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The People’s Pharmacy: Shoulder pain after flu shot

Last year, we learned a new acronym from our readers. One wrote: “It has been seven weeks since I had my annual flu shot, and my arm is still sore at the injection site.

“I do not think I have a Shoulder Injury Related to Vaccine Administration (SIRVA) from having the vaccine injected into the wrong area. Nonetheless, the shoulder feels as if I received the shot two days ago.

“There appears to be anecdotal information that the new quad vaccine has left many recipients with sore arms for an extended period. Have you read any reports that this sore-arm issue is widespread this year?”

Many other people indeed reported trouble with sore arms after vaccination, but that was the first we had heard of SIRVA. This shoulder pain, presumably due to injury to the tendons, ligaments or bursa of the shoulder, may limit range of motion significantly. And, as tendon- or ligament-related pain often does, it can last a very long time.

One reader wrote: “It has been almost one year since I had a flu shot at my local drugstore. I am unable to raise my left arm, and any movement causes severe pain.

“I wake up at night when I move in bed and am not guarding my arm. The pain is excruciating. I first thought that it was tendinitis, but then realized that this had been going on since right after I got the flu shot last year.”

We have now gotten the first case report from this year’s flu season, though the vaccination period is barely underway: “On Aug. 10, 2015, I got a flu shot at CVS for a new job. Initially, I wanted to get it from my physician or the Occupational Health location where I got my TB shot, but neither had it in stock this early in the flu season. The pharmacist wiped the top of my shoulder with alcohol, then a little higher. When he injected, I saw him go in on the highest point of my deltoid. I felt pain with the injection.

“Afterward, I asked why he injected so high. He said the vaccine needs to go into the deltoid. I think it needs to go into the meatiest part. That’s always been my experience, and I’ve had many flu shots because I work in health care.

“I felt pain driving home, and by early evening, I was taking a pain reliever. The pain was so severe, I could not sleep on my left side (the arm that was injected).

“Two days later, I returned and told the pharmacist that he injured me and that he needs to understand and document it. If it didn’t feel better, I was going to see my physician. After another week, I had to do just that. She referred me to an orthopedist to look into it further.

“I am convinced this is a very real problem. There should be better protocols for those administering shots in the arm so they stay away from the top of the shoulder, especially the attachment point of the deltoid. This is incredibly painful, to the point of nausea. I also have poor range of motion and am unable to lift with that arm. It is a serious injury.

“Education, awareness and compensation for the injured all are necessary. What more can we do to get the word out?”

According to the Wall Street Journal (Aug. 24), compensation for SIRVA is on the rise. The cases are handled through vaccine court. With more publicity, people administering vaccines should get better training on safe injection technique.