Aiming too high: Shoulder injury related to vaccine administration (SIRVA): A case series

Marshall, Tessa S.; Addison, Mel; Crawford, Nigel; Buttery, Jim; Cheng, Daryl R

doi:10.1016/j.vaccine.2022.10.086

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…It has been hypothesized that a "too high" injection site may predispose to the development of SIRVA. 22,23 The standard teaching for a shoulder intramuscular injection is to inject in the midline of the lateral aspect of the upper arm, one to three fingers' breadth below the edge of the acromion, to avoid injection through the deltoid and into the underlying bursa. It also avoids the complication of injury to the neurovascular structures.…”

Section: Introductionmentioning

confidence: 99%

SIRVA: Shoulder injury related to vaccine administration

Jenkins,

Duckworth

2023

Bone Joint J

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Shoulder injury related to vaccine administration (SIRVA) is a prolonged episode of shoulder dysfunction that commences within 24 to 48 hours of a vaccination. Symptoms include a combination of shoulder pain, stiffness, and weakness. There has been a recent rapid increase in reported cases of SIRVA within the literature, particularly in adults, and is likely related to the mass vaccination programmes associated with COVID-19 and influenza. The pathophysiology is not certain, but placement of the vaccination in the subdeltoid bursa or other pericapsular tissue has been suggested to result in an inflammatory capsular process. It has been hypothesized that this is associated with a vaccine injection site that is “too high” and predisposes to the development of SIRVA. Nerve conduction studies are routinely normal, but further imaging can reveal deep-deltoid collections, rotator cuff tendinopathy and tears, or subacromial subdeltoid bursitis. However, all of these are common findings within a general asymptomatic population. Medicolegal claims in the UK, based on an incorrect injection site, are unlikely to meet the legal threshold to determine liability.Cite this article: Bone Joint J 2023;105-B(8):839–842.

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Section: Introductionmentioning

confidence: 99%