{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:31:14Z","timestamp":1777879874548,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["T42OH008429"],"award-info":[{"award-number":["T42OH008429"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010001","name":"Federal Office of Rural Health Policy","doi-asserted-by":"publisher","award":["D33HP31668"],"award-info":[{"award-number":["D33HP31668"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Workplace Health Saf"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Transient shoulder pain is a common complaint following intramuscular vaccine administration into the deltoid. More severe vaccination-associated shoulder complications comprising of weakness and decreased range of motion are categorized under the construct \u201cshoulder injury related to vaccine administration\u201d (SIRVA) that subsumes both subjective and objective findings consistent with injury. We describe the presentation and management of a case of SIRVA in a health care worker following seasonal influenza vaccine administration as part of a hospital-based employee health program and review the relevant biomedical literature. We present a case from a single medical center. All data were collected by professionals in occupational health by interviewing, performing physical examinations, and reviewing medical records associated with the injured worker. Severe pain and limited range of shoulder motion developed following an influenza vaccination that was administered using a poorly positioned, larger than recommended needle. Magnetic resonance imaging (MRI) demonstrated moderate glenohumeral joint effusion and synovitis, with fluid accumulating in the subscapularis recess within 1 week of injury. At 8 months after initial injury, MRI showed persistent mild tenosynovitis of the long head of the biceps tendon, interval accumulation of a large glenohumeral joint effusion, and infraspinatus tendinitis with subjacent reactive bone marrow edema. The affected worker experienced work restrictions but had no complete lost workdays to date due to the injury. Occupationally related SIRVA is a preventable adverse event that should be considered in workplace vaccine administration programs, and appropriate education and training provided to vaccine administrators to address this.<\/jats:p>","DOI":"10.1177\/2165079919875161","type":"journal-article","created":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T01:23:05Z","timestamp":1569028985000},"page":"501-505","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Shoulder Injury Related to Vaccine Administration (SIRVA): An Occupational Case Report"],"prefix":"10.1177","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-2127","authenticated-orcid":false,"given":"Michael","family":"Shahbaz","sequence":"first","affiliation":[{"name":"University of California, San Francisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Blanc","sequence":"additional","affiliation":[{"name":"University of California, San Francisco"},{"name":"San Francisco VA Health Care System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra J.","family":"Domeracki","sequence":"additional","affiliation":[{"name":"University of California, San Francisco"},{"name":"San Francisco VA Health Care System"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Guntur","sequence":"additional","affiliation":[{"name":"University of California, San Francisco"},{"name":"San Francisco VA Health Care System"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"bibr1-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.07.055"},{"key":"bibr2-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.10.005"},{"key":"bibr3-2165079919875161","unstructured":"Bancsi A., Houle S., Grindrod K. A. (2019). Shoulder injury related to vaccine administration and other injection site events. Canadian Family Physician M\u00e9decin de Famille Canadien, 65, 40-42. Retrieved from https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6347325\/"},{"key":"bibr4-2165079919875161","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2012.06.110334"},{"key":"bibr5-2165079919875161","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6738a2"},{"key":"bibr6-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.08.034"},{"key":"bibr7-2165079919875161","unstructured":"Centers for Disease Control and Prevention. (2019). National Center for Immunization and Respiratory Diseases vaccine administration. Retrieved from https:\/\/www.cdc.gov\/vaccines\/hcp\/acip-recs\/general-recs\/administration.html#t6\u20132"},{"key":"bibr8-2165079919875161","doi-asserted-by":"publisher","DOI":"10.4161\/hv.27232"},{"key":"bibr9-2165079919875161","unstructured":"Cross G. B., Moghaddas J., Bittery J., Ayoub S., Korman T. M. (2016). Don\u2019t aim too high: Avoiding shoulder injury related to vaccine administration. Australian Family Physician, 45, 303-306. Retrieved from https:\/\/www.racgp.org.au\/afp\/2016\/may\/don%E2%80%99t-aim-too-high-avoiding-shoulder-injury-related-to-vaccine-administration\/"},{"key":"bibr10-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2012.11680872"},{"key":"bibr11-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2017.1348442"},{"key":"bibr12-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2703-4"},{"key":"bibr13-2165079919875161","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v40is3a03"},{"key":"bibr14-2165079919875161","unstructured":"National Center for Emerging and Zoonotic Infectious Diseases. (2017). Reports of shoulder dysfunction following inactivated influenza vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2010-2016. Retrieved from https:\/\/stacks.cdc.gov\/view\/cdc\/57624"},{"key":"bibr15-2165079919875161","unstructured":"National Vaccine Injury Compensation Program: Revisions to the Vaccine Injury Table. A Rule by the Health and Human Services Department. 82 FR 6294. Effective date February 21, 2017. Retrieved from https:\/\/www.federalregister.gov\/documents\/2017\/01\/19\/2017-00701\/national-vaccine-injury-compensation-program-revisions-to-the-vaccine-injury-table"},{"key":"bibr16-2165079919875161","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-014-1875\u20139"},{"key":"bibr17-2165079919875161","unstructured":"U.S. Department of Health & Human Services. (2019). Vaccine adverse event reporting system. Available from https:\/\/vaers.hhs.gov\/"}],"container-title":["Workplace Health &amp; Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2165079919875161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2165079919875161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2165079919875161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:55:51Z","timestamp":1777593351000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2165079919875161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,20]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1177\/2165079919875161"],"URL":"https:\/\/doi.org\/10.1177\/2165079919875161","relation":{},"ISSN":["2165-0799","2165-0969"],"issn-type":[{"value":"2165-0799","type":"print"},{"value":"2165-0969","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,20]]}}}