SIRVA (Shoulder Injury Related to Vaccine Administration)

What is SIRVA?

SIRVA, or “Shoulder Injury Related to Vaccine Administration” is often the result of a vaccine that is injected too high or too deep into the shoulder. It can cause several types of injuries, and lead to intense and prolonged pain, as well as limited range of motion that can potentially lead to other shoulder-related injuries such as Adhesive Capsulitis or Frozen Shoulder Syndrome.

What causes SIRVA?

While a majority of cases of SIRVA are as a result of the seasonal flu shot, the most commonly administered vaccine in adults, studies have shown that it is not the vaccine itself that results in SIRVA. In their research, Bodor and Montalvo determined that it was not a reaction to the chemicals in the vaccine, rather, the injection site that primarily led to the development of SIRVA in patients. They hypothesized and later concluded, that weakness and pain in the shoulder after receiving influenza and pneumococcal vaccines were as a result of the vaccinations having been administered too high in the deltoid muscle, which punctures the bursa—a fluid-filled sac that decreases friction between tissues. They stated that vaccine-related shoulder injury or pain can be avoided by not using the upper third of the deltoid muscle for vaccine injections. This is why the seasonal flu shot produces nearly 70% of all cases of SIRVA – not because it is particularly prone to causing SIRVA, but because it is given to so very many adults as compared to many other common vaccines. It is also worth noting that because SIRVA is the result of an injection technique it can be caused by any vaccine.

What are the symptoms of SIRVA?

SIRVA can present with several different symptoms, with the most common symptom being shoulder pain. Generally, symptoms of SIRVA occur anywhere from 0-48 hours after receipt of the initial injection. Although intense or persistent shoulder pain and limited range of motion are the most prominent symptoms, SIRVA may also include the following:

  • Frozen Shoulder
  • Shoulder Tendonitis
  • Rotator Cuff Tear
  • Shoulder Bursitis
  • Adhesive Capsulitis
  • Brachial Neuritis
  • Impingement Syndrome

While it’s true that most vaccinations injected into the shoulder can cause muscle irritation, in particular SIRVA persists due to inflammation. If you are still experiencing restricted movement and chronic pain in the shoulder where you received a vaccine injection, then you may be suffering from SIRVA.

How is SIRVA diagnosed?

For many, the first sign of SIRVA is a sharp or stabbing shoulder pain that occurs immediately or within hours or days of receiving a vaccination. Many who experience SIRVA often simply report just unexplained shoulder pain — not realizing that the pain is a direct result of improper administration of the vaccine. If you are experiencing the symptoms of SIRVA, mentioned above, it is critical to schedule an appointment with your doctor as soon as possible. Be sure to describe your symptoms and mention your recent vaccination, as this may be the key to obtaining the correct diagnosis.

How is SIRVA treated?

For most, treatment for SIRVA includes physical therapy and medicine. In rare cases, surgery may be necessary. Some of the most common forms of treatment for SIRVA include the following:


For many, simply resting the affected area may lead to recovery. SIRVA injuries in particular involve inflammation, which resting the muscle, ligaments, and tendons in the shoulder can help.

Physical Therapy

Various forms of physical therapy can be used to treat SIRVA. In general, vaccine-related shoulder injuries typically result in stiffness, as well as muscle weakness and a limited range of motion. Throughout the SIRVA recovery period, range of motion, muscle strength and motor control need to be rebuilt. Physical therapy can help expedite this process and accelerate the healing process.  Physical therapy is also used after shoulder surgery.

Steroid Injections / Oral Steroids

For those who are not able to resolve the inflammation with rest alone, it is recommended to speak to your doctor, who may then prescribe steroids. The most common steroids to treat SIRVA include Prednisone, hydrocortisone, and other corticosteroids that suppress inflammation. However, these steroids may also lead to serious side effects that include high blood pressure, mood swings, and increased blood sugar. It is very important to consult with your doctor about the risks of each treatment before choosing what is right for you.

Pain Medication

It is possible that your doctor may prescribe a variety of different pain management medications to treat your SIRVA injury. This could include nonsteroidal drugs designed to alleviate inflammation, or prescription narcotics to help mitigate the pain. Some affected with SIRVA may also find that over-the-counter medications such as ibuprofen or acetaminophen may relieve the pain of SIRVA. Please consult with your doctor to determine what treatment plan is best for you.


The final option, when more conservative treatment options have not alleviated SIRVA, is surgery. Many affected by SIRVA have found that surgery in combination with a sling and physical therapy after the operation have been the answer to solving the pain experienced from the result of an improperly administered vaccine.  Again it is important for you to consult with your doctor to determine whether surgery is an option for you.

SIRVA Compensation

The National Vaccine Injury Compensation Program (VICP) indicates that if a person suffers from a SIRVA injury within 48 hours of receiving any vaccine on the Vaccine Injury Table they will be given the presumption that the vaccine caused the injury. In particular, to qualify for a SIRVA compensation claim, there must be no existing history of shoulder problems prior to the vaccination and the causative vaccine must be covered under the VICP.   Because SIRVA was added to the vaccine injury table if a person developed SIRVA within 48 hours of any table vaccination after March 21st, 2009, they may apply for compensation before March 21, 2019, by filing a petition in the vaccine court. It is recommended from the Health Resources and Services Administration (HRSA) that those who believe they sustained a shoulder-related vaccine injury hire an attorney, as well as gain a clear picture of your physical, financial, and emotional harm as a result of SIRVA. This is because, generally, you only get one chance to file a claim and once your case is over there is no option to go back. As a result, it is important to think about the damages that may have been caused by SIRVA. This may include your medical bills — both past and future — as well as your pain and suffering, and even lost earnings.

File a SIRVA-related claim today

Contact us today for any questions about compensation from SIRVA, or to discuss your claim.