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How can a vaccine cause SIRVA?
What does SIRVA feel like? When you receive a flu shot or other common vaccine, you may experience normal soreness in your shoulder.
If you experience persistent shoulder pain, it could be a sign you have a more severe shoulder injury and need SIRVA treatment. Vaccines are commonly administered in the deltoid muscle of the shoulder. However, improper techniques, such as using a needle that's too long or injecting the vaccine too high on the arm, can lead to accidental contact with the bone or the fluid-filled bursa sac that protects shoulder tendons. This impact can result in inflammation of the bursa, tendons, and ligaments, triggering pain within the deltoid muscle. According to guidelines from the U.S. Department of Health and Human Services, healthcare providers should receive comprehensive training on deltoid intramuscular injection techniques to reduce the likelihood of shoulder injury related to vaccine administration. Establishing a lack of sufficient training constitutes a potential claim of negligence.
Which Vaccines Are Associated with SIRVA?
Any type of vaccine can cause SIRVA due to improper injection technique, but here are some of the more commonly associated vaccines:
- Influenza (Flu) Vaccine: The flu vaccine is one of the most frequently administered vaccines, and thus, cases of SIRVA following flu vaccination are relatively common.
- Tetanus, Diphtheria, Pertussis (Tdap) Vaccine: Tdap vaccines, which protect against tetanus, diphtheria, and pertussis (whooping cough), are routinely given to adolescents and adults. Consequently, instances of SIRVA may occur following Tdap vaccination.
- Pneumococcal Vaccine: Vaccines targeting pneumococcal bacteria are commonly administered to prevent pneumonia and other pneumococcal diseases, especially in older adults and individuals with certain medical conditions.
- Other Routine Vaccines: Certain routine vaccinations, such as those for hepatitis B, measles, mumps, and rubella (MMR), and varicella (chickenpox), may also be associated with SIRVA, although less frequently.
Factors Contributing to Higher Risk
- Injection Site and Technique: Injection Site and Technique: SIRVA often occurs when a vaccine is injected into the shoulder joint space or surrounding tissues rather than the intended deltoid muscle. The upper arm bone, known as the humerus, is adjacent to the deltoid muscle and is a reference point for ensuring accurate vaccine placement during intramuscular injections. Vaccines administered too high or too deep in the shoulder can lead to inflammation and injury.
- Needle Size and Angle: The size of the needle and the angle at which it is inserted can influence the risk of SIRVA. For instance, using a too long needle or inserting it at an improper angle may increase the likelihood of shoulder injury.
- Individual Variation: Certain individuals may have anatomical variations or medical conditions that put them at higher risk of SIRVA. Factors such as tissue thinning, prior shoulder injuries, or anatomical abnormalities can contribute to increased vulnerability.
What are the symptoms of SIRVA?
The primary SIRVA symptoms become evident within 48 hours of vaccine injection, commonly presenting as abrupt pain in the deltoid muscle or restricted arm movement. This discomfort ranges from a persistent dull ache to sharp shooting pains, potentially radiating from the shoulder down the arm during rest and movement.
Additional indicators include:
- Tingling or numbness in the arm
- Swelling
- Stiffness
- Weakness, possibly accompanied by limited shoulder mobility.
Alarmingly, SIRVA's consequences can extend to chronic pain or even long-term disability, underscoring the importance of swift recognition and treatment to mitigate potential complications.
