Treating SIRVA Early With Corticosteroid Injections: A Case Series

Author:

Macomb Christopher V1,Evans Martin O2,Dockstater Jo E3,Montgomery Jay R2,Beakes Douglas E2

Affiliation:

1. Internal Medicine, Walter Reed National Military Medical Center, 4494 N Palmer Rd, Bldg 19, Rm 2500, Bethesda, MD 20889

2. Allergy and Immunology, Walter Reed National Military Medical Center, 4494 N Palmer Rd, Bldg 19, Rm 4132, Bethesda, MD 20889

3. Immunization Healthcare Branch, Walter Reed National Military Medical Center, 4494 N Palmer Road, Bldg 19, Rm 4024, Bethesda, MD 20889

Abstract

ABSTRACT Shoulder injury related to vaccine administration (SIRVA) is defined as “shoulder pain with limited range of motion within 48 hours after vaccine receipt in individuals with no prior history of pain, inflammation, or dysfunction of the affected shoulder before vaccine administration.” Corticosteroid injections (CSIs) have been proposed as a reasonable treatment modality for SIRVA, although evidence regarding efficacy is scanty. In this case series, we present two patients diagnosed with SIRVA who received CSI within 5 days of symptom onset and saw symptom resolution within 1 month. This is in comparison to a Centers for Disease Control and Prevention report that showed 65% of patients with SIRVA will have pain lasting longer than 1 month, and 25% will have pain lasting longer than 3 months. Our case series shows that CSIs may be an effective treatment modality for SIRVA. It would be reasonable to use CSIs as a first line treatment and should especially be considered in patients who have contraindications to nonsteroidal anti-inflammatory drugs.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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