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Vaccine Injury Blog

Legal Disclaimer: This blog is not intended to diagnose, treat or cure a disease. Nor is it intended as medical advice. The reader is responsible for their decisions and their health.

  • Writer's pictureDavid Tierney

How Common are Shoulder Injuries Related to Vaccines?

What are shoulder injuries related to vaccines?

Shoulder injuries related to vaccine administration (call SIRVA) are a result of a needle which is misplaced during a vaccine administration, or due to a local reaction to the serum in the vaccine.

While some discomfort or pain can be expected from every vaccine, a SIRVA is pain that lasts far longer than expected pain should last. Often the pain from a SIRVA can last for months or longer, and can also limit the ability to use the affected arm.

There is a program established by Congress to compensate people who are injured by certain vaccines called the National Vaccine Injury Compensation Program or NVICP. The NVICP included SIRVA in 2010 and unsuccessfully attempted to remove it in 2021.

Since SIRVA was added to the table of injuries, more than half of the petitions filed for compensation under the NVICP allege either SIRVA or Vasovagal Syncope, with SIRVA being by far the highest number. That makes it sound like SIRVA is incredibly common. But, is that the case?

To determine how common SIRVAs are, we must first ask what is the best way to determine that? In other words, how can we know how many SIRVA cases happen? It turns out, this isn't easy.

How do we know how many SIRVAs occur?

First, to determine how common any adverse reaction to a vaccine may be, we must know how many vaccines are administered. Currently, there are multiple reporting systems in the United States, including differing reporting in each state and immunization information systems databases which are not used consistently.

However, most state health departments are successful in having their care providers adhere to CDC recommended standards for reporting. So, estimates of numbers of vaccines administered is reasonably precise.

After determining how many vaccines are administered, we can look at sources for how many adverse events, particularly SIRVAs occur.

The Problem With VAERS

The first source is the Vaccine Adverse Event Reporting System or VAERS. VAERS allows anyone, either the recipient of a vaccine or a care provider, to report any adverse event they believe may have occurred because of a vaccine administration. You may already see the problem with relying on VAERS: There is no filter for who can report or what is reported.

Some adverse events may not be associated in any way with a vaccine administration other than timing. For example, a person who experiences nausea and vomiting the same day as they received a flu vaccine could believe that their symptoms were caused by the vaccine. However, their symptoms were far more likely caused by something else, such as having contracted the flue prior to receiving their vaccination, or having experienced something else, such as food poisoning.

Also, VAERS is subject to occasional false reporting where the person doing reports something they did not experience. Finally, many people do not know about VAERS so do not use it. Therefore, VAERS is potentially subject to both over-reporting and underreporting.

VAERS, however, is not intended to provide an accurate count of the number of vaccine injuries. It was created as an early warning system for new adverse issues so that the CDC, vaccine manufacturers, state health departments, and individual care providers can be informed quickly of reporting trends involving a certain batch of a vaccine or a certain vaccine. They can then do a specific investigation to determine if there really is some vaccine-caused injury and take appropriate steps to protect the public.

Other sources of investigation information.

Another source of information that we've already discussed is NVICP itself. This is not necessarily reliable as it likely underrepresents the total number of SIRVAs as many people never file a petition with the NVICP. Also, the number of SIRVA petitions filed has increased over time from 2 in 2011 to approximately 1500 in 2021, further indicating underreporting.

Some SIRVA petitions are also found to be without sufficient evidence, indicating that their shoulder injury may not have been related to the vaccine. Also, the NVICP has criteria for compensation that go beyond what would otherwise be considered a clinical SIRVA (such as a "severity" requirement of, for example, six months of pain and/or limited range of motion). So, like VAERS, the NVICP suffers from both the risks of over-reporting and underreporting.

One other important source are studies which have been undertaken to determine how many SIRVAs have occurred. These are limited, as well, but with the various sources they use, they can provide at least some idea of how often SIRVAs occur within certain circumstances.

SIRVA is rare.

So, how common are SIRVAs? Not very.

Based on at least one study, not more than 2% of flu vaccines resulted in VAERS reports of "atypical shoulder pain which began within 48 hours and lasted more than 7 days." Other studies suggest that the incidence rate is much lower. Even if we rely on a recent year of SIRVA petitions to the NVICP, the incidence rate looks extremely low.

Of the nearly 11 million children born between 2018 and 2020 (recent years for which we have reporting data), more than 90% received all recommended vaccinations, most of which have between 3-4 doses, in their first 24 months. Add to that the number of flu vaccinations in those years (roughly 50% of the US population received the flu vaccine). That means that, in 2020, there were roughly 160 million vaccine doses of various kinds administered. That same year there 739 SIRVA petitions filed. In 2021, there were approximately 1500 filed in 2021.

Any way you slice it, SIRVAs are very rare.

However, they do happen and people are compensated by the NVICP. Therefore, if you believe that you have experienced a SIRVA, you should contact an attorney experienced with the NVICP as soon as possible.

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