Don't aim too high: Avoiding shoulder injury related to vaccine administration

Aust Fam Physician. 2016 May;45(5):303-6.


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.

Discussion: 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.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage
  • Diphtheria-Tetanus-Pertussis Vaccine / adverse effects*
  • Female
  • Humans
  • Injections, Intramuscular / adverse effects
  • Injections, Intramuscular / methods
  • Pneumococcal Vaccines / administration & dosage
  • Pneumococcal Vaccines / adverse effects*
  • Shoulder Injuries / etiology*
  • Shoulder Pain / etiology
  • Young Adult


  • Diphtheria-Tetanus-Pertussis Vaccine
  • Pneumococcal Vaccines