# what effects how painful an injection (vaccination) is? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 25, 2018, 10:16pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486 "2018-01-25T22:16:10Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![jz78817](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jz78817/32/1028_2.png) [@jz78817](https://boards.straightdope.com/u/jz78817)\ **Post date:** [January 25, 2018, 10:16pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/1 "2018-01-25T22:16:10Z")
Reason I ask is because when I get a flu shot (intramuscular injection into my upper arm) I barely feel the injection and have no residual soreness. On the other hand, the last time I had a Td (or Tdap, don’t remember) booster, it was injected into basically the same muscle and that was significantly more painful with the site being sore for the rest of the day. I didn’t get a look at the syringe to see; is it the size of the needle? or the actual substance being injected? ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [January 25, 2018, 10:19pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/2 "2018-01-25T22:19:53Z")
My WAG is it’s both the substance and the injection site, not the needle size per se. ---
**Author:** ![Chefguy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chefguy/32/138_2.png) [@Chefguy](https://boards.straightdope.com/u/Chefguy)\ **Post date:** [January 26, 2018, 12:04am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/3 "2018-01-26T00:04:44Z")
The skill of the person giving it to you. Same with blood draws. If the phlebotomist is good, you barely feel a thing. ---
**Author:** ![harmonicamoon](https://avatars.discourse-cdn.com/v4/letter/h/65b543/32.png) [@harmonicamoon](https://boards.straightdope.com/u/harmonicamoon)\ **Post date:** [January 26, 2018, 12:24am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/4 "2018-01-26T00:24:48Z")
I have had lots of legal injections. And the most painful has always been a tetanus booster. ---
**Author:** ![elfkin477](https://avatars.discourse-cdn.com/v4/letter/e/a9a28c/32.png) [@elfkin477](https://boards.straightdope.com/u/elfkin477)\ **Post date:** [January 26, 2018, 12:46am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/5 "2018-01-26T00:46:13Z")
Most people find the tetanus booster more painful than other shots. This [article](http://www.wisegeek.org/why-does-the-tetanus-vaccine-hurt-so-much.htm) suggests that it might be related to properties of the bacteria. ---
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [January 26, 2018, 2:13am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/6 "2018-01-26T02:13:21Z")
Yellow Fever is the worst I’ve ever had. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [January 26, 2018, 4:26am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/7 "2018-01-26T04:26:28Z")
I’ve also heard that the Gardasil vaccine is often quite painful. Plus, some vaccines only inject a fraction of a milliliter, whereas the tetanus vaxes, whether alone or in combination, are an ml. MMR is given sub-q, which is another issue altogether. ---
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [January 26, 2018, 5:46am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/8 "2018-01-26T05:46:29Z")
I have administered nearly a thousand (estimate) tetanus shots. Usually people are pleasantly surprised when I’m done. They were anticipating much worse. Needles used in intramuscular (IM) injections have 2 size parameters. Gauge and length. Gauge is a measure of the outer dimension of the needle, how thick it is. The thicker a needle, the larger the inside diameter. A more viscous medicine, needs a larger diameter inner bore. Length is primarily important for how deep your needle needs to penetrate. The needles used for tetanus are small. Not the smallest available, but close. The substance being injected, the size of the needle, the amount being administered, and the speed at which it is injected can all affect the amount of pain. AND every body is different. Tetanus vaccination which is usually administered as a combination vaccine with diphtheria and pertussis (in the US), uses just 0.5 ml of fluid, a small amount. Now get ready to be scared…Any one who has had a one shot treatment for various bacterial infections (cough syphilis cough) has had the MOST painful IM shot commonly used. Penicillin is very viscous (thick) and needs a large gauge needle. The usual dose is 2ml, 4X the size of the tetanus shot. Additionally it needs to be administered deep in muscular tissue. Usually the butt. ---
**Author:** ![Fugazi](https://avatars.discourse-cdn.com/v4/letter/f/f08c70/32.png) [@Fugazi](https://boards.straightdope.com/u/Fugazi)\ **Post date:** [January 26, 2018, 7:39am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/9 "2018-01-26T07:39:03Z")
I think there might be an element of dumb luck too. I’m diabetic and inject insulin twice a day. Sometimes I literally don’t feel it at all. Other times it stings a bit. Very rarely it stings quite a bit and I wind up rubbing the spot for a few minutes. I guess it just depends on whether I hit a nerve or not. ---
