From the Research
Definition and Causes of SIRVA
- Shoulder Injury Related to Vaccine Administration (SIRVA) is a recognized complication and possible source of morbidity associated with incorrectly administered intramuscular deltoid vaccinations 1.
- SIRVA is postulated to be an immune-mediated inflammatory response to a vaccine antigen injected into or near the subacromial bursae or synovium, leading to shoulder pain and dysfunction 2.
- The condition can occur when an intramuscular deltoid injection is administered into the shoulder joint 3.
Clinical Characteristics and Diagnoses
- Patients with SIRVA typically present with severe pain and limited range of motion within 48 hours of vaccination 4.
- The most common symptoms are shoulder pain and reduced range of motion (ROM) 2.
- The most common diagnoses are shoulder bursitis, adhesive capsulitis, and rotator cuff tears 2.
- Adhesive capsulitis is the most common diagnosis, followed by bursitis and supraspinatus tear 3.
Management Approaches and Outcomes
- The most frequent management modalities include physical or occupational therapy, NSAIDs, and steroid injections, followed by surgery 2.
- Full resolution of symptoms is reported in 2.9% to 56% of patients 2.
- Conservative care, such as exercise and manual therapies, can be effective in reducing pain and improving shoulder ROM 3.
- Surgery may be required to treat underlying pathology, such as rotator cuff or biceps tendinopathy 4.
Awareness and Knowledge of SIRVA
- Healthcare practitioner knowledge of SIRVA is poor, with mean scores of 55% 5.
- Non-immunising healthcare practitioners scored significantly higher than immunising practitioners for anatomy and safe injecting knowledge 5.
- Greater education and awareness of SIRVA is needed in all healthcare disciplines 5.