Over the past decade, the childhood vaccine schedule has increased in complexity. De-
pending upon the combinations adminis-tered, children now may receive as many as 24
immunizations via intramuscular (IM) injection by 2 years of age (Centers for Disease
Control and Prevention [CDC], 2011). Pediatric nurses administer the majority of injections
and thus have an essential role in maintaining safe and successful immunization programs.
The administration of injections is a fundamental nursing skill, yet it is not without risk …