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. 2023 Aug 1;105-B(8):839-842.
doi: 10.1302/0301-620X.105B8.BJJ-2023-0435.

SIRVA: Shoulder injury related to vaccine administration

Paul J Jenkins  1   2 , Andrew D Duckworth  3
Affiliations

SIRVA: Shoulder injury related to vaccine administration

Paul J Jenkins et al. Bone Joint J. .

Abstract

Shoulder injury related to vaccine administration (SIRVA) is a prolonged episode of shoulder dysfunction that commences within 24 to 48 hours of a vaccination. Symptoms include a combination of shoulder pain, stiffness, and weakness. There has been a recent rapid increase in reported cases of SIRVA within the literature, particularly in adults, and is likely related to the mass vaccination programmes associated with COVID-19 and influenza. The pathophysiology is not certain, but placement of the vaccination in the subdeltoid bursa or other pericapsular tissue has been suggested to result in an inflammatory capsular process. It has been hypothesized that this is associated with a vaccine injection site that is "too high" and predisposes to the development of SIRVA. Nerve conduction studies are routinely normal, but further imaging can reveal deep-deltoid collections, rotator cuff tendinopathy and tears, or subacromial subdeltoid bursitis. However, all of these are common findings within a general asymptomatic population. Medicolegal claims in the UK, based on an incorrect injection site, are unlikely to meet the legal threshold to determine liability.

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Conflict of interest statement

P. J. Jenkins is Honorary Treasurer for the British Elbow and Shoulder Society, and receives payments for expert testimony related to personal injury and medical negligence (for both pursuers and defenders). A. D. Duckworth reports research grants from NIHR, OTA, SORT-IT, Stryker, Smith & Nephew, and Acumed, book royalties from Taylor & Francis and Elsevier, and payments for a hip fracture lecture from AgNovos Healthcare and an elbow masterclass from Smith & Nephew, all of which are unrelated to this article. A. D. Duckworth is also an editorial board member for The Bone & Joint Journal, Bone & Joint Research, and Bone & Joint 360, an Associate Editor for Trials, OTAI, and JBJS Case Connector, and a member of the OTA and OTS Research Committee.

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