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Vaccinations are one of the greatest medical advances of the 20th century, reducing child mortality by 50% and averting up to 3 million deaths per year. Ensuring public trust and safety in vaccines is more important than ever, which is why extensive testing is performed before a vaccine is released. However, sometimes injuries can occur; the most common injury is known as Shoulder-Injury-Related Vaccine Administration (SIRVA). Fortunately, SIRVA only happens in 1 out of 100,000 injections but accounts for 53% of vaccine-related claims to the national no-fault Vaccine Injury Compensation Program. This can occur when a vaccination is inadvertently injected too high and too deep in the shoulder and therefore deposited into the rotator cuff or shoulder capsule. This causes inflammation and severe pain because the vaccine cannot be cleared from tendons and collagenous structures as normally occurs when injected properly into muscle. The problem can be treated with oral medications, cortisone injections, physical therapy and arthroscopic surgery; however, in two thirds of SIRVA cases, these methods don’t work and patients continue to suffer from chronic pain.
Dr. Bodor and Enoch Montalvo, RN were the first to describe vaccination-related shoulder dysfunction in 2007. Six months ago, Dr. Bodor came up with a way to use ultrasound to identify the location of the deposited vaccine in patients with SIRVA, then perform an ultra-minimally invasive procedure to aspirate the vaccine and clean out the tendon. Up until this procedure, there was no treatment to help patients with chronic pain as a result of SIRVA. So far, 5 out of 5 patients treated with the new method experienced resolution of their long-lasting pain and disability within 1-2 weeks of the procedure. The NMRF has been following outcomes of these patients and at 6 months following the procedure, they remain pain-free.
If you suspect you may have vaccination-related shoulder dysfunction and your shoulder pain is not going away after 2 weeks, we recommend you contact your primary care physician, or an orthopedic/sports medicine specialist. Let them know that you have had shoulder pain since the vaccination and that it is not going away. If they are skeptical about this problem, tell them that there are over 30 peer-reviewed publications in the National Library of Medicine available on PubMed. https://pubmed.ncbi.nlm.nih.gov/?term=SIRVA.
There is a review article on the prevalence of this problem: https://pubmed.ncbi.nlm.nih.gov/28774564/
Unfortunately, there have been no articles specifically addressing treatment. Referral to a physical medicine and rehabilitation or sports medicine specialist with expertise in musculoskeletal diagnostic ultrasound is advisable to further assess the shoulder via ultrasound and sonopalpation to potentially perform targeted ultrasound-guided injections. In general, we are against the use of non-steroidal anti-inflammatories (NSAIDs) for disorders that benefit from an increase in blood flow, which is lacking in the rotator cuff tendons. Magnetic resonance imaging (MRI) is useful to look for the track of the vaccination needle and where the vaccine may have been deposited.
Subacromial and glenohumeral joint corticosteroid injections can be performed, which we have found helpful for the auto-immune response caused by vaccines deposited in the deeper shoulder structures. Physical therapy can help with frozen shoulder, which can occur with vaccination-related shoulder dysfunction. If the pain and disability do not resolve with these measures, various surgical techniques are available to treat the shoulder bursa, rotator cuff and adjacent structures. The Bodor Clinic has developed a method to precisely identify the source of pain and treat it using an ultra-minimally invasive technique.
To read more about Dr. Bodor and scheduling an evaluation with the Bodor Clinic, please visit: https://bodorclinic.com/
To learn more about SIRVA, go to:
wired.com/2015/09/cases-shoulder-injuries-vaccines-increasing/
to read the article, “Why Are Cases of Shoulder Injuries From Vaccines Increasing?” from Wired Magazine; the article includes excerpts from interviews with Dr. Marko Bodor and Elizabeth Cassayre from Napa, the first patient to be diagnosed with this condition in 2007.
A former fellow of the Bodor Clinic, Naveed Natanzi, MD, recently submitted a paper to the journal Radiology Case Reports based on Dr. Bodor’s original findings, which help clarify why some patients have chronic pain following vaccine administration. We are excited to announce that the paper was just accepted and published to the journal, which is available world-wide for free (open access). NMRF is listed in the acknowledgement. To view the article, go to: ncbi.nlm.nih.gov/pmc/articles/PMC7078120/