Shoulder Injury Related to Vaccine Administration

Shoulder injury related to vaccine administration (SIRVA) is a rare yet increasingly recognized complication of immunization. Although a medicolegal term rather than a true diagnosis, SIRVA was introduced in 2010 by the Vaccine Injury Compensation Program after an increase in claims filed for vaccine-related shoulder injury. Patients typically present with severe pain and limited range of motion within 48 hours of vaccination and may experience notable functional limitations. Although the underlying pathophysiology is incompletely understood, the existing literature suggests that SIRVA results from the inflammatory response produced when the vaccine is injected into tissues containing a preexisting antibody. Current treatment modalities include physical therapy, corticosteroid injections, and antiinflammatory medications. In some cases, surgery may be required to treat underlying pathology, such as rotator cuff or biceps tendinopathy. Although the available literature indicates modest improvement in patients with SIRVA undergoing treatment, current data are limited to case series. Larger, high-quality studies are needed to determine the natural history and optimal treatment of this increasingly prevalent condition.