[MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine Administration)

[Swift, Melanie]

We could not find takers for intradermal either – lots of local reactions, and it is not painless!
Plus, when we tried it about 5 years ago, the plunger required a crazy amount of force to activate. I had to use both thumbs to depress the plunger. I was seriously concerned about the vaccinators getting ergonomic injuries! Have they improved the design?

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Tuesday, November 17, 2015 10:12 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine Administration)

We ordered intradermal, I think about 50 vaccines 3 years ago, thinking this would help the needle phobic as it is a shorter needle and after such people read the intradermal side effects which were greater than the IM, no one wanted it so we have not re-ordered since.  We only use preloaded IM flu vaccines; just over 15,000 per season. Warner

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<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kris Arnold
Sent: Monday, November 16, 2015 7:37 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] SIRVA (Shoulder Injury Related to Vaccine Administration)

Ed,

Curious, why are you not using the intradermal flu vaccine?  We did a cost/time analysis a couple of years ago and found that it was cost/time advantageous to use the intradermal.  We do 3-5 flu clinics with 100-120 persons per session and one practitioner, so the time factor was a real part of the calculation, but just on the materials it was very close if not slightly in favor of the pre-loaded intradermal.

Thanks,

Kris

On Mon, Nov 16, 2015 at 2:00 PM, Galaid Edward I <Edward.Galaid at ropersaintfrancis.com<mailto:Edward.Galaid at ropersaintfrancis.com>> wrote:
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<tel:843-906-0519>


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