Shoulder injury related to SARS-CoV-2 vaccine administration.
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ABSTRACT:
SUBMITTER: Chow JCK
PROVIDER: S-EPMC8900789 | biostudies-literature | 2022 Jan
REPOSITORIES: biostudies-literature
Publications
Shoulder injury related to SARS-CoV-2 vaccine administration.
Chow Jacky C K JCK Koles Sarah L SL Bois Aaron J AJ
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20220101 2
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Project description: Not available
| S-EPMC8641978 | biostudies-literature
Project description:BackgroundVaccine pharmacovigilance is at the forefront of the public eye. Shoulder Injuries Related to Vaccine Administration (SIRVA) is a poorly understood Adverse Event Following Immunisation, with iatrogenic origins. Criteria for medicolegal diagnosis of SIRVA is conflicting, current literature and educational materials are lacking, and healthcare practitioner knowledge of the condition is unknown.MethodsA cross-sectional, convenience sampled survey, utilising a validated online questionnaire assessed practitioner knowledge of SIRVA, safe injecting, and upper limb anatomy, and preferred definition for SIRVA.ResultsMean scores were moderate for safe injecting knowledge (69%), and poor for knowledge of anatomy (42%) and SIRVA (55%). Non-immunising healthcare practitioners scored significantly (p = 0.01, and < 0.05, respectively) higher than immunising practitioners for anatomy (2.213 ± 1.52 vs. 3.12 ± 1.50), and safe injecting knowledge (6.70 ± 1.34 vs. 7.14 ± 1.27). Only 52% of authorised vaccinators accurately selected a 40 × 20 mm area recommended for safe injecting. Majority (91.7%) of respondents thought nerve injuries should be included in the diagnostic criteria for SIRVA.Discussion and conclusionsGreater education and awareness of SIRVA is needed in all healthcare disciplines. Consensus regarding SIRVA definition is paramount for accurate reporting and improved future understanding of all aspects of SIRVA.
| S-EPMC9787830 | biostudies-literature
Project description:BackgroundShoulder injury related to vaccine administration (SIRVA) has been recognised as the compensable term for any shoulder injury that may result from an improper vaccination technique since 2017, however, its incidence and impact remain poorly understood.ObjectivesTo examine knowledge of SIRVA through reported cases, determine SIRVA incidence related to COVID-19 vaccinations, and investigate recovery rates.MethodsSix pharmacovigilance agencies in the United States of America (USA), Canada, United Kingdom, European Union, Australia, and New Zealand were systematically search to identify all reported cases of SIRVA between January 2017 to July 2021. Primary outcome measures were SIRVA case reports. Secondary outcome measures included recovery status as well as vaccine received, age, and sex. SIRVA-related outcome measures were retrieved between July 18th and July 22nd 2021, with UK data received via personal correspondence.ResultsRetrospective analysis yielded 505 SIRVA cases since 2017, with 330 (65%) of cases reported from January to July 2021. Sub-analysis, using COVID-19 data of 189 SIRVA cases from 891,906,986 vaccinations, estimated incidence to be 2 per 10 million. 32 cases (7%) had recovered from symptoms at the time of reporting, with 311 (62%) reported as 'not recovered', and 162 cases (32%) 'unknown'. Females represented 75% of reported cases.ConclusionSIRVA case report numbers and incidence from COVID-19 data, compared with prior evidence, raises questions around health practitioner knowledge and reporting accuracy of SIRVA. Recovery rates are poorly understood. A global consensus definition of SIRVA and more transparent and routine reporting is required. The disproportionate representation of females is of concern with no known reasons for this disparity. Further research is needed on SIRVA knowledge in healthcare practitioners, reporting rates, incidence, management, and long-term outcomes for those impacted. Pharmacist vaccinators should be aware of their role in preventing SIRVA and be active in its detection.
