccines compared with the anterolateral thigh vaccination site.