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Risk for Shoulder Conditions After Vaccination: A Population-Based Study Using Real-World Data
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5 2022
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Source: Ann Intern Med. 175(5):634-643
[PDF-566.08 KB]
Details:
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Alternative Title:Ann Intern Med
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Personal Author:
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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.
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Subjects:
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Source:
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Pubmed ID:35313110
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Pubmed Central ID:PMC9117507
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Document Type:
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Funding:
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Volume:175
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Issue:5
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