| S-EPMC9576975 | biostudies-literature
Project description:PurposeIdentify chronic shoulder MRI findings in patients with known shoulder injury related to vaccine administration (SIRVA).Materials and methodsTwo fellowship-trained musculoskeletal radiologists retrospectively reviewed the MRI of nine patients with clinically established SIRVA. MRI was performed at least 4 weeks after vaccination and included intravenous contrast-enhanced sequences. MRI was reviewed for the presence of erosions, tendonitis, capsulitis, synovitis, bone marrow oedema, joint effusion, bursitis, cartilage defects, rotator cuff lesions, and lymphadenopathy. The number and location of focal lesions were recorded.ResultsErosions of the greater tuberosity were present in 8/9 (89%), tendonitis of the infraspinatus muscle tendon in 7/9 (78%), capsulitis, synovitis, and bone marrow oedema in 5/9 (56%) cases, respectively. Effusion was found in three, and subdeltoid bursitis, rotator cuff lesions as well as cartilage defects in one patient, respectively. None of our included subjects showed axillary lymphadenopathy.ConclusionIn this case series, greater humeral tuberosity erosions, infraspinatus muscle tendonitis, capsulitis, synovitis, and bone marrow oedema were common MRI findings in chronic SIRVA.
| S-EPMC10069733 | biostudies-literature
Project description:IntroductionAfter a vaccination, patients frequently have clinical symptoms of pain and swelling over the injection area which usually resolve 2-3 days after the injection. If the symptoms do not improve, a shoulder injury related to vaccine administration (SIRVA) will be considered, perhaps related to an improper injection technique. Herein we report our first case of a SIRVA after a Sinovac COVID-19 vaccination which occurred due to deep penetration and direction of the needle. The clinical symptoms of the patient improved after treatment with combined oral non-steroidal anti-inflammatory drugs and a short course of intravenous antibiotic.Case presentationA 52-year-old Thai male without prior shoulder pain had a Sinovac COVID-19 vaccination at his right shoulder. The injection was given by a nurse using a 27-gauge needle, 1.5 inches in length. The injection landmark was 3 finger breadths below the midlateral edge of the acromial process. The direction of the needle was 45° to the skin cephalad. Three days after receiving the vaccine the patient began to have right shoulder pain with limited range of motion and acute fever. He was admitted for medical treatment which his clinical symptoms gradually improved.ConclusionWe report a case of subacromial-subcoracoid-subdeltoid bursitis following a Sinovac COVID-19 vaccine injection. This condition is rare, and usually related to an incorrect vaccination technique. To avoid this complication, nurses should identify the correct landmark, use an appropriate needle length, and point the needle in the correct direction.
| S-EPMC8314792 | biostudies-literature
Project description: Not available
| S-EPMC8933051 | biostudies-literature
Project description:ObjectiveWe constructed two DNA vaccines containing the receptor-binding domain (RBD) genes of multiple SARS-CoV-2 variants and used them in combination with inactivated vaccines in a variety of different protocols to explore potential novel immunization strategies against SARS-CoV-2 variants.MethodsTwo DNA vaccine candidates with different signal peptides (namely, secreted and membrane signal peptides) and RBD protein genes of different SARS-CoV-2 strains (Wuhan-Hu-1, B.1.351, B.1.617.2, C.37) were used. Four different combinations of DNA and inactivated vaccines were tested, namely, Group A: three doses of DNA vaccine; B: three doses of DNA vaccine and one dose of inactivated vaccine; C: two doses of inactivated vaccine and one dose of DNA vaccine; and D: coadministration of DNA and inactivated vaccines in two doses. Subgroups were grouped according to the signal peptide used (subgroup 1 contained secreted signal peptides, and subgroup 2 contained membrane signal peptides). The in vitro expression of the DNA vaccines, the humoral and cellular immunity responses of the immunized mice, the immune cell population changes in local lymph nodes, and proinflammatory cytokine levels in serum samples were evaluated.ResultsThe antibody responses and cellular immunity in Group A were weak for all SARS-CoV-2 strains; for Group B, there was a great enhancement of neutralizing antibody (Nab) titers against the B.1.617.2 variant strain. Group C showed a significant increase in antibody responses (NAb titers against the Wuhan-Hu-1 strain were 768 and 1154 for Group C1 and Group C2, respectively, versus 576) and cellular immune responses, especially for variant B.1.617.2 (3240 (p < 0.001) and 2430 (p < 0.05) for Group C1 and Group C2, versus 450); Group D showed an improvement in immunogenicity. Group C induced higher levels of multiple cytokines.ConclusionThe DNA vaccine candidates we constructed, administered as boosters, could enhance the humoral and cellular immune responses of inactivated vaccines against COVID-19, especially for B.1.617.2.
