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

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Zheng, Chengyi ; Duffy, Jonathan ; Liu, In-Lu Amy ; Sy, Lina S. ; Chen, Wansu ; Qian, Lei ; Navarro, Ronald A. ; Ryan, Denison S. ; Kim, Sunhea S. ; Mercado, Cheryl ; Jacobsen, Steven J.
• 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:
  Adolescent Adult Aged Article Child Child, Preschool Female Humans Incidence Influenza Vaccines Male Middle Aged Retrospective Studies Shoulder Vaccination Young Adult

  More +
• 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/
• Volume:
  175
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7cb3f974073f9765d76eab36b1680e546fa1606033c0126fc52a924914b396fd
• Download URL:
  https://stacks.cdc.gov/view/cdc/117640/cdc_117640_DS1.pdf
• File Type:
  [PDF - 566.08 KB ]