Vaccines are safe.
Of course, they aren’t 100% safe.
One possible problem though, SIRVA, isn’t necessarily caused by the vaccine itself, but how it is given.
Or more precisely, where it is given.
What is SIRVA?
SIRVA is an acronym for shoulder injury related to vaccine administration.
It can occur when a vaccine is injected into the underlying bursa of the shoulder joint, instead of the deltoid muscle, causing shoulder pain and limited range of motion.
“These symptoms are thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying bursa of the shoulder resulting in an inflammatory reaction. SIRVA is caused by an injury to the musculoskeletal structures of the shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological injury and abnormalities on neurological examination or nerve conduction studies (NCS) and/or electromyographic (EMG) studies would not support SIRVA as a diagnosis (even if the condition causing the neurological abnormality is not known).”
Vaccine Injury Table
Why would someone want to give you a vaccine in the shoulder joint?
They shouldn’t!

In older kids and adults, intramuscular injections are typically given “in the central and thickest portion of the deltoid muscle – above the level of the armpit and approximately 2–3 fingerbreadths (~2″) below the acromion process.”

If the shot is given in the shoulder joint, then it was given too high, typically in the upper 1/3 of the deltoid muscle.
Improved education will hopefully decrease SIRVA cases, but tell your doctor and report your case to VAERS if you think you developed SIRVA within 48 hours of getting a vaccine in your upper arm.
As a table injury, folks with SIRVA can also get compensated under the National Childhood Vaccine Injury Act of 1986.
More on SIRVA
- Which Vaccines can be Given SQ?
- Which Vaccines Can Be Given IM?
- Where Will Your Kids Get Their Shots?
- Making Shots Hurt Less
- Table Injuries and Vaccine Court
- Let’s Get It Right! How to Avoid Shoulder Injury with Deltoid Intramuscular Injections
- AAP – Vaccine Administration
- ACIP – General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices
- How to Administer IM (Intramuscular) Injections
- CDC – Reports of shoulder dysfunction following inactivated influenza vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2010-2016
- CDC – Intramuscular Influenza (Flu) Vaccination Infographic
- Shoulder injury related to vaccine administration reported more frequently
- Shoulder injury related to vaccine administration and other injection site events
- ACIP – Prevention of SIRVA
- Vaccine Injury Table
- SIRVA – Shoulder Injury Related to Vaccine Administration
- Shoulder injury related to vaccine administration