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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(03): 299-306
DOI: 10.1055/s-0040-1719086
Revisão Sistemática
Ombro e Cotovelo

Lesão de ombro após a vacinação: Uma revisão sistemática

Article in several languages: português | English
Paul J. Cagle  Jr.
1   Departamento de Cirurgia Ortopédica, Icahn School of Medicine at Mount Sinai, Nova York, Nova York, Estados Unidos
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Resumo

As reações adversas às injeções de vacina tendem a ser brandas e são incrivelmente raras. No entanto, vários casos de eventos em ombros, como bursite, dor generalizada ou diminuição da amplitude de movimento, foram relatados após vacinações de rotina. Esses eventos são conhecidos como lesões em ombro relacionadas à administração de vacina (SIRVA, do inglês shoulder injury related to vaccine administration).

Uma revisão sistemática da literatura foi realizada para identificar todos os relatos publicados de SIRVA. Vinte e sete artigos que relataram um ou mais casos de SIRVA foram encontrados. A vacina mais comumente citada foi a vacina contra influenza. Os sintomas mais comuns foram dor com início em até 48 horas e perda da amplitude de movimento do ombro. As modalidades de tratamento mais comuns foram fisioterapia, injeções de corticosteroides e administração de medicamentos anti-inflamatórios; alguns pacientes, porém, precisaram de cirurgia. Independentemente da intervenção, a grande maioria dos casos apresentou melhora da dor e da função, à exceção dos pacientes com lesão nervosa.

A SIRVA tem múltiplas possíveis etiologias, inclusive comprimento da agulha, lesão mecânica por penetração excessiva da agulha e resposta inflamatória aos componentes da vacina; no entanto, ainda não há um exame definitivo ou resultado quantificável.

