Vaccine-Related Shoulder Injuries (SIRVA)
What is SIRVA?
SIRVA, or Shoulder Injury Related to Vaccine Administration, manifests as shoulder pain and limited range of motion occurring as a result of the administration of a vaccine injection. While some degree of pain may be expected from any shoulder injection, the improper administration of a vaccine can cause severe, often debilitating, pain, which can lead to complications. Pain lasting longer than a few days is not associated with the normal side effects of receiving a vaccination.
What are the most common SIRVA diagnoses?
The most common diagnoses associated with SIRVA are brachial plexus, torn rotator cuff, frozen shoulder or adhesive capsulitis, shoulder bursitis, shoulder tendinitis, ulnar neuropathy and shoulder impingement syndrome.
What causes SIRVA?
The relevant medical and scientific literature suggests that SIRVA is due to an inflammatory effect from vaccine administration into the subdeltoid bursa. This inflammatory response may be due either to the antigenic or nonantigenic components of the vaccine (antimicrobial, preservative, etc). They based these assumptions on the consistent presentations of adhesive capsulitis (as demonstrated by the patient's pain, lack of motion, weakness, and impaired mobility/functionality) and multiple noted pathologies on imaging, more than would be expected by the trauma of vaccination.
Approximately 70% of cases are flu shot shoulder injuries which are most commonly administered to adults. It is thought that the flu shot is the most common cause of SIRVA injuries simply due to the sheer volume of flu shots administered to the general public year after year. It is important to note that any vaccine that is administered improperly can cause a SIRVA injury.
Recent scientific studies on the topic, including Bodor and Montalvo in 2006, and Atanasoff in 2010 and Barnes in 2012, hypothesized that weakness and pain in the shoulder following influenza and other vaccinations were administered too high in the deltoid muscle. In order to avoid SIRVA, they concluded that the upper third of the deltoid or shoulder muscle should not be used for vaccine injections.
The literature suggests that doctors must consider SIRVA as part of the differential diagnosis in patients presenting with acute shoulder pain after vaccine administration. The growing number of cases and events reported to VAERS (the vaccine adverse event reporting database) serve as a reminder for what may be an underreported condition. This underreporting may be due, in part, to the Vaccine Adverse Event Reporting System being a passive reporting mechanism or to concerns for medicolegal implications for reporting.
Today, the National Vaccine Injury Compensation Program recognizes a causal connection between vaccines and SIRVA if a person experiences pain within 48 hours of receiving a vaccination and that pain continues to manifest for at least 6 months.
What treatment is available?
SIRVA injuries are often diagnosed by way of MRI or sometimes an EMG. Many times, the diagnosis is made through a physical examination of the shoulder joint. While an MRI have normal findings, a physical examination may still pinpoint a shoulder injury related to the vaccine.
Treatment of SIRVA injuries can be conservative such as physical therapy and over the counter pain relievers (Aleve, Ibuprofen, etc.). More aggressive treatments include cortisone injections, shoulder manipulation techniques and surgical intervention.
What to do if you believe your shoulder injury is related to a vaccine?
If you believe that you have experienced a shoulder injury from a vaccine, we recommend you follow these steps:
Obtain a copy of your vaccine consent form, especially if you received a vaccine at a pharmacy (CVS, Walgreens, Rite-Aid, Publix, etc.) or through your employer. This document is critical for proving that you received a vaccine and is required by the National Vaccine Injury Compensation Program.
Report your symptoms and complaints to your family doctor as soon as possible. Pay particular attention to when your symptoms began so you can report the correct timing to your doctor.
Follow your doctor’s medical treatment plan for dealing with your shoulder injury. Treatment plans can begin conservatively with ice, rest, and over-the-counter Ibuprofens, and can escalate to prescription medications and physical therapies.
Consult with a licensed vaccine attorney to discuss how to best proceed with legal remedies through the Vaccine Injury Compensation Program.
Continue to follow up with your doctor for treatment in order to document your progress to make sure you are effectively treating your shoulder injury.
Seek a referral from your family doctor. After presenting to your family doctor, it is common for your family doctor to refer you to an orthopedist or sports medicine doctor, and physical therapy. Shoulder injuries are unique to each individual and so one treatment plan may work from one person, but may not work for another. There is a lot of trial and error to see how one progresses. Be active and dedicated through your doctors to find the best treatment plan that works for you.
Remember, all SIRVA cases must be filed in the National Vaccine Injury Compensation Program so you will not have to worry about suing your family doctor or pharmacist that administered the vaccine. In fact, we rely on family doctors and pharmacists in helping us document your shoulder injury.
Licensed Vaccine Attorney
At Green & Schafle LLC, we have skilled vaccine lawyers, licensed in the National Vaccine Injury Compensation Program and the United States Court of Federal Claims in Washington, D.C. who are ready to represent your interests.
Our licensed vaccine attorneys have been representing vaccine-injured clients nationwide for the last decade and they are actively involved in the Vaccine Injured Petitioners Bar Association, the national organization dedicated to the representation of individuals with vaccine injuries.
If you know someone with a shoulder injury from a vaccine, contact us at 215 462 3330 or by using our online contact form.