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What Is SIRVA?

Medically Reviewed by Neha Pathak, MD on September 15, 2021

After you get a vaccine shot in your upper arm to protect yourself against the flu, COVID-19, or another disease, there’s a chance you’ll feel some soreness where you got jabbed. But in rare cases, people get an injury known as SIRVA. That stands for shoulder injury related to vaccine administration.

Even though you shouldn’t let this small risk stop you from getting vaccinated, it’s a good idea to learn about SIRVA symptoms, SIRVA treatment, and more. That way, you can get help if you need it.

What Are the Symptoms?

The main signs of SIRVA are serious shoulder pain and less range of motion, meaning trouble with moving your shoulder normally. The symptoms usually show up within 48 hours after you get a vaccine shot in your upper arm. Research also suggests that over-the-counter pain meds don’t help the symptoms get better.

How Does It Happen?

SIRVA can happen if a medical worker gives you a vaccine shot too high up on your upper arm. That could accidentally damage tissues or structures in the shoulder.

The right place to give this type of shot is in the middle, thickest part of the deltoid, a large triangular muscle that goes from your upper arm bone to your collarbone.

To prevent SIRVA and give these shots properly, many medical workers are trained to look or feel for specific physical “landmarks” on the arm that guide them to the deltoid muscle.

Why Does It Happen?

The symptoms of SIRVA stem from the shot going into the wrong part of your upper arm or due to trauma from the needle. Research suggests that this brings on inflammation, and it could injure body parts inside your shoulder like:

  • Ligaments. These tough bands of tissue connect two bones in a joint.
  • Tendons. These thick cords connect muscles to bones.
  • Bursae. These fluid-filled sacs cushion bones, tendons, and muscles.

How Common Is It?

Some researchers say SIRVA is rare but underreported.

How Is It Diagnosed?

Talk to your doctor if you have bad pain or trouble moving your shoulder after you get vaccinated in the upper arm.

They’ll ask you about your symptoms, and they may do a physical exam. They might do tests to rule out other conditions that could bring on similar symptoms, like an infection or a rheumatic disease like arthritis.

They may also recommend imaging tests like:

  • Ultrasound. This uses sound waves to take a picture inside your body.
  • MRI. This uses a magnet and radio waves to see inside your body.

They doctor might diagnose you with SIRVA if:

  • Your shoulder felt fine before the vaccine shot.
  • Your symptoms started within a certain number of hours of days afterward.
  • The symptoms are only in the arm and shoulder area where you got jabbed.
  • Tests don’t spot signs of another health problem that would explain the symptoms.

What Are the Treatments?

Talk to your doctor if you have serious pain or trouble moving your arm or shoulder after you get vaccinated. If the doctor thinks you might have SIRVA, they may recommend treatments like:

  • Physical therapy
  • Steroid shots
  • Anti-inflammatory drugs

You may need surgery if the injury is severe.

Some experts say more research is needed to figure out the ideal treatment for SIRVA.

Does It Ever Go Away?

The little research available suggests that people with SIRVA who get treatment show “modest” improvements. But some have symptoms that never go away completely. For instance, it’s possible to have ongoing shoulder pain and less range of motion.

One study suggests that most people with SIRVA have symptoms for at least 6 months, and less than a third make full recoveries.

WebMD Medical Reference

Sources

SOURCES:

Journal of the American Academy of Orthopaedic Surgeons: “Shoulder Injury Related to Vaccine Administration.”

The College of Family Physicians of Canada: “Shoulder injury related to vaccine administration and other injection site events.”

Federal Practitioner: “Shoulder Injury Related to Vaccine Administration: A Rare Reaction.”

Up to Date: “COVID-19 mRNA vaccines: Drug information.”

Medscape: “Common COVID Vaccine Administration Errors to Watch For.”

Stat Pearls: “Anatomy, Shoulder and Upper Limb, Deltoid Muscle.”

Health Resources and Services Administration: “Vaccine Injury Table.”

Children’s Hospital of Philadelphia: “Technically Speaking: Let’s Get It Right! How to Avoid Shoulder Injury with Deltoid Intramuscular Injections.”

KidsHealth: “Word! Ligament.”

Mayo Clinic: “Sprains,” “Tendinitis,” “Bursitis.”

Cleveland Clinic: “Bursitis.”

Medline Plus: “MRI Scans,” “Sonogram.”

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