title: Don't aim too high: Avoiding shoulder injury related to vaccine administration.
abstract: BACKGROUND
  Shoulder injury related to vaccine administration (SIRVA) is a previously described phenomenon that is the result of improper vaccine delivery. Appropriate injection technique for administration of intramuscular vaccinations can reduce the risk of shoulder injury.
  
  
  OBJECTIVE
  In this article, we describe the cases of two patients who developed SIRVA. A literature review was conducted to find and describe other cases of shoulder injury that developed post-vaccination.
  
  
  CONCLUSIONS
  SIRVA has previously been described in the world literature. Seventeen cases in women and five cases in men were found. Pain and reduction in the range of movement within a few hours of vaccination were cardinal signs of a shoulder injury. This included injuries to the soft tissues of the shoulder as well as injuries to bone and joint. SIRVA can be avoided with correct vaccination technique as described.
authors.forename: Gail B
authors.initials: GB
authors.lastname: Cross
authors.forename: Jason
authors.initials: J
authors.lastname: Moghaddas
authors.forename: Jim
authors.initials: J
authors.lastname: Buttery
authors.forename: Sally
authors.initials: S
authors.lastname: Ayoub
authors.forename: Tony M
authors.initials: TM
authors.lastname: Korman
mesh_terms: D000369:Aged, 80 and over; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000379:methods; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D000070599:Shoulder Injuries / Q000209:etiology*; D020069:Shoulder Pain / Q000209:etiology; D055815:Young Adult
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022242:Pneumococcal Vaccines