| S-EPMC9228235 | biostudies-literature
Project description:BackgroundShoulder injury related to vaccine administration (SIRVA) accounts for more than half of all claims received by the National Vaccine Injury Compensation Program. However, due to the difficulty of finding SIRVA cases in large health care databases, population-based studies are scarce.ObjectiveThe goal of the research was to develop a natural language processing (NLP) method to identify SIRVA cases from clinical notes.MethodsWe conducted the study among members of a large integrated health care organization who were vaccinated between April 1, 2016, and December 31, 2017, and had subsequent diagnosis codes indicative of shoulder injury. Based on a training data set with a chart review reference standard of 164 cases, we developed an NLP algorithm to extract shoulder disorder information, including prior vaccination, anatomic location, temporality and causality. The algorithm identified 3 groups of positive SIRVA cases (definite, probable, and possible) based on the strength of evidence. We compared NLP results to a chart review reference standard of 100 vaccinated cases. We then applied the final automated NLP algorithm to a broader cohort of vaccinated persons with a shoulder injury diagnosis code and performed manual chart confirmation on a random sample of NLP-identified definite cases and all NLP-identified probable and possible cases.ResultsIn the validation sample, the NLP algorithm had 100% accuracy for identifying 4 SIRVA cases and 96 cases without SIRVA. In the broader cohort of 53,585 vaccinations, the NLP algorithm identified 291 definite, 124 probable, and 52 possible SIRVA cases. The chart-confirmation rates for these groups were 95.5% (278/291), 67.7% (84/124), and 17.3% (9/52), respectively.ConclusionsThe algorithm performed with high sensitivity and reasonable specificity in identifying positive SIRVA cases. The NLP algorithm can potentially be used in future population-based studies to identify this rare adverse event, avoiding labor-intensive chart review validation.
| S-EPMC9175103 | biostudies-literature
Project description:With the COVID-19 pandemic globally, the ongoing threat of new challenges of mucosal infections was once again reminded human beings. Hence, access to the next-generation vaccine to elicit mucosal immunity is required to reduce virus shedding. SARS-CoV-2 retains a unique polybasic cleavage motif in its spike protein, recognized by the host furin protease. The proteolytic furin cleavage site at the junction of S1/S2 glycoprotein plays a key role in the pathogenesis of SARS-CoV-2. Here, we examined the protective immunity of a double-deleted PRRA/GTNGTKR motifs cold-adapted live-attenuated candidate vaccines as a called "KaraVac." using a hamster animal model of infected attenuated SARS-CoV-2. The KaraVac vaccinated hamsters were challenged against the wild-type (WT) SARS-CoV-2. No apparent bodyweight loss and histopathological lesions were observed in the hamsters. The establishment of sterilizing immunity was induced via stimulating a robust neutralizing antibody (NAb) response in a hamster model. Consequently, deletions in the spike sequence and inoculation into hamsters provide resistance to the subsequent challenge with WT SARS-CoV-2. We have suggested that deletion of the furin cleavage site and GTNGTKR motifs in the spike sequence attenuates the virus from the parental strain and can be used as a potent immunogen.
| S-EPMC9270963 | biostudies-literature
Project description:Intranasal vaccines can prime or recruit to the respiratory epithelium mucosal immune cells capable of preventing transmission of SARS-CoV-2. We found that a single intranasal dose of serotype 5-based adenoviral vectors expressing either the receptor binding domain (Ad5-RBD) or the complete ectodomain (Ad5-S) of the SARS-CoV-2 spike protein was effective in inducing i) secretory and serum anti-spike IgA and IgG, ii) robust SARS-CoV-2-neutralizing activity in the serum and in respiratory secretions, iii) rigorous spike-directed T helper 1 cell/cytotoxic T cell immunity, and iv) protection of wild-type mice from a challenge with the SARS-CoV-2 beta variant. Our data confirm and extend previous studies reporting promising preclinical results on vector-based intranasal SARS-CoV-2 vaccination, and support the potential of this approach to elicit mucosal immunity for preventing reinfection and transmission of SARS-CoV-2 more effectively than the currently available vaccines.
2023-05-01 | GSE223476 | GEO