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H1N1 immunization administration (intramuscular, intranasal), including counseling when performed

CPT4 code

Name of the Procedure:

H1N1 Immunization Administration (Intramuscular, Intranasal)


H1N1 immunization, commonly referred to as the flu shot or nasal spray flu vaccine, involves administering a vaccine to protect against the H1N1 strain of influenza. This can be done via an intramuscular injection or an intranasal spray.


The purpose of the H1N1 immunization is to prevent seasonal influenza caused by the H1N1 virus. The vaccine aims to reduce illness severity, prevent flu-related complications, and decrease the spread of the virus within the community.


  • Seasonal flu prevention for individuals older than 6 months.
  • High-risk groups (e.g., pregnant women, elderly, those with chronic medical conditions).
  • Healthcare workers and caregivers.
  • Individuals planning to travel to areas with high flu activity.


  • Inform the healthcare provider of any allergies or adverse reactions to previous vaccinations.
  • Avoid taking antiviral medications 48 hours before receiving the nasal spray vaccine.
  • No other specific preparation for the intramuscular shot, but wearing short sleeves may be helpful.

Procedure Description

Intramuscular Injection:
  1. The healthcare provider cleans the injection site, typically the upper arm.
  2. The vaccine is injected into the muscle using a sterile needle.
  3. A bandage is applied to the injection site if necessary.
Intranasal Spray:
  1. The patient is asked to breathe normally.
  2. The healthcare provider gently squirts the nasal spray into each nostril.

No anesthesia or sedation is required for either method.


The procedure typically takes less than 5 minutes.


The H1N1 immunization can be performed in various settings, including:

  • Outpatient clinics
  • Doctor’s offices
  • Hospitals
  • Pharmacies
  • Community health events


  • Nurses
  • Physicians
  • Pharmacists
  • Medical assistants

Risks and Complications

Common Risks:
  • Mild pain or soreness at the injection site
  • Redness or swelling
  • Low-grade fever
  • Mild aches
Rare Risks:
  • Severe allergic reactions (anaphylaxis)
  • Guillain-Barré syndrome (extremely rare)


  • Reduced risk of contracting H1N1 influenza.
  • Decreased severity of illness if infected.
  • Lower likelihood of flu-related complications and hospitalizations.
  • Contribution to community immunity (herd immunity).


  • Most individuals can return to normal activities immediately.
  • Soreness at the injection site may persist for a day or two.
  • Intranasal recipients might experience mild nasal congestion or runny nose.
  • Follow up with a healthcare provider if severe side effects occur.


  • Antiviral medications (used for treatment, not prevention).
  • Other flu vaccines containing different strains.
  • Non-pharmacological preventions like hand hygiene and wearing masks.

Patient Experience

During the Procedure:
  • Intramuscular injection may cause brief discomfort or stinging.
  • Intranasal spray typically feels like a mist in the nostrils.
After the Procedure:
  • Mild soreness or nasal congestion might be experienced.
  • Over-the-counter pain relievers can manage minor pain or fever.
  • Cold compresses can reduce swelling at the injection site.

Overall, most patients tolerate the H1N1 immunization well with minimal discomfort.

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