Shoulder Injury Related to Vaccine Administration (SIRVA) is a rare complication of suspected incorrect vaccine administration into the shoulder and not into the correct site of the deltoid muscle. Damage to local structures within the shoulder joint can occur, including to ligaments and tendons, as well as a local inflammatory response to the vaccine components. This results in shoulder pain and limited range of movement of the affected limb. Symptoms are usually immediate and can last for days, months or as long as years. Following investigation, many affected individuals are diagnosed with bursitis, impingement syndrome or ligament tears.
Implications of SIRVA
SIRVA can be an extremely painful condition. The pain and limited range of movement can impact a patient’s ability to perform work duties, sporting activities and basic activities of daily living. When symptoms persist for months, individuals can experience impacts on their mental and emotional wellbeing. There are other implications of SIRVA to consider including the immunogenicity of the vaccine, cost of time off work, investigations and treatments, vaccine hesitancy and consumer confidence in healthcare providers.
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
- 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
Authors: 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)
Reviewed by: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)
Date: August 2020
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.