Palavras-chave

bursite - impacto no ombro - dor em ombro - vacinas contra influenza


Publication History

Received: 20 May 2020

Accepted: 16 September 2020

Article published online:
16 December 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Cunningham LS, Kelsey JL. Epidemiology of musculoskeletal impairments and associated disability. Am J Public Health 1984; 74 (06) 574-579
    CrossrefPubMedGoogle Scholar
  • 2 Luime JJ, Koes BW, Hendriksen IJM. et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004; 33 (02) 73-81
    CrossrefPubMedGoogle Scholar
  • 3 Current Trends Vaccine Adverse Event Reporting System–United States. Accessed March 1, 2019 at: https://www.cdc.gov/mmwr/preview/mmwrhtml/00001804.htm
    Google Scholar
  • 4 The National Childhood Vaccine Injury Act of 1986. Public Health Service Act *** 2125. (42 U.S.C. *** 300aa-25 (Supp. 1987))
  • 5 Ryan T. 2011 Institute of Medicine (IOM) Report generated Proposals for Updates to the Vaccine Injury Table
  • 6 Vaccine Injury Table. [Accessed March 1, 2019] at: https://www.hrsa.gov/sites/default/files/hrsa/vaccine-compensation/vaccine-injury-table.pdf
    Google Scholar
  • 7 Atanasoff S, Ryan T, Lightfoot R, Johann-Liang R. Shoulder injury related to vaccine administration (SIRVA). Vaccine 2010; 28 (51) 8049-8052
    CrossrefPubMedGoogle Scholar
  • 8 Salmon JH, Geoffroy M, Eschard JP, Ohl X. Bone erosion and subacromial bursitis caused by diphtheria-tetanus-poliomyelitis vaccine. Vaccine 2015; 33 (46) 6152-6155
    CrossrefPubMedGoogle Scholar
  • 9 Terreri MT, Yamada AF. Osteitis caused by BCG vaccination. Pediatr Radiol 2008; 38 (04) 481
    CrossrefPubMedGoogle Scholar
  • 10 Barnes MG, Ledford C, Hogan K. A “needling” problem: shoulder injury related to vaccine administration. J Am Board Fam Med 2012; 25 (06) 919-922
    CrossrefPubMedGoogle Scholar
  • 11 Shaikh MF, Baqai TJ, Tahir H. Acute brachial neuritis following influenza vaccination. BMJ Case Rep 2012; 2012: 1-2
    CrossrefPubMedGoogle Scholar
  • 12 Messerschmitt PJ, Abdul-Karim FW, Iannotti JP, Gobezie RG. Progressive osteolysis and surface chondrolysis of the proximal humerus following influenza vaccination. Orthopedics 2012; 35 (02) e283-e286
    CrossrefPubMedGoogle Scholar
  • 13 Kuether G, Dietrich B, Smith T, Peter C, Gruessner S. Atraumatic osteonecrosis of the humeral head after influenza A-(H1N1) v-2009 vaccination. Vaccine 2011; 29 (40) 6830-6833
    CrossrefPubMedGoogle Scholar
  • 14 Bodor M, Montalvo E. Vaccination-related shoulder dysfunction. Vaccine 2007; 25 (04) 585-587
    CrossrefPubMedGoogle Scholar
  • 15 Cook IF. Subdeltoid/subacromial bursitis associated with influenza vaccination. Hum Vaccin Immunother 2014; 10 (03) 605-606
    CrossrefPubMedGoogle Scholar
  • 16 Saleh ZM, Faruqui S, Foad A. Onset of frozen shoulder following pneumococcal and influenza vaccinations. J Chiropr Med 2015; 14 (04) 285-289
    Google Scholar
  • 17 Hexter AT, Gee E, Sandher D. Management of glenohumeral synovitis secondary to influenza vaccination. Shoulder Elbow 2015; 7 (02) 100-103
    CrossrefPubMedGoogle Scholar
  • 18 Martín Arias LH, Sanz Fadrique R, Sáinz Gil M, Salgueiro-Vazquez ME. Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations. Vaccine 2017; 35 (37) 4870-4876
    CrossrefPubMedGoogle Scholar
  • 19 Floyd MW, Boyce BM, Castellan RM, McDonough EB. Pseudoseptic arthritis of the shoulder following pneumococcal vaccination. Orthopedics 2012; 35 (01) e101-e103
    CrossrefPubMedGoogle Scholar
  • 20 Cross GB, Moghaddas J, Buttery J, Ayoub S, Korman TM. Don't aim too high: Avoiding shoulder injury related to vaccine administration. Aust Fam Physician 2016; 45 (05) 303-306
    PubMedGoogle Scholar
  • 21 Okur G, Chaney KA, Lomasney LM. Magnetic resonance imaging of abnormal shoulder pain following influenza vaccination. Skeletal Radiol 2014; 43 (09) 1325-1331
    CrossrefPubMedGoogle Scholar
  • 22 Degreef I, Debeer P. Post-vaccination frozen shoulder syndrome. Report of 3 cases. Acta Chir Belg 2012; 112 (06) 447-449
    Google Scholar
  • 23 McColgan BP, Borschke FA. Pseudoseptic arthritis after accidental intra-articular deposition of the pneumococcal polyvalent vaccine: a case report. Am J Emerg Med 2007; 25 (07) 864.e1-864.e3
    CrossrefPubMedGoogle Scholar
  • 24 Bathia NA, Stitik T. “Influenza vaccine shoulder”–vaccination related traumatic injury to the infraspinatus: a case report [Poster presentation]. Assoc Acad Physiat Ann Meet 2010;. PM R 2009; 1: S118
    Google Scholar
  • 25 Shafer B, Burroughs K. Shoulder pain in a 25-year-old female following an influenza vaccination. Am Med Soc Sport Med 2010. Available at: https://www.amssm.org/shoulder_pain_in_a_25_year-csa
