Risk for Shoulder Conditions After Vaccination: A Population-Based Study Using Real-World Data
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Risk for Shoulder Conditions After Vaccination: A Population-Based Study Using Real-World Data

Filetype[PDF-566.08 KB]


English

Details:

  • Alternative Title:
    Ann Intern Med
  • Personal Author:
  • Description:
    Background:

    Although shoulder conditions have been reported as an adverse event after intramuscular vaccination in the deltoid muscle, epidemiologic data on shoulder conditions after vaccination are limited.

    Objective:

    To estimate the risk for shoulder conditions after vaccination and assess possible risk factors.

    Design:

    Retrospective cohort study.

    Setting:

    Kaiser Permanente Southern California, a large integrated health care organization.

    Participants:

    Kaiser Permanente Southern California members aged 3 years or older who had an intramuscular vaccination administered in the deltoid muscle between 1 April 2016 and 31 December 2017.

    Measurements:

    A natural language processing (NLP) algorithm was used to identify potential shoulder conditions among vaccinated persons with shoulder disorder diagnosis codes. All NLP-identified cases were manually chart confirmed on the basis of our case definition. The characteristics of vaccinated persons with and without shoulder conditions were compared.

    Results:

    Among 3 758 764 administered vaccinations, 371 cases of shoulder condition were identified, with an estimated incidence of 0.99 (95% CI, 0.89 to 1.09) per 10 000 vaccinations. The incidence was 1.22 (CI, 1.10 to 1.35) for the adult (aged ≥18 years) and 0.05 (CI, 0.02 to 0.14) for the pediatric (aged 3 to 17 years) vaccinated populations. In the adult vaccinated population, advanced age, female sex, an increased number of outpatient visits in the 6 months before vaccination, lower Charlson Comorbidity Index, and pneumococcal conjugate vaccine were associated with a higher risk for shoulder conditions. Among influenza vaccines, quadrivalent vaccines were associated with an increased risk for shoulder conditions. Simultaneous administration of vaccines was associated with a higher risk for shoulder conditions among elderly persons.

    Limitation:

    Generalizability to other health care settings, use of administrative data, and residual confounding.

    Conclusion:

    These population-based data suggest a small absolute risk for shoulder conditions after vaccination. Given the high burden of shoulder conditions, clinicians should pay attention to any factors that may further increase risks.

    Primary Funding Source:

    Centers for Disease Control and Prevention.

  • Subjects:
  • Source:
  • Pubmed ID:
    35313110
  • Pubmed Central ID:
    PMC9117507
  • Document Type:
  • Funding:
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