The process of administering a vaccine (i.e. giving an intramuscular injection) may cause severe anxiety in some individuals with anxiety disorders or needle-phobia, and/or may be difficult in certain individuals with behavioural disorders. A tiered approach initially using non-pharmacological measures may assist in facilitating vaccination. In patients where non-pharmacological techniques have failed, sedation may facilitate safe administration of vaccines in some special circumstances. Informed consent must be obtained prior to each dose from the patient themselves, or, where the patient does not have capacity to give consent, from the parent, guardian or substitute decision-maker. Sedation should not be used as a measure to enforce compliance with vaccination requirements.