Got Pfizer Feb- SIRVA next day -concerned that vaccine did not take

Hi Katherine, currently the recommended dosing and scheduling for the Pfizer-BioNTech COVID-19 Vaccine is a 2-dose series separated by 21 days (https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/).

Members here on Mayo Clinic Connect are not medical professionals and cannot make medical recommendations. It is best to rely on your doctor's advice or, if necessary, seek a second opinion. Are protective measures practised at your place of employment like masks, distancing and hand washing? Are students vaccinated?

I too developed SIRVA after my 2nd Moderna shot. None of my doctor's seemed concern. If you find out anymore info please let me know!

Here is an article that may help: https://www.health.com/condition/flu/sirva

It describes how SIRVA can occur from a wrongly placed injection. My daughters are both nurses, and each spent a long time perfecting her injection technique to avoid causing this problem.

According to my PCP, the standard protocol for sustained (3+ months) of pain that does not respond to icing, analgesics and exercise is a steroid injection. The proper site for injection of a steroid must be determined by ultrasound or other imaging.

To avoid this issue in future injections, have you PCP or a skilled nurse show you how to "landmark" your correct injection sit, and pay attention whenever anyone is preparing to give you a shot. If they are not locating it correctly, STOP them and insist they check again.

Finally, SIRVA does not mean you are adversely reacting to the vaccine itself, so don't avoid it in future.

Sue

Unfortunately Sue, this article does not help! As much as I wanted to have a skilled nurse at Mayo give me the vaccine, I somehow slipped through their algorithm and was not called. Ended up at a Walmart with a Pharmacist assistant. We know that SIRVA is from a wrongly placed injection. What we do not know is whether the vaccine was effective. Would love to find some research on this.

I suspect I have SIRVA. Shoulder was perfect before getting a vaccination. Saw orthopedic doctor who ordered X-rays, then gave a cortisone shot and prefer PT. Condition got worse. Then got an MRI which showed inflammation and fluid in Bursa. Then got another cortisone shot in the bursa. Condition continued to get worse. Have limited range of motion and pain if I try to stretch or move on certain directions. Taking ibuprofen several times during the day and can’t sleep at night. Anyone have similar story? Any suggestions for next steps?

@esw Hello, and welcome to Connect. We are not medical professions, so we can't diagnose medical problems, but we can share our experiences. I had only one flu shot in my life and it caused my shoulder to swell, so for about 3 months, I could not raise my arm straight up over my head. I had presumed it was an allergy issue with eggs used to culture the vaccine, but it could have been another ingredient in the vaccine. Later I saw an orthopedic doctor for a shoulder instability problem and he did a diagnostic MRI with a gadolinium injection into the shoulder capsule. That caused swelling and a lot of pain right away... so much pain that just the amount my shoulder moved while I was breathing hurt. Moving my arm at all was out of the question, so I put my arm in a sling. It took about 6 weeks until that started getting better, and I had a frozen shoulder. These were old issues, but 6 years ago, I had a diagnostic epidural steroid injection in my spine. That caused immediate pain and burning electrical zapping pains in my hand. Then the doctor injected a dye to evaluate why I had so much pain. I was prescribed a steroid card of pills, but it didn't help. The shooting pain went on for about 6 weeks. The first 2 weeks were the worst, and it got less frequent as time went on. Every time I moved, I got a sharp stabbing pain, so I stayed in bed as much as possible and didn't move. Last March, I had the first Pfizer vaccination for Covid and had an allergic reaction. I had an immediate headache, and noticed a slight pain in the back of my tongue about 45 minutes after the injection, so they sent me to the emergency room. With an IV of antihistamine and a steroid, I felt fine with no symptoms in 20 minutes and they sent me home. The next day, I felt fine, no symptoms, but the 2 days after that, I had asthma breathing issues, headache, some slight facial swelling, and some tingling on my face (presumably caused by the swelling). I took antihistamines, and used my asthma inhalers and the symptoms were controlled.

What all of these reactions might be telling me is that I have an allergic reaction to polyethylene glycol ( "PEG") or an ingredient of a product that was injected. PEG is an ingredient in the Pfizer Covid vaccine and there is a similar component in the Moderna vaccine. I had found something online from another patient about a spinal cortizone injection that caused a problem and he discussed polyethylene glycol as an ingredient of the injection that he thinks caused his reaction. I don't have specific information about ingredients of various products, but this is information that a pharmacist will know, and that is a good question to ask any time an injection is concerned if there was a previous adverse reaction. It is worth asking and keeping track of what the common ingredients are in any injection or prescription that caused a reaction.

I was not able to get the second Pfizer dose, and I completed my Covid vaccination with the J & J vaccine. Instead of PEG, the J & J uses Polysorbate 80 which is a food additive that is used in some ice cream among other things. I tested it by eating at Dairy Queen and that gave me some asthma issues and a headache for a day, but nothing like the reaction to the Pfizer. After the J & J vaccination, I did feel like I had a mild case of the flu for 48 hours, but it resolved quickly after that.

Everytime I had an issue, time resolved it, and sometimes physical therapy to treat a frozen shoulder. When I discussed my Pfizer vaccine response with my doctor, he advised me to use anti-histamines and 3500 mg vitamin C prior to vaccination, get plenty of sleep before and also use my preventative asthma inhalers. I did that before my J & J vaccination and it helped.

After reading your story, I wonder if every steroid injection just made it worse because it injected something your body reacts to. If you just had a vaccination containing PEG and reacted to that, did the steroid injections also contain PEG? That would be a question to ask your orthopedist. Since you have a lot of inflammation that is evident on your imaging, trying to stretch is probably not going to help. Have you tried soaking in an Epsom salt bath? That will allow your skin to absorb magnesium which is needed for detoxification. I don't know if it will help your shoulder inflammation, but it might help you relax a bit. Have you tried taking an over the counter anti-histamine? That helped my reaction to PEG. I think it will just take time for your body to process this and to detox and remove it. I know sleeping is tough when you are in pain. Have you tried ice packs on your shoulder? It sounds like you already have a frozen shoulder, and it might be better to wait until the pain subsides before you try PT to move it. You should ask if PT could cause damage to your joint to try to move it while it is in this inflamed state. Your doctor was trying to help, but unfortunately it made things worse. I think you will be OK in time just based on my experience in a similar situation, and you will need to be proactive in the future and question everything and possible adverse effects of medical procedures.

Hi @esw, I echo @jenniferhunter welcome. You will notice that I moved your post to a discussion that is ongoing about the same subject as yours. I did this so you could connect with people like @seaspray, @sueinmn, and @katherine345

Did you happen to catch Jennifer's questions above? Would love to hear your answer to those.

Thank you for putting my post with the others that deal with Frozen shoulder caused by an incorrectly delivered COVID vaccine. The shoulder continues to be frozen, but the sharpe pains have decreased over the last month (4 months since vaccine) but my real major concern if only being partially vaccinated with the Variants entering the US. Dr. Fauci said 1 shot is only 30 percent effective against the COVID Variants. I still can't get any advice about the safety of getting a 3rd Pfizer shot. As far as I know antibody tests are still not considered a good indication of how vaccinated a person is and booster shots are not yet available. Any advice is appreciated. Thank you.

@katherine345 You may want to look at my long post above yours about reactions to the vaccine ingredients. I have reacted to a lot of stuff and had an allergic reaction to my first Pfizer Covid vaccination a few months ago, and I could not get a second dose. I recently got the J & J to complete my Covid vaccinations. That is a bit hard to find since most US pharmacies in my area are doing either Pfizer or Moderna. I believe I had an allergic reaction to "