Preventing Shoulder Pain After Vaccine Injection (SIRVA)

Shoulder pain is a common side effect of a vaccine. Usually, it gets better fairly quickly and causes no long-term problems. However, some people develop a rare problem called shoulder injury related to vaccine administration (SIRVA).

This article will go over why SIRVA happens and what you can do to prevent it if you’re getting vaccinated.

doctor standing behind a patient with hands on shoulder.

What Is SIRVA?

It's common to feel some pain in your arm after you have a shot. The aching is usually temporary and relieved by an ice pack, anti-inflammatory medications, and a few days of resting your arm.

Sometimes, the shoulder pain that comes on after a vaccine does not get better. When this happens, it's called shoulder injury related to vaccine administration (SIRVA).

What Causes SIRVA? 

SIRVA is thought to happen because the vaccine needle goes into the shoulder joint or the shoulder bursa instead of the deltoid muscle tissue. When the vaccine is injected into the synovial tissue of the joint or bursa, an immune response can happen and cause severe inflammation. 

Vaccines are safe and effective. For most people, the benefits of vaccinations outweigh the possible risks. That said, even relatively simple medical procedures like getting a shot need to be done carefully and appropriately to avoid problems.

While caregivers and patients should be aware of SIRVA, worrying about the risk is not a reason to avoid vaccinations. SIRVA is not caused by the ingredients in a vaccine. It happens when the needle that gives the vaccine is not put in the right place.

What Are the Symptoms of SIRVA?

The signs and symptoms of SIRVA include:

  • Significant chronic shoulder pain after vaccination in someone who did not have shoulder problems before
  • Limited mobility of the shoulder joint

How Is SIRVA Treated?

People diagnosed with SIRVA may get relief from treatments that are targeted at controlling the inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and cortisone injections. These treatments can take weeks or even months to work. Surgery is not usually needed for SIRVA.

How to Prevent SIRVA

Most of the key steps for preventing SIRVA are (literally) in the hands of healthcare providers who give vaccines. That said, there are some steps that you can take to advocate for yourself when you're getting a vaccine:

  • Make sure that the person giving you any injection (vaccine or otherwise) is trained to give shots in the shoulder.
  • When it's time to get your shot, take off your shirt or wear a shirt that you can pull up over your shoulder. Do not pull your shirt down to expose only the top of your shoulder. The placement of the needle too high in your arm can make it more likely to end up in the shoulder joint by mistake.
  • If you have pain that does not get better after a few days, let your healthcare provider know. If you do have SIRVA, there are treatments for it.


It’s normal to have some mild pain in your arm when you have a shot, including a vaccine. However, there is a more serious kind of pain that can happen after vaccination. Shoulder injury related to vaccine administration (SIRVA) is rare but it does happen.

SIRVA is not caused by any ingredients in a vaccine; rather, it is caused by the injection itself. While you can't always prevent SIRVA, you can take steps to ensure you are given a vaccine safely. If you do have lingering pain after a vaccine, talk to your provider. If you have SIRVA, there are ways that it can be treated.

A Word From Verywell

Vaccines administered to the shoulder area are exceedingly safe, and there is no question that research demonstrates that the benefits from the flu vaccine, and other immunizations, far outweigh the risks of these injections.

However, there are problems that can occur, including chronic shoulder pain resulting from incorrectly administered injections. Making sure your healthcare provider is trained in proper vaccine administration can help to ensure this complication will not happen to you.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Cook IF. Subdeltoid/subacromial bursitis associated with influenza vaccination. Hum Vaccin Immunother. 2014;10(3):605-6. doi:10.4161/hv.27232

  4. World Health Organization. Risk scales: benefits of vaccines far outweigh the risks.

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By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.