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Technically Speaking
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October 2018
Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
Check out a recent issue of Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events.
TECHNICALLY SPEAKING
Let's Get It Right! How to Avoid Shoulder Injury with Deltoid Intramuscular Injections
Published October 2018
During influenza vaccination season, and at all times of the year, it is critically important that clinic staff who administer vaccines avoid injury to patients’ shoulders by being knowledgeable about how to properly administer intramuscular injections in the deltoid muscle.

At the October 2017 Advisory Committee on Immunization Practices meeting, a presentation titled "Reports of Shoulder Dysfunction Following Inactivated Influenza Vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2010–2016", included the following background information about shoulder injury related to vaccine administration (SIRVA):

  • Definition: SIRVA is caused by injury to the musculoskeletal structures of the shoulder (e.g., tendons, ligaments, bursae, etc.)
  • It manifests itself as shoulder pain and limited range of motion occurring after a patient receives a vaccine intended for intramuscular administration.
  • These symptoms are thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle going into and around the underlying bursa of the shoulder, resulting in an inflammatory reaction.

SIRVA may result in patients having chronic shoulder pain and limited range of motion, and require ongoing medical intervention.

To avoid SIRVA, make sure clinic staff who administer vaccines recognize the anatomic landmarks for identifying the deltoid muscle and use proper intramuscular administration technique.

Helpful resources to assist with staff education

IAC resources

CDC resources

2018 ISSUES >> view all issues
DECEMBER 2018
Looking Back Over 2018 Can Help Ensure Optimal Vaccination Practices in 2019
NOVEMBER 2018
CDC's Vaccine Administration Training Materials – A Great Collection of 4-Minute Videos and Web-Based Training Programs
OCTOBER 2018
Let's Get It Right! How to Avoid Shoulder Injury with Deltoid Intramuscular Injections
SEPTEMBER 2018
What's New for Flu This Season?
JULY/AUGUST 2018
CDC Publishes Recommendations that Newborns Receive Hepatitis B Vaccine within 24 Hours of Birth — AAFP, AAP and ACOG Concur
JUNE 2018
History of Fever > 105 Degrees, Inconsolable Crying, and Hypotonic Episode Following a Previous DTaP Dose Are No Longer Precautions According to ACIP
MAY 2018
Immunize.org Provides a Wide Range of Practical Resources on Vaccine Administration, Storage and Handling, and More
APRIL 2018
New! 2018 Laminated U.S. Immunization Schedules and Updated Educational Materials
MARCH 2018
Subscribe to IAC Express from the Immunization Action Coalition
FEBRUARY 2018
CDC Publishes Updated Guidance on the Use of Zoster Vaccines
JANUARY 2018
CDC Issues New Requirements for VFC Vaccine Storage
 
This page was updated on November 8, 2018.
This page was reviewed on November 8, 2018.
 
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