SIRVA or "Shoulder Injury Related to Vaccine Administration" is a medical term used to describe any one of the various shoulder injuries caused by vaccines such as the flu shot, tetanus shot, or the TDaP and DTaP vaccines. Roughly 70% of shoulder related vaccine injuries are caused by the flu shot. SIRVA usually occurs when the vaccine is administered too high into the deltoid muscle at the top of the arm or shoulder. It is unlikely that a vaccination given lower on the arm will cause a shoulder injury (although it may cause other inflammatory injuries).
In many cases, the injury is caused by a vaccine being injected too high on the arm. Near the top of the shoulder there are several sensitive areas, including the bursa sac. The bursa functions as a lubricant and allows the muscles, tendons and bones of the shoulder joint to move smoothly. A vaccine administered into the bursa can penetrate the fluid-filled sac, causing an inflammatory response. The inflammation can present in the bursa (bursitis), tendons (tendonitis) or around the rotator cuff. Inflammation causes pain and reduced range of motion. Those who believe they may have been injured should be cognizant of prolonged weakness in their affected shoulder. It is important to seek treatment sooner rather than later as side effects can persist indefinitely.
Other factors into SIRVA injuries are crucial. Shorter needles run the risk of more painful injections, a less effective vaccine, or sometimes increased chances of a skin reaction. If the needle is too long, it may hit a nerve or bone in the recipient. According to the United States National Library of Medicine, SIRVA instances are severely underreported throughout the United States and the rest of the globe. The incorrect administration technique by a medical technician can result in numerous inflammatory responses within the recipient’s shoulder. Usually, SIRVA symptoms begin within 48 hours of vaccination and can range from any of the following:
Since its creation in 1987, the National Vaccine Injury Compensation Program has seen a steady increase in the amount of shoulder injury from vaccine cases across the United States. In fact, the VICP has seen an average of 500 SIRVA cases filed over the last few years. This number is expected to grow as the number of adults in the United States who receive vaccinations such as the flu shot continues to climb. A credible source about research on SIRVA injuries across the globe can be found here at the College of Family Physicians of Canada. In addition, the VICP provides historical data about SIRVA injuries and their corresponding vaccines from its inception through to present day - you can read about it here. The Centers for Disease Control and Prevention states that from 2006 to 2017, there were roughly 3.4 billion vaccines distributed throughout the United States that were deemed covered under the VICP criteria. Out of the 3.4 billion, only 4,311 injured petitioner’s were compensated for their injuries. This ratio means that roughly 1 injured person was compensated for every 1 million doses of a covered vaccine that was administered.
Recently, My Vaccine Lawyer's founding partner Paul Brazil was interviewed by Jodie Fleischer of NBC4 Washington about SIRVA injuries from vaccines along with the National Vaccine Injury Compensation Program, a federal compensation program for vaccine injuries in the United States. Paul and Jodie also discuss the frequency of vaccine injuries and the lack of public knowledge about the VICP.
In some cases, the shoulder pain will resolve on its own within a week or two. If it does not, then the pain is likely being caused by a significant injury. A person suffering from one of the various shoulder injuries following vaccine should see a primary care physician as soon as possible.
Primary care physicians will likely refer the patient to an orthopedist who specializes in these injuries following an adverse vaccine reaction. In order to diagnose the injury, the orthopedist will likely prescribe an MRI of the shoulder. MRIs are the most useful diagnostic test when it comes to diagnosing shoulder injuries. The MRI may show inflammation, fluid collection, swelling, or even tears. After the orthopedist reviews the MRI, they can offer a diagnosis that usually includes one or all of the following: bursitis, tendonitis, adhesive capsulitis and rotator cuff injury. Important factors in determining a diagnosis can stem from where the vaccine was administered on the recipient’s arm: if the injection was too far to the side, it may injure the axillary nerve, or if the injection was too low, it may injure the radial nerve.
Treatment for SIRVA injuries is often identical to other non-vaccine related shoulder injuries. In mild cases, the patient will recover fully after a course of physical therapy. Physical therapy will usually be prescribed two to three (2-3) times per week for approximately three (3) months. If physical therapy does not resolve the shoulder pain, the orthopedist may recommend corticosteroid injections. These steroid injections can relieve inflammation and help the patient regain some range of motion. In some cases, the injections will completely resolve the problem. In others, the relief may be temporary. In severe cases, surgery may be necessary. The damage could be substantial enough to require removal of the bursa or repair of the tendons.
If you or a loved one has suffered one of the aforementioned shoulder injuries from a vaccine, you may be entitled to compensation from the National Vaccine Injury Compensation Program. For more information, please contact us for a free consultation.
Page last reviewed and updated: November 4, 2019