Elisabeth M Hesse1, Ronald A Navarro2, Matthew F Daley3, Darios Getahun4, Michelle L Henninger5, Lisa A Jackson6, James Nordin7, Scott C Olson8, Ousseny Zerbo9, Chengyi Zheng4, Jonathan Duffy1. 1. Epidemic Intelligence Service and Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia (E.M.H., J.D.). 2. Kaiser Permanente South Bay Medical Center, Harbor City, California (R.A.N.). 3. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado (M.F.D.). 4. Kaiser Permanente, Pasadena, California (D.G., C.Z.). 5. Kaiser Permanente Center for Health Research, Portland, Oregon (M.L.H.). 6. Kaiser Permanente Washington Health Research Institute, Seattle, Washington (L.A.J.). 7. HealthPartners Institute for Education and Research, Minneapolis, Minnesota (J.N.). 8. Marshfield Clinic Research Institute, Center for Clinical Epidemiology and Population Health, Marshfield, Wisconsin (S.C.O.). 9. Kaiser Permanente Vaccine Study Center, Oakland, California (O.Z.).
Abstract
BACKGROUND: Subdeltoid bursitis has been reported as an adverse event after intramuscular vaccination in the deltoid muscle. Most published case reports involved influenza vaccine. OBJECTIVE: To estimate the risk for subdeltoid bursitis after influenza vaccination. DESIGN: Retrospective cohort study. SETTING: The Vaccine Safety Datalink, which contains health encounter data for 10.2 million members of 7 U.S. health care organizations. PATIENTS: Persons who received an inactivated influenza vaccine during the 2016-2017 influenza season. MEASUREMENTS: Potential incident cases were identified by searching administrative data for persons with a shoulder bursitis diagnostic code within 180 days after receiving an injectable influenza vaccine in the same arm. The date of reported bursitis symptom onset was abstracted from the medical record. A self-controlled risk interval analysis was used to calculate the incidence rate ratio of bursitis in a risk interval of 0 to 2 days after vaccination versus a control interval of 30 to 60 days, which represents the background rate. The attributable risk was also estimated. RESULTS: The cohort included 2 943 493 vaccinated persons. Sixteen cases of symptom onset in the risk interval and 51 cases of symptom onset in the control interval were identified. The median age of persons in the risk interval was 57.5 years (range, 24 to 98 years), and 69% were women. The incidence rate ratio was 3.24 (95% CI, 1.85 to 5.68). The attributable risk was 7.78 (CI, 2.19 to 13.38) additional cases of bursitis per 1 million persons vaccinated. LIMITATION: The results may not be generalizable to vaccinations done in other types of health care settings. CONCLUSION: Although an increased risk for bursitis after vaccination was present, the absolute risk was small. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.
BACKGROUND: Subdeltoid bursitis has been reported as an adverse event after intramuscular vaccination in the deltoid muscle. Most published case reports involved influenza vaccine. OBJECTIVE: To estimate the risk for subdeltoid bursitis after influenza vaccination. DESIGN: Retrospective cohort study. SETTING: The Vaccine Safety Datalink, which contains health encounter data for 10.2 million members of 7 U.S. health care organizations. PATIENTS: Persons who received an inactivated influenza vaccine during the 2016-2017 influenza season. MEASUREMENTS: Potential incident cases were identified by searching administrative data for persons with a shoulder bursitis diagnostic code within 180 days after receiving an injectable influenza vaccine in the same arm. The date of reported bursitis symptom onset was abstracted from the medical record. A self-controlled risk interval analysis was used to calculate the incidence rate ratio of bursitis in a risk interval of 0 to 2 days after vaccination versus a control interval of 30 to 60 days, which represents the background rate. The attributable risk was also estimated. RESULTS: The cohort included 2 943 493 vaccinated persons. Sixteen cases of symptom onset in the risk interval and 51 cases of symptom onset in the control interval were identified. The median age of persons in the risk interval was 57.5 years (range, 24 to 98 years), and 69% were women. The incidence rate ratio was 3.24 (95% CI, 1.85 to 5.68). The attributable risk was 7.78 (CI, 2.19 to 13.38) additional cases of bursitis per 1 million persons vaccinated. LIMITATION: The results may not be generalizable to vaccinations done in other types of health care settings. CONCLUSION: Although an increased risk for bursitis after vaccination was present, the absolute risk was small. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.
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