Atypical Shoulder Pain and Dysfunction After Vaccinations Reported to the Vaccine Adverse Event Reporting System...

Area of Science:

• Immunology
• Public Health
• Vaccinology

Background:

• Shoulder injury related to vaccine administration (SIRVA) stems from incorrect vaccine placement near shoulder joint structures.
• Improper technique can lead to persistent shoulder pain, reduced mobility, and long-term impairment.

Purpose of the Study:

• To identify and characterize cases of SIRVA reported in the Vaccine Adverse Event Reporting System (VAERS).
• To determine the incidence and demographic factors associated with SIRVA.

Main Methods:

• Searched VAERS for reports of shoulder pain and dysfunction post-vaccination between January 1, 2018, and October 31, 2022.
• Applied SIRVA definition criteria including symptom onset within 48 hours, pain, decreased range of motion, and symptom duration of at least 7 days.

Main Results:

• Identified a SIRVA reporting rate of approximately 0.5% among reviewed reports.
• SIRVA was infrequent in children, with adult females most commonly affected (74% of serious reports).
• Incorrect vaccine "high" arm placement was a factor in 68% of cases, leading to functional impairment in 64% of serious reports.

Conclusions:

• SIRVA is an uncommon but significant vaccine adverse event with potential for substantial functional impact.
• Findings confirm higher incidence in females, rarity in children, and association with high arm injection, underscoring the need for improved vaccination techniques.
• Prioritizing prevention through enhanced vaccinator training is crucial to minimize SIRVA occurrence.