[MCOH-EH] MCOH-EH Digest, Vol 250, Issue 160

[Jeff Jacobs, MD]

We had a series of 12 about 4 years ago. I became the local expert. Most people took several months w/ PT and restrictions to recover. We believed it to be due to vaccinator error as most people reported the placement of the vaccine being "too high" or "hitting the bone" as their chief complaint. We tried re-training and haven't had the debacle of a few years ago, but have seen 1 or 2 trickle in with milder complaints which seem to resolve much more rapidly (and don't present as simple local reactions). There are 2 good articles on this subject which I will look for and send to the list, but I recall one discussed the sub deltoid bursa as being affected by the injection and producing a bursitis as the cause of these symptoms, so needle length might be a reasonable way to proceed as well, or in some of our "survivors" from the cohort, Intradermal injections. Jeff
Jeffrey A Jacobs, MD, MPH
Medical Director
Einstein LiveWell EHS
1303 Tabor Rd
Philadelphia, PA 19141
215-456-1084
FAX: 215-456-1840
>>>  11/16/15 3:00 PM >>>
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Today's Topics:

   1.  SIRVA (Shoulder Injury Related to Vaccine Administration)
      (Galaid Edward I)
   2. Re:  SIRVA (Shoulder Injury Related to Vaccine
      Administration) (Hudson, T. Warner)


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Message: 1
Date: Mon, 16 Nov 2015 19:00:19 +0000
From: Galaid Edward I 
To: "mcoh-eh at mylist.net" 
Subject: [MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine
    Administration)
Message-ID:
    
    
Content-Type: text/plain; charset="us-ascii"

Half a dozen cases of SIRVA this flu season thus far.  Not just a little localized tenderness.  This is substantial impairment requiring work restrictions, weeks out from day of administration.
It's behaving like a subacromial or subdeltoid bursitis.
Same group of nurses administering year-to-year with 1" needles.
Do your vaccine administrators use weight-based calculation to determine needle length?

Ed Galaid

Edward I. Galaid, MD, MPH
ABIM, ABPM
Medical Director, Occupational Health Partners
Roper St . Francis       Charleston, SC
Member, ACOEM Task Group on Medical Guidance for Law Enforcement Officers
Member, NFPA 1582 Writing Group - NFPA Technical Committee on Fire Fighter Safety and Health
843-906-0519


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Message: 2
Date: Mon, 16 Nov 2015 19:06:29 +0000
From: "Hudson, T. Warner" 
To: MCOH/EH 
Subject: Re: [MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine
    Administration)
Message-ID:
    <2134A5387858914BBE80D079ECF6880C3CA489D1 at SOPEXMB3.ad.medctr.ucla.edu>
Content-Type: text/plain; charset="us-ascii"

We have seen a few over the last 3 years we believed were more related to location of injection so bolstered vaccinator training in this regard and have not seen it this year.

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu
Website www.ohs.uclahealth.org

From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Galaid Edward I
Sent: Monday, November 16, 2015 11:00 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine Administration)

Half a dozen cases of SIRVA this flu season thus far.  Not just a little localized tenderness.  This is substantial impairment requiring work restrictions, weeks out from day of administration.
It's behaving like a subacromial or subdeltoid bursitis.
Same group of nurses administering year-to-year with 1" needles.
Do your vaccine administrators use weight-based calculation to determine needle length?

Ed Galaid

Edward I. Galaid, MD, MPH
ABIM, ABPM
Medical Director, Occupational Health Partners
Roper St . Francis       Charleston, SC
Member, ACOEM Task Group on Medical Guidance for Law Enforcement Officers
Member, NFPA 1582 Writing Group - NFPA Technical Committee on Fire Fighter Safety and Health
843-906-0519


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End of MCOH-EH Digest, Vol 250, Issue 160
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