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Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography
Published on: March 12, 2021
Risk for Shoulder Conditions After Vaccination: A Population-Based Study Using Real-World Data
Chengyi Zheng1, Jonathan Duffy2, In-Lu Amy Liu1
1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California (C.Z., I.A.L., L.S.S., W.C., L.Q., D.S.R., S.S.K., C.M., S.J.J.).
Background:
Although shoulder conditions have been reported as an adverse event after intramuscular vaccination in the deltoid muscle, epidemiologic data on shoulder conditions after vaccination are limited.
Objective:
To estimate the risk for shoulder conditions after vaccination and assess possible risk factors.
Design:
Retrospective cohort study.
Setting:
Kaiser Permanente Southern California, a large integrated health care organization.
Participants:
Kaiser Permanente Southern California members aged 3 years or older who had an intramuscular vaccination administered in the deltoid muscle between 1 April 2016 and 31 December 2017.
Measurements:
A natural language processing (NLP) algorithm was used to identify potential shoulder conditions among vaccinated persons with shoulder disorder diagnosis codes. All NLP-identified cases were manually chart confirmed on the basis of our case definition. The characteristics of vaccinated persons with and without shoulder conditions were compared.
Results:
Among 3 758 764 administered vaccinations, 371 cases of shoulder condition were identified, with an estimated incidence of 0.99 (95% CI, 0.89 to 1.09) per 10 000 vaccinations. The incidence was 1.22 (CI, 1.10 to 1.35) for the adult (aged ≥18 years) and 0.05 (CI, 0.02 to 0.14) for the pediatric (aged 3 to 17 years) vaccinated populations. In the adult vaccinated population, advanced age, female sex, an increased number of outpatient visits in the 6 months before vaccination, lower Charlson Comorbidity Index, and pneumococcal conjugate vaccine were associated with a higher risk for shoulder conditions. Among influenza vaccines, quadrivalent vaccines were associated with an increased risk for shoulder conditions. Simultaneous administration of vaccines was associated with a higher risk for shoulder conditions among elderly persons.
Limitation:
Generalizability to other health care settings, use of administrative data, and residual confounding.
Conclusion:
These population-based data suggest a small absolute risk for shoulder conditions after vaccination. Given the high burden of shoulder conditions, clinicians should pay attention to any factors that may further increase risks.
Primary Funding Source:
Centers for Disease Control and Prevention.
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