**Author:** ![kopek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kopek/32/337_2.png) [@kopek](https://boards.straightdope.com/u/kopek)\ **Post date:** [January 26, 2018, 7:44am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/10 "2018-01-26T07:44:35Z")
> [@Chefguy](#): > > The skill of the person giving it to you. Same with blood draws. If the phlebotomist is good, you barely feel a thing. In my experience – this. My regular nurse/tech is a wizard and can hit me with any kind of needle anywhere and I never notice. I’ve been to a couple where simplest shot can be a visit to the Pit of Misery. The hands, IMHO, matter more than the substance or placement. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [January 26, 2018, 8:08am UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/11 "2018-01-26T08:08:16Z")
They never bother me. I also gave blood 2 - 3 times a year for over 30 years in a variety of locations, and that never hurt either. The pneumonia vaccine I just got made my shoulder sore, but only hours after the shot, so that was a side effect, not the injection. ---
**Author:** ![Senegoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senegoid/32/6606_2.png) [@Senegoid](https://boards.straightdope.com/u/Senegoid)\ **Post date:** [January 26, 2018, 7:13pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/12 "2018-01-26T19:13:08Z")
I’ve had the tetanus/etc booster shot five times at ten-year intervals. Four of those times, no appreciable soreness afterward. ONE of those times, my are was so sore that I could barely move it for a whole week! ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [January 26, 2018, 7:48pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/13 "2018-01-26T19:48:07Z")
> [@steatopygia](#): > > I have administered nearly a thousand (estimate) tetanus shots. Usually people are pleasantly surprised when I’m done. They were anticipating much worse. > > Needles used in intramuscular (IM) injections have 2 size parameters. Gauge and length. > Gauge is a measure of the outer dimension of the needle, how thick it is. The thicker a needle, the larger the inside diameter. A more viscous medicine, needs a larger diameter inner bore. Length is primarily important for how deep your needle needs to penetrate. > > The needles used for tetanus are small. Not the smallest available, but close. > > The substance being injected, the size of the needle, the amount being administered, and the speed at which it is injected can all affect the amount of pain. AND every body is different. Tetanus vaccination which is usually administered as a combination vaccine with diphtheria and pertussis (in the US), uses just 0.5 ml of fluid, a small amount. > > Now get ready to be scared…Any one who has had a one shot treatment for various bacterial infections (cough syphilis cough) has had the MOST painful IM shot commonly used. Penicillin is very viscous (thick) and needs a large gauge needle. The usual dose is 2ml, 4X the size of the tetanus shot. Additionally it needs to be administered deep in muscular tissue. Usually the butt. When I had a tetanus shot a few years ago, I thought the syringe was filled to the 1ml mark; maybe it’s changed in the meantime. And prior to that, when I was a volunteer at a free clinic, I dispensed a few of those penicillin shots designed for syphilis (can’t recall the brand right now). The hospital where I worked had them too but I don’t remember ever dispensing one. Anyway, it was a huge syringe with a really big needle on it, and required TWO injections because a 4ml IM injection would be painful AND dangerous. That hospital also had some smaller Bicillin syringes for people who came in and either needed a lot of penicillin right now, or (more likely) for whatever reason probably couldn’t be relied upon to take a 10-day course of meds. Ceftriaxone also produces a very painful IM injection, even when it’s diluted with lidocaine. p.s. Has anyone had a vaccination that was given with an air gun? Does the military still do that? Anyway, I remember when I was in grade school in the early 1970s and the health department came to the school and gave shots to kids whose parents gave permission, due to some kind of outbreak, most likely measles. I didn’t get the shot, but most of my classmates did, and they did indeed use an air gun which left a lot of them bruised. Anyway, what did that feel like relative to needles? ---
**Author:** ![iamthewalrus\_3](https://avatars.discourse-cdn.com/v4/letter/i/258eb7/32.png) [@iamthewalrus\_3](https://boards.straightdope.com/u/iamthewalrus_3)\ **Post date:** [January 26, 2018, 7:54pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/14 "2018-01-26T19:54:24Z")
> [@elbows](#): > > Yellow Fever is the worst I’ve ever had. Me too. I fainted. Only time I ever have, and I’m not at all squeamish about needles. Although that was also the 3rd vaccination I received at the same time. ---
**Author:** ![dalej42](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@dalej42](https://boards.straightdope.com/u/dalej42)\ **Post date:** [January 26, 2018, 8:12pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/15 "2018-01-26T20:12:27Z")
> [@steatopygia](#): > > Now get ready to be scared…Any one who has had a one shot treatment for various bacterial infections (cough syphilis cough) has had the MOST painful IM shot commonly used. Penicillin is very viscous (thick) and needs a large gauge needle. The usual dose is 2ml, 4X the size of the tetanus shot. Additionally it needs to be administered deep in muscular tissue. Usually the butt. I have had the penicillin shot twice for syphilis and it is awful. Of course, it’s made even more fun by sitting a bumpy bus on the way home. ---
**Author:** ![Clothahump](https://avatars.discourse-cdn.com/v4/letter/c/51bf81/32.png) [@Clothahump](https://boards.straightdope.com/u/Clothahump)\ **Post date:** [January 26, 2018, 8:16pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/16 "2018-01-26T20:16:59Z")
I have to inject myself every two weeks (I’m on Humira). If I don’t let the hypo warm up for about 10-15 minutes, the injection process will be unpleasant because what I am injecting is cold. And every once in a blue moon, I’ll get a dull needle. That is NEVER pleasant! ---
**Author:** ![Chefguy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chefguy/32/138_2.png) [@Chefguy](https://boards.straightdope.com/u/Chefguy)\ **Post date:** [January 26, 2018, 8:39pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/17 "2018-01-26T20:39:55Z")
> [@nearwildheaven](#): > > When I had a tetanus shot a few years ago, I thought the syringe was filled to the 1ml mark; maybe it’s changed in the meantime. > > And prior to that, when I was a volunteer at a free clinic, I dispensed a few of those penicillin shots designed for syphilis (can’t recall the brand right now). The hospital where I worked had them too but I don’t remember ever dispensing one. Anyway, it was a huge syringe with a really big needle on it, and required TWO injections because a 4ml IM injection would be painful AND dangerous. That hospital also had some smaller Bicillin syringes for people who came in and either needed a lot of penicillin right now, or (more likely) for whatever reason probably couldn’t be relied upon to take a 10-day course of meds. > > Ceftriaxone also produces a very painful IM injection, even when it’s diluted with lidocaine. > > p.s. Has anyone had a vaccination that was given with an air gun? Does the military still do that? Anyway, I remember when I was in grade school in the early 1970s and the health department came to the school and gave shots to kids whose parents gave permission, due to some kind of outbreak, most likely measles. I didn’t get the shot, but most of my classmates did, and they did indeed use an air gun which left a lot of them bruised. Anyway, what did that feel like relative to needles? Yeah, they lined us up in boot camp in the late 60s, air guns on both sides. I didn’t like them, and they left a welt. The two worst were some sort of booster that left my arm so sore I could barely lift it; and the other was a gamma globulin in the ass just before I left Vietnam, that gave me a hitch in my giddy-up for a day. ---
**Author:** ![crowmanyclouds](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crowmanyclouds/32/19884_2.png) [@crowmanyclouds](https://boards.straightdope.com/u/crowmanyclouds)\ **Post date:** [January 26, 2018, 9:07pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/18 "2018-01-26T21:07:03Z")
> [@nearwildheaven](#): > > {…} Anyway, I remember when I was in grade school in the early 1970s and the health department came to the school and gave shots to kids whose parents gave permission, due to some kind of outbreak, most likely measles. {…} [1976 swine flu outbreak.](https://en.wikipedia.org/wiki/1976_swine_flu_outbreak) CMC fnord! ---
**Author:** ![Patx2](https://avatars.discourse-cdn.com/v4/letter/p/73ab20/32.png) [@Patx2](https://boards.straightdope.com/u/Patx2)\ **Post date:** [January 26, 2018, 9:40pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/19 "2018-01-26T21:40:19Z")
> [@Clothahump](#): > > I have to inject myself every two weeks (I’m on Humira). If I don’t let the hypo warm up for about 10-15 minutes, the injection process will be unpleasant because what I am injecting is cold. > > And every once in a blue moon, I’ll get a dull needle. That is NEVER pleasant! Same here, I also do Humira and I agree, I need to let it sit out before doing the injection. I also find if I do it immediately after wiping the area with alcohol it hurts more. ---
**Author:** ![DrCube](https://avatars.discourse-cdn.com/v4/letter/d/a3d4f5/32.png) [@DrCube](https://boards.straightdope.com/u/DrCube)\ **Post date:** [January 26, 2018, 10:09pm UTC](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486/20 "2018-01-26T22:09:34Z")
> [@Chefguy](#): > > The skill of the person giving it to you. Same with blood draws. If the phlebotomist is good, you barely feel a thing. I think this is the case. I have gotten an allergy shot from the same nurse every three weeks for years, and it was every week for a couple years before that. It’s almost always nearly painless, but once in a while she has an off day and it really stings. [Next page](https://boards.straightdope.com/t/what-effects-how-painful-an-injection-vaccination-is/807486.md?page=2)