Shoulder injury following COVID-19 vaccine administration: a case series and proposed diagnostic algorithm

Expert Rev Vaccines. 2023 Jan-Dec;22(1):299-306. doi: 10.1080/14760584.2023.2189463.

Abstract

Background: Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable adverse event following incorrect vaccine administration, which can result in significant long-term morbidity. There has been a notable surge in reported cases of SIRVA as a rapid national population-based COVID-19 immunization program has been rolled out across Australia.

Methods: Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC) in Victoria identified 221 suspected cases of SIRVA following the commencement of the COVID-19 vaccination program, reported between February 2021 and February 2022. This review describes the clinical features and outcomes of SIRVA in this population. Additionally, a suggested diagnostic algorithm is proposed, in order to facilitate early recognition and management of SIRVA.

Results: 151 cases were confirmed as SIRVA, with 49.0% having received vaccines at state vaccination centers. 75.5% were suspected incorrect administration site, with most patients experiencing shoulder pain and restricted movement within 24 hours of vaccination, lasting on average 3 months.

Conclusion: Improved awareness and education regarding SIRVA is imperative in a pandemic vaccine roll-out. The development of a structured framework for evaluating and managing suspected SIRVA will aid in timely diagnosis and treatment, essential to mitigate potential long-term complications.

Keywords: COVID-19 vaccine; SIRVA; shoulder injury; vaccine adverse event; vaccine complication.

Publication types

  • Review

MeSH terms

  • Algorithms
  • COVID-19 Testing
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19* / diagnosis
  • COVID-19* / prevention & control
  • Humans
  • Shoulder Injuries*
  • Vaccination
  • Vaccines
  • Victoria / epidemiology

Substances

  • COVID-19 Vaccines
  • Vaccines