Elisabeth M Hesse1, Sarah Atanasoff2, Beth F Hibbs3, Oluwasegun J Adegoke4, Carmen Ng3, Paige Marquez3, Mark Osborn2, John R Su3, Pedro L Moro3, Tom Shimabukuro3, Narayan Nair2. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MS V24-5, Atlanta, GA 30329, United States; Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States. Electronic address: nrn3@cdc.gov. 2. National Vaccine Injury Compensation Program, Health Resources and Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, United States. 3. Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MSV18-4, Atlanta, GA 30329, United States. 4. Public Health Informatics Fellowship Program, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, United States; Global Immunizations Division, Center for Global Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 1600 Clifton Rd, MS H24-2, Atlanta, GA 30329, United States.
Abstract
BACKGROUND: Since 2010, petitioner claims of shoulder injury related to vaccine administration (SIRVA) to the National Vaccine Injury Compensation Program (VICP) have been increasing. OBJECTIVE: To conduct a scientific review of clinical characteristics of SIRVA petitions to the VICP. METHODS: We queried the VICP's Injury Compensation System database for medical reports of alleged SIRVA and SIRVA-like injuries. Medical reports are summaries of petitioner claims and supporting documentation along with a VICP clinician reviewer diagnosis and assessment of criteria for concession. We conducted a descriptive analysis of SIRVA petitioner claims recommended by the VICP for concession as SIRVA injuries. RESULTS: We identified 476 petitioner claims recommended for concession. Claims per year increased from two in 2011, the first full year in the analytic period, to 227 in 2016. Median age was 51 years, 82.8% were women, and median body mass index was 25.1 (range 17.0-48.9). Four hundred cases (84.0%) involved influenza vaccine. Pharmacy or store (n = 168; 35.3%) was the most common place of vaccination followed by doctor's office (n = 147; 30.9%). Fewer than half of cases reported a suspected administration error; 172 (36.1%) reported 'injection too high' on the arm. Shoulder pain, rotator cuff problems, and bursitis were common initial diagnoses. Most (80.0%) cases received physical or occupational therapy, 60.1% had at least one steroid injection, and 32.6% had surgery. Most (71.9%) healthcare providers who gave opinions on causality considered the injury was caused by vaccination. A minority (24.3%) of cases indicated that symptoms had resolved by the last visit available in medical records. CONCLUSIONS: Most conceded claims for SIRVA were in women and involved influenza vaccines. Injection too high on the arm could be a factor due to the risk of injecting into underlying non-muscular tissues. Healthcare providers should be aware of proper injection technique and anatomical landmarks when administering vaccines.
BACKGROUND: Since 2010, petitioner claims of shoulder injury related to vaccine administration (SIRVA) to the National Vaccine Injury Compensation Program (VICP) have been increasing. OBJECTIVE: To conduct a scientific review of clinical characteristics of SIRVA petitions to the VICP. METHODS: We queried the VICP's Injury Compensation System database for medical reports of alleged SIRVA and SIRVA-like injuries. Medical reports are summaries of petitioner claims and supporting documentation along with a VICP clinician reviewer diagnosis and assessment of criteria for concession. We conducted a descriptive analysis of SIRVA petitioner claims recommended by the VICP for concession as SIRVA injuries. RESULTS: We identified 476 petitioner claims recommended for concession. Claims per year increased from two in 2011, the first full year in the analytic period, to 227 in 2016. Median age was 51 years, 82.8% were women, and median body mass index was 25.1 (range 17.0-48.9). Four hundred cases (84.0%) involved influenza vaccine. Pharmacy or store (n = 168; 35.3%) was the most common place of vaccination followed by doctor's office (n = 147; 30.9%). Fewer than half of cases reported a suspected administration error; 172 (36.1%) reported 'injection too high' on the arm. Shoulder pain, rotator cuff problems, and bursitis were common initial diagnoses. Most (80.0%) cases received physical or occupational therapy, 60.1% had at least one steroid injection, and 32.6% had surgery. Most (71.9%) healthcare providers who gave opinions on causality considered the injury was caused by vaccination. A minority (24.3%) of cases indicated that symptoms had resolved by the last visit available in medical records. CONCLUSIONS: Most conceded claims for SIRVA were in women and involved influenza vaccines. Injection too high on the arm could be a factor due to the risk of injecting into underlying non-muscular tissues. Healthcare providers should be aware of proper injection technique and anatomical landmarks when administering vaccines.
Keywords:
Concession; National Vaccine Injury Compensation Program (VICP); Petitioner claims; Shoulder injury; Shoulder injury related to vaccine administration (SIRVA); Vaccination
Authors: Silvia Perez-Vilar; Graça M Dores; Paige L Marquez; Carmen S Ng; Maria V Cano; Anuja Rastogi; Lucia Lee; John R Su; Jonathan Duffy Journal: Vaccine Date: 2021-12-07 Impact factor: 3.641
Authors: Chengyi Zheng; Jonathan Duffy; In-Lu Amy Liu; Lina S Sy; Wansu Chen; Lei Qian; Ronald A Navarro; Denison S Ryan; Sunhea S Kim; Cheryl Mercado; Steven J Jacobsen Journal: Ann Intern Med Date: 2022-03-22 Impact factor: 25.391
Authors: Chengyi Zheng; Jonathan Duffy; In-Lu Amy Liu; Lina S Sy; Ronald A Navarro; Sunhea S Kim; Denison S Ryan; Wansu Chen; Lei Qian; Cheryl Mercado; Steven J Jacobsen Journal: JMIR Public Health Surveill Date: 2022-05-24