Progressive Monoarticular Inflammatory Arthritis Following Influenza Vaccination

Introduction After a vaccination, patients frequently have clinical symptoms of pain and swelling over the injection area which usually resolve 2–3 days after the injection. If the symptoms do not improve, a shoulder injury related to vaccine administration (SIRVA) will be considered, perhaps related to an improper injection technique. Herein we report our first case of a SIRVA after a Sinovac COVID-19 vaccination which occurred due to deep penetration and direction of the needle. The clinical symptoms of the patient improved after treatment with combined oral non-steroidal anti-inflammatory drugs and a short course of intravenous antibiotic. Case presentation A 52-year-old Thai male without prior shoulder pain had a Sinovac COVID-19 vaccination at his right shoulder. The injection was given by a nurse using a 27-gauge needle, 1.5 inches in length. The injection landmark was 3 finger breadths below the midlateral edge of the acromial process. The direction of the needle was 45° to the skin cephalad. Three days after receiving the vaccine the patient began to have right shoulder pain with limited range of motion and acute fever. He was admitted for medical treatment which his clinical symptoms gradually improved. Conclusion We report a case of subacromial-subcoracoid-subdeltoid bursitis following a Sinovac COVID-19 vaccine injection. This condition is rare, and usually related to an incorrect vaccination technique. To avoid this complication, nurses should identify the correct landmark, use an appropriate needle length, and point the needle in the correct direction.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Shoulder injury related to Sinovac COVID-19 vaccine: A case report

Chuaychoosakoon

Parinyakhup

Tanutit

et al. 2021

“…These symptoms normally improve in a few days. If the clinical symptoms persist for more than 2–3 days, a shoulder injury related to vaccine administration (SIRVA) should be considered [ [2] , [3] , [4] , [5] , [6] ]. A SIRVA usually occurs due to an incorrect injection technique such as inappropriate needle direction or depth of penetration.…”

Section: Introductionmentioning

confidence: 99%

Combined subacromial-subdeltoid bursitis and supraspinatus tear following a COVID-19 vaccination: A case report

Boonsri

Chuaychoosakoon

2021

Introduction After a vaccine administration, many people have localized symptoms such as pain, redness, warmth, swelling, itching and/or bruising, which usually improve in a few days. If the clinical symptoms do not improve in this period, a shoulder injury related to vaccine administration (SIRVA) should be ruled out. The most common cause of a SIRVA is an improper injection technique. Herein, we reported the first case of combined subacromial-subdeltoid bursitis and supraspinatus tendon tear which was apparently caused by an improper COVID-19 vaccination technique. Case presentation A 51-year-old Thai female began to experience severe right shoulder pain about 3 hours after receiving a COVID-19 vaccination. Ultrasonography showed combined subacromial-subdeltoid bursitis and supraspinatus tendon tear. Her clinical symptoms gradually improved after treatment with an oral non-steroidal anti-inflammatory drug. Our investigation found that an improper injection technique had been used, namely inserting the needle too deeply, and using an incorrect landmark. Conclusion We report a case of combined subacromial-subdeltoid bursitis and supraspinatus tendon tear following a second dose of the Oxford-AstraZeneca COVID-19 vaccine. This is a rare condition which is usually related to an incorrect injection technique. To reduce the chance of SIRVA, the healthcare worker giving the injection should pay careful attention to find the appropriate landmark, and ensuring the correct needle length and direction of the injection.

“…Local symptoms are mainly things such as pain, redness, warmth, swelling, itching and/or bruising, while systematic symptoms involve things such as skin rash, gastrointestinal side effects (nausea, vomiting and/or diarrhea), headache, fever, malaise, chills, and joint or muscle pain [ 1 , 2 ]. If these clinical symptoms continue longer than few days, a shoulder injury related to vaccine administration (SIRVA) should be considered [ [3] , [4] , [5] , [6] , [7] ]. A SIRVA is usually the result of an incorrect vaccine injection technique, usually from one (or more) of three things: using the wrong landmark or incorrect needle direction and/or depth of needle penetration.…”

Section: Introductionmentioning

confidence: 99%

A COVID-19 vaccination precipitating symptomatic calcific tendinitis: A case report

Klabklay

Boonsri

Kanyakool

et al. 2022

Introduction Shoulder pathology may be symptomatic or asymptomatic depending on the patient. We report the first case of a COVID-19 vaccination administration precipitating symptomatic calcific tendinitis from pre-existing, asymptomatic calcific tendinitis. Case presentation A 50-year-old Thai male began experiencing left shoulder pain about 3 hours following a COVID-19 vaccination. He waited at home for the pain to improve, and when it did not improve in about 3 days he decided to see a doctor at the orthopedics clinic. He was sent for ultrasonography of his shoulder, which revealed calcific tendinitis of the subscapularis tendon. Discussion A SIRVA is normally considered if post-vaccination shoulder pain has not improved within a few days following a vaccination in a patient without shoulder pain prior to the vaccination. In our patient, a COVID-19 vaccination precipitated asymptomatic calcific tendinitis to symptomatic calcific tendinitis. Conclusion Previously asymptomatic shoulder pathologies can be precipitated to symptomatic by a COVID-19 vaccination.