From the Guidelines
COVID-19 vaccine injuries, such as vaccine-induced immune thrombocytopenia and thrombosis (VITT), are rare but can be life-threatening, and management includes anticoagulation with non-heparin based anticoagulants and intravenous immunoglobulin, as recommended by the BMJ study 1. If you suspect a vaccine injury, contact your healthcare provider immediately for evaluation. Common side effects like soreness at the injection site, fatigue, headache, muscle pain, chills, fever, and nausea typically resolve within a few days and can be managed with over-the-counter medications like acetaminophen or ibuprofen. More serious adverse events such as myocarditis, pericarditis, or severe allergic reactions (anaphylaxis) require immediate medical attention. Some populations, such as those with rheumatologic and autoimmune disorders, cancer, or neurologic disorders, may require special consideration when it comes to COVID-19 vaccination, as certain treatments may affect the vaccine response or increase the risk of adverse events, as discussed in the Reviews in Medical Virology studies 1. However, the benefits of vaccination in preventing severe COVID-19 disease, hospitalization, and death generally outweigh the risks of vaccine side effects for most people. Key considerations for vaccination in special populations include:
- Rheumatologic and autoimmune disorders: tapering corticosteroids to <10 mg/day prior to vaccination, withholding methotrexate for 2 weeks before and after vaccination, and considering the timing of vaccination in relation to other immunosuppressive therapies 1.
- Cancer: vaccinating patients with cancer as soon as possible, considering the timing of vaccination in relation to chemotherapy and other treatments, and being aware of the potential for reduced vaccine response in patients with hematologic malignancies 1.
- Neurologic disorders: vaccinating patients with neurologic disorders, such as multiple sclerosis, as soon as possible, and being aware of the potential for reduced vaccine response or exacerbation of underlying conditions 1.
From the Research
Covid Vaccine Injury
- Covid vaccine injury can occur due to various reasons, including improper administration technique 2, 3.
- Shoulder Injury Related to Vaccine Administration (SIRVA) is a preventable adverse event that can result in significant long-term morbidity 2, 3.
- SIRVA cases may occur and should be suspected in all individuals without a history of shoulder symptoms or dysfunction who experience sudden pain and reduced range of motion following deltoid muscle vaccination 2.
- Treatment for SIRVA must be initiated early with corticosteroids and rehabilitation 2, 3.
- Other vaccine injuries, such as anaphylaxis, can also occur, and management of patients at risk of anaphylaxis after COVID-19 vaccination is crucial 4.
- Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce COVID-19 vaccine-induced systemic side effects, such as fever, headache, and generalized fatigue, due to their immunosuppressive property 5.
Types of Covid Vaccine Injuries
- SIRVA: characterized by shoulder pain and restricted movement within 24 hours of vaccination, lasting on average 3 months 3.
- Anaphylaxis: a severe, life-threatening allergic reaction that can occur even in the form of a severe reaction 4.
- Systemic side effects: such as fever, headache, and generalized fatigue, which can be reduced by NSAIDs 5.