Shoulder Injury Related to Vaccine Administration (SIRVA) Following COVID-19 Vaccination: Correlating MRI Findings with Patient Demographics.

OBJECTIVES

Shoulder injury related to vaccine administration (SIRVA), previously observed with influenza vaccines, has gained clinical significance with widespread COVID-19 vaccination. However, few studies correlate vaccine types and demographic factors with the MRI findings of SIRVA. This study aimed to evaluate MRI findings of SIRVA following COVID-19 vaccination and assess associations with vaccine type and patient characteristics.

METHODS

A retrospective cohort study was conducted on 35 patients with new-onset shoulder complaints within six weeks of COVID-19 vaccination between May 2021 and May 2022. MRI findings suggestive of SIRVA were reviewed, including subacromial bursitis, rotator cuff tears, and adhesive capsulitis. Demographic data, vaccine type, clinical symptoms, and treatments were collected. Follow-up interviews (1-30 September 2024) assessed symptom persistence and vaccine hesitancy. Descriptive statistics and Chi-square tests were used to explore associations.

RESULTS

Of the 35 patients (mean age 53.6 ± 9.0 years; 54.3% female), subacromial bursitis was the most common MRI finding (89.5%), followed by tendonitis (47.4%) and adhesive capsulitis (36.8%). Tendonitis correlated with older age (p = 0.024) and AstraZeneca vaccination (p = 0.033). Subacromial bursitis was linked to female sex (p = 0.013) and higher BMI (p = 0.023). Adhesive capsulitis was associated with receiving the Sinopharm vaccine (p = 0.029). Persistent symptoms (22.9%) were more common in younger patients, women, and those with right-sided injections.

CONCLUSIONS

SIRVA following COVID-19 vaccination showed different MRI patterns associated with female sex, higher BMI, and vaccine type. Awareness of these patterns may expedite recognition of COVID-19-associated SIRVA in routine practice.