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 an injected vaccine. 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.
The first case study linking shoulder pain to improperly administered vaccines was performed in 2006. Between 2011 and 2015, 112 claimants/petitioners received compensation for SIRVA, and the number of cases continues to rise.
How is it caused?
Approximately 70% of SIRVA cases are caused by the seasonal flu shot, the most commonly administered vaccine to adults.
Bodor and Montalvo, in their 2006 study, hypothesized that weakness and pain in the shoulder following influenza and pneumococcal vaccinations were administered too high in the deltoid muscle. They concluded that, in order to avoid vaccine-related shoulder dysfunction, the upper third of the deltoid muscle should not be used for vaccine injections.
How is SIRVA diagnosed?
Patients diagnosed with SIRVA experience acute shoulder pain, typically within 48 hours of vaccine administration. Shoulder pain increases over time, limiting range of motion, function of the arm and shoulder, and arm strength. Some SIRVA cases present as or can occur concurrently with tendonitis, rotator cuff tears, frozen shoulder, bone erosion, and brachial nerve damage.
How is it treated?
There are several methods for treating SIRVA. Some patients find that resting the affected area may help to reduce inflammation over time. Physicians may recommend a series of steroid injections in order to alleviate symptoms. Prednisone, hydrocortisone, and other corticosteroids all work to suppress inflammation. Physicians may also prescribe pain medication to treat the symptoms.
Treatment plans often include physical therapy to aid in improving range of motion and muscle strength.
If pain persists, surgery may be an option. Coupled with physical therapy, surgery may help alleviate the pain many individuals experience.