EWJ June 61 2025 web - Flipbook - Page 76
Understanding
SIRVA Injuries:
Causes, Symptoms
and Treatment
by Rosie Nelson - www.penningtonslaw.com
In recent years, SIRVA - which stands for 'shoulder injury related to vaccine administration' is a term that has been gaining attention in the medical community. This type of injury occurs
when a person experiences shoulder pain or injury after receiving a vaccine. While vaccines are
a crucial part of maintaining public health, the occurrence of SIRVA has raised concerns,
especially regarding the technique of vaccine administration.
Our team has been receiving a high number of
enquiries from patients who have received a diagnosis of SIRVA and wish to know whether they can make
a clinical negligence claim. We are currently in the
process of investigating some of these claims to determine whether the legal tests for negligence can be
demonstrated. This article will explore SIRVA, its
causes, symptoms and treatment, as well as making a
claim.
Injection into the shoulder joint: If the needle enters
the shoulder joint itself, it can cause direct injury to
the structures inside the joint, including the cartilage,
ligaments and tendons.
Where there has been a negligent failure to correctly
identify the appropriate injection site and the injection has been inappropriately administered into the
bursa or the shoulder joint, it may be possible to bring
a clinical negligence claim.
What is SIRVA?
SIRVA appears to occur when the needle is inserted
incorrectly or inappropriately into the shoulder joint
area, resulting in an inflammatory response and damage to the muscles, nerves or tendons surrounding
the shoulder. The injury typically manifests itself
within a few days or weeks of being vaccinated
and can lead to significant pain, discomfort and,
sometimes, long-term disability.
Symptoms of SIRVA
Common signs and symptoms include:
Pain: The most common symptom, typically starting
as a sharp, localised pain in the shoulder. Over time,
this pain may radiate down the arm or increase in intensity. This will typically significantly affect a patient’s
ability to perform daily activities and will often affect
the patient’s sleep.
Swelling: Inflammation around the shoulder joint
and upper arm can occur, making the shoulder
appear swollen.
The SIRVA injuries are most commonly associated
with vaccines administered in the upper arm, such as
the flu or Covid-19 vaccine, but they can occur with
any injection given in the shoulder region.
Stiffness: Many people with SIRVA experience a
limited range of motion, making it difficult to raise the
arm or perform overhead activities.
Causes of SIRVA
SIRVA injuries typically appear to result from
inappropriate injection techniques. Intramuscular
vaccinations administered into the upper arm should
be delivered with the needle at a 90-degree angle into
the middle of the deltoid muscle. This tends to be
around 2.5cm below the acromion process, which is a
bony prominence at the top of the shoulder joint. The
acromion process should be located and used as
a landmark in order to administer the injection
correctly into the deltoid muscle.
Tingling or numbness: Damage to the nerves in the
area may cause sensations of tingling, numbness or
weakness in the arm.
Weakness: As the muscles in the shoulder are affected, there may be noticeable weakness, making
tasks like lifting, carrying or reaching more difficult to
do.
Diagnosis of SIRVA
A healthcare provider will typically diagnose SIRVA
based on the patient's history and symptoms. Since the
injury occurs soon after vaccination, the healthcare
provider will often inquire about the timing of the
vaccine and the nature of the pain.
SIRVA can occur in the following instances:
Incorrect needle placement: When the vaccine is
injected too high or too deep into the shoulder, it can
damage the muscles or tendons in the rotator cuff or
the bursa.
EXPERT WITNESS JOURNAL
74
JUNE 2025
