Department of Orthopaedics and Traumatology, Selahaddin Eyyubi State Hospital, Diyarbakır, Turkey.
Department of Orthopaedics and Traumatology, Eskisehir City Hospital, Eskişehir, Turkey.
BMC Musculoskelet Disord. 2023 Jul 4;24(1):551. doi: 10.1186/s12891-023-06660-y.
Shoulder injury related to vaccine administration (SIRVA) is a rare but increasing complication after vaccination. The aim of this study was to increase awareness of post-vaccination shoulder pain and to investigate the effect of the clinical condition of the shoulder before vaccination on the loss of function that may occur after vaccination.
This prospective study included 65 patients aged > 18 years who were diagnosed with unilateral shoulder impingement and/or bursitis. The first vaccination was performed on the shoulders with rotator cuff symptoms, then the second vaccination was performed on healthy shoulders of same patients as soon as the health system allowed. Pre-vaccination MRI of the symptomatic shoulders of the patients was performed and VAS, ASES and Constant scores were evaluated. At 2 weeks after vaccination of the symptomatic shoulder, scores were reassessed. For the patients with changes in the scores, MRI was performed again and the treatment of all patients was started. A second vaccination was given to asymptomatic shoulders and the patients were recalled two weeks later and their scores were evaluated.
After vaccination, the symptomatic shoulder of 14 patients was affected. No clinical changes were observed in the asymptomatic shoulders after vaccination. The VAS scores of the symptomatic shoulders evaluated after vaccination were significantly higher than the scores evaluated before vaccination (p = 0.001). The ASES and Constant scores of symptomatic shoulders evaluated after vaccination were significantly decreased compared to the scores evaluated before vaccination (p = 0.001).
Exacerbation of symptoms may occur if symptomatic shoulders are vaccinated. Before vaccination, a detailed anamnesis should be taken from the patients and vaccination should be performed to the asymptomatic side.
与疫苗接种相关的肩部损伤（SIRVA）是疫苗接种后罕见但日益增加的并发症。本研究旨在提高对疫苗接种后肩部疼痛的认识，并研究接种前肩部的临床状况对疫苗接种后可能发生的功能丧失的影响。
这项前瞻性研究纳入了 65 名年龄大于 18 岁的单侧肩袖撞击症和/或滑囊炎患者。首先在有肩袖症状的肩部进行首次疫苗接种，然后一旦卫生系统允许，立即在同一位患者的健康肩部进行第二次疫苗接种。对患者有症状肩部的接种前 MRI 进行评估，并评估 VAS、ASES 和 Constant 评分。在接种有症状肩部后 2 周再次评估评分。对于评分发生变化的患者，再次进行 MRI 检查，并开始对所有患者进行治疗。对无症状肩部进行第二次疫苗接种，并在两周后召回患者，评估他们的评分。
接种后，14 名患者的症状肩部受到影响。接种后无症状肩部无临床变化。接种后评估的有症状肩部的 VAS 评分明显高于接种前评估的评分（p=0.001）。接种后评估的有症状肩部的 ASES 和 Constant 评分明显低于接种前评估的评分（p=0.001）。
如果给有症状的肩部接种疫苗，可能会加重症状。接种前，应从患者那里详细询问病史，并应将疫苗接种到无症状侧。