    Google Scholar
  • 26 Uchida S, Sakai A, Nakamura T. Subacromial bursitis following human papilloma virus vaccine misinjection. Vaccine 2012; 31 (01) 27-30
    CrossrefPubMedGoogle Scholar
  • 27 DeRogatis MJ, Parameswaran L, Lee P, Mayer TG, Issack PS. Septic Shoulder Joint After Pneumococcal Vaccination Requiring Surgical Debridement. HSS J 2018; 14 (03) 299-301
    CrossrefPubMedGoogle Scholar
  • 28 Jotwani V, Narducci DM. Pain in right shoulder · recent influenza vaccination · history of hypertension and myocardial infarction · Dx?. J Fam Pract 2019; 68 (01) 44-46
    Google Scholar
  • 29 Imran M, Hayley D. Injection-induced axillary nerve injury after a drive- through Flu shot. Clin Geriatr 2013;21(12):
    Google Scholar
  • 30 Meirelles H, Filho GRM. Axillary nerve injury caused by deltoid muscle intramuscular injection: case report. Rev Bras Ortop 2004; 39 (10) 615-619
    Google Scholar
  • 31 Erickson BJ, DiCarlo EF, Brause B, Callahan L, Hannafin J. Lytic Lesion in the Proximal Humerus After a Flu Shot: A Case Report. JBJS Case Connect 2019; 9 (03) e0248
    CrossrefPubMedGoogle Scholar
  • 32 Shahbaz M, Blanc PD, Domeracki SJ, Guntur S. Shoulder Injury Related to Vaccine Administration (SIRVA): An Occupational Case Report. Workplace Health Saf 2019; 67 (10) 501-505
    CrossrefPubMedGoogle Scholar
  • 33 Macomb CV, Evans MO, Dockstader JE, Montgomery JR, Beakes DE. Treating SIRVA Early With Corticosteroid Injections: A Case Series. Mil Med 2020; 185 (1-2): e298-e300
    PubMedGoogle Scholar
  • 34 Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) e1000097
    CrossrefPubMedGoogle Scholar
  • 35 Obremskey WT, Pappas N, Attallah-Wasif E, Tornetta 3rd. P, Bhandari M. Level of evidence in orthopaedic journals. J Bone Joint Surg Am 2005; 87 (12) 2632-2638
    CrossrefPubMedGoogle Scholar
  • 36 Bilgili SG, Karadag AS, Ceylan MF, Calka O, Turktas U, Bulut G. The development of giant lipoma on the BCG vaccine caused scar. Cutan Ocul Toxicol 2012; 31 (01) 70-73
    CrossrefPubMedGoogle Scholar
  • 37 Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 1999; 8 (04) 296-299
    CrossrefPubMedGoogle Scholar
  • 38 Minagawa H, Yamamoto N, Abe H. et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop 2013; 10 (01) 8-12
    CrossrefPubMedGoogle Scholar
  • 39 Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg 2001; 10 (03) 199-203
    CrossrefPubMedGoogle Scholar
  • 40 Centers for Disease Control and Prevention. Dose, route, site, and needle size. [Accessed March 22, 2019] at: www.immunize.org/catg.d/p3085.pdf
    Google Scholar
  • 41 Poland GA, Borrud A, Jacobson RM. et al. Determination of deltoid fat pad thickness. Implications for needle length in adult immunization. JAMA 1997; 277 (21) 1709-1711
    CrossrefPubMedGoogle Scholar
  • 42 Lippert WC, Wall EJ. Optimal intramuscular needle-penetration depth. Pediatrics 2008; 122 (03) e556-e563
    CrossrefPubMedGoogle Scholar
  • 43 Cook IF, Williamson M, Pond D. Definition of needle length required for intramuscular deltoid injection in elderly adults: an ultrasonographic study. Vaccine 2006; 24 (07) 937-940
    CrossrefPubMedGoogle Scholar
  • 44 Zuckerman JN. The importance of injecting vaccines into muscle. Different patients need different needle sizes. BMJ 2000; 321 (7271): 1237-1238
    CrossrefPubMedGoogle Scholar
  • 45 Beals TC, Harryman 2nd DT, Lazarus MD. Useful boundaries of the subacromial bursa. Arthroscopy 1998; 14 (05) 465-470
    CrossrefPubMedGoogle Scholar
  • 46 How to Administer Intramuscular and Subcutaneous Vaccine Injections to Adults. [Accessed March 15, 2019] at. http://www.immunize.org/catg.d/p2020A.pdf
    Google Scholar
  • 47 Dumonde DC, Glynn LE. The production of arthritis in rabbits by an immunological reaction to fibrin. Br J Exp Pathol 1962; 43 (04) 373-383
    PubMedGoogle Scholar
  • 48 Cooke TD, Jasin HE. The pathogenesis of chronic inflammation in experimental antigen-induced arthritis. I. The role of antigen on the local immune response. Arthritis Rheum 1972; 15 (04) 327-337
    CrossrefPubMedGoogle Scholar
  • 49 Cooke TD, Hurd ER, Ziff M, Jasin HE. The pathogenesis of chronic inflammation in experimental antigen-induced arthritis. II. Preferential localization of antigen-antibody complexes to collagenous tissues. J Exp Med 1972; 135 (02) 323-338
    CrossrefPubMedGoogle Scholar
  • 50 Jasin HE. Mechanism of trapping of immune complexes in joint collagenous tissues. Clin Exp Immunol 1975; 22 (03) 473-485
    PubMedGoogle Scholar
  • 51 Trollmo C, Carlsten H, Tarkowski A. Intra-articular immunization induces strong systemic immune response in humans. Clin Exp Immunol 1990; 82 (02) 384-389
    CrossrefPubMedGoogle Scholar