Shoulder Injury Related to Vaccine Administration (SIRVA) describes a complication of incorrect vaccine administration whereby the vaccine is injected too high in the upper arm, causing pain and limited range of movement. Symptoms are usually immediate and can last for days or as long as years. Common diagnoses include tendon and ligament damage, bursitis, and impingement syndrome.
Implications of SIRVA
SIRVA can be an extremely painful condition. The limited range of movement can impact a patient’s ability to perform even the basic activities of daily living. Diagnostic imaging, analgesia, time off work/school as well as treatments such as physiotherapy and corticosteroid joint injections are costly outcomes for the patient.
Given that the vaccine has not been correctly administered into the intended muscle or subcutaneous tissue (depending on the recommended route of administration), the level of protection provided by the vaccine is unclear and should be discussed with a healthcare professional (see SAEFVIC reporting).
Incorrect site- injection given too high Correct site- in the deltoid muscle
Please refer to MVEC: Administration of injected vaccines- correct technique for further information on correct injection technique.
Suspected cases of SIRVA
Any adverse event following immunisation (AEFI) should be reported to SAEFVIC.
Reports can be made online via AEFI-CAN or by telephone on 1300 882 924 (option 1) during business hours.
- Australian immunisation handbook: Avoiding shoulder injury related to vaccine administration
- MVEC: Administration of injected vaccines- correct technique
- SIRVA (Shoulder injury related to vaccine administration); A case series- “Are you on target?”
- Cross GB, Moghaddas J, ButteryJ, Ayoub S, Korman TM. Don’t aim too high: Avoiding shoulder injury related to vaccine administration. Aust Fam Physician 2016;45(5):303-306
Reviewed by: 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 Institue)
Date: June 2019
Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.