ACV meeting statement, Meeting 11, 5 December 2018

Section A: Submissions for registration

No item was on the agenda regarding a submission for registration.

Section B: Safety and Section C: Immunisation Programs

The committee provided advice on one issue.

Shoulder Injury Related to Vaccine Administration (SIRVA)

The number of cases of SIRVA reported to the TGA has increased each year since 2012, although it remains a rare adverse event.

SIRVA occurs when a vaccine is incorrectly administered. Bursitis, ‘frozen shoulder’ and other types of shoulder pain and injury can occur. Many patients require ongoing management for weeks or months following vaccination and there can be significant pain and decreased mobility. The ACV members noted that rates of local injection site pain soon after vaccination differs between vaccines and these local reactions are different to the longer-lasting SIRVA reactions.

The committee noted previous work to reduce the occurrence of SIRVA ^[1] and recent American data on shoulder dysfunction following inactivated influenza vaccine.^[2]

Members noted that there has recently been an increase to the length of needles attached to pre-filled syringes of influenza vaccines, to facilitate intramuscular injection. The shorter needle previously provided for subcutaneous injection would have limited inadvertent injection into the sub-deltoid bursa or joint space.

The ACV supported an educational initiative such as a fact sheet for all vaccinators on injection technique and the avoidance of SIRVA.

Further information

For further information on the ACV, please visit Advisory Committee on Vaccines or contact the ACV by email ACV@health.gov.au.