वैक्सीन प्रशासन से संबंधित कंधे की चोट (SIRVA)
इन्फ्लुएंजा क्या है?
Shoulder Injury Related to Vaccine Administration (SIRVA) is a rare but serious complication following suspected inadvertent administration of a vaccine too high in the deltoid or into the shoulder joint. This may cause a local inflammatory response and potential trauma to local structures within the shoulder joint including bursae, ligaments and tendons resulting in sudden onset shoulder pain and restricted movement. Symptoms can last for weeks to months or as long as years. Affected individuals can experience varying degrees of disability which can impact on their activities of daily living, social and emotional wellbeing.
Symptoms
Distinguishing symptoms/features of SIRVA include:
- sudden onset shoulder pain within 48 hours of vaccination- different to the injection site pain expected following vaccination
- restricted range of movement (RROM) of affected shoulder
- persistent shoulder pain and RROM lasting >1 week, lasting weeks to months
- suspicion of incorrect vaccination site – too high in the upper arm.
Impacts and implications
The impacts of SIRVA can include:
- interrupted sleep due to pain
- difficulty with personal care, care of others and activities of daily living
- inability to participate in sports or hobbies
- modified work duties
- time off work related to symptoms and/or treatments and investigations
- एलoss of income due to time off work
- financial burden due to cost of treatments and investigations
- emotional and social wellbeing.
Further implications for an individual with SIRVA can include vaccine hesitancy, reduced confidence in healthcare/immunisation providers and the potential for impaired immunogenicity.
Diagnosis
A GP, specialist or allied health professional such as a physiotherapist can diagnose SIRVA based on presenting symptoms and clinical history following an immunisation.
If radiological investigations such as ultrasound or MRI are undertaken to support or confirm a diagnosis, abnormalities including bursitis, adhesive capsulitis, impingement syndrome, synovitis or tendon tears may be identified.
Early diagnosis of SIRVA leads to timely treatment which is thought to lessen the duration and severity of symptoms.
Treatment options
SIRVA can be treated in a variety of ways and may include any of the following:
- over the counter pain/anti-inflammatory medications
- prescription pain/anti-inflammatory medication
- oral corticosteroids
- corticosteroid joint injections
- physiotherapy or other allied health professionals
- massage
- surgery(rare).
How to prevent SIRVA
SIRVA can be prevented by following the recommendeडी vaccination procedureएस for correct injection technique.
| Expose | Identify | Imagine | Inject |
| Expose the whole upper arm | Identify upper and lower anatomical landmarks (acromion and deltoid tuberosity) | Imagine an inverted triangle 2-3 fingers below the acromion | Inject vaccine in the centre of the triangle into the deltoid muscle |
कृपया देखें एमवीईसी: इंजेक्शन वाले टीकों का प्रशासन- सही तकनीक for further information on correct injection technique.
Where to report a case of SIRVA
All confirmed or suspected cases of SIRVA should be reported to सैफविक (the Victorian vaccine safety service). Reports can be made by consumers, immunisation providers or treating healthcare professionals.
SAEFVIC can provide clinical advice or facilitate consultation with an immunisation specialist if required.
संसाधन
- एमवीईसी: इंजेक्शन वाले टीकों का प्रशासन- सही तकनीक
- MVEC Education portal eLearning package: Shoulder Injury Related to Vaccine Administration (SIRVA)
- Australian immunisation handbook: Avoiding shoulder injury related to vaccine administration
- SIRVA (Shoulder injury related to vaccine administration); A case series- “Are you on target?”
- Cross GB, Moghaddas J, Buttery J, Ayoub S, Korman TM. Don’t aim too high: Avoiding shoulder injury related to vaccine administration. Aust Fam Physician 2016;45(5):303-306
- D. R (2023) Shoulder injury following COVID-19 vaccine administration: a case series and proposed diagnostic algorithm, Expert Review of Vaccines, 22:1, 299-306
लेखक: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute), Georgie Lewis (SAEFVIC Clinical Manager, Murdoch Children’s Research Institute) and Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute)
द्वारा समीक्षित: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)
तारीख: मार्च 23, 2023
नई जानकारी और टीके उपलब्ध होते ही इस अनुभाग की सामग्रियों को अद्यतन किया जाता है। मेलबर्न वैक्सीन एजुकेशन सेंटर (MVEC) कर्मचारी सटीकता के लिए नियमित रूप से सामग्रियों की समीक्षा करते हैं।
आपको इस साइट की जानकारी को अपने व्यक्तिगत स्वास्थ्य या अपने परिवार के व्यक्तिगत स्वास्थ्य के लिए विशिष्ट, पेशेवर चिकित्सा सलाह नहीं मानना चाहिए। टीकाकरण, दवाओं और अन्य उपचारों के बारे में निर्णय सहित चिकित्सा संबंधी चिंताओं के लिए, आपको हमेशा एक स्वास्थ्य देखभाल पेशेवर से परामर्श लेना चाहिए।