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

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  • English
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    Details:

    • Alternative Title:
      Ann Intern Med
    • Publisher's site:
    • 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.

    • Subject:
    • Source:
      Ann Intern Med. 175(5):634-643
    • Pubmed ID:
      35313110
    • Pubmed Central ID:
      PMC9117507
    • Document Type:
      Journal Article
    • Funding:
      CC999999/ImCDC/Intramural CDC HHSUnited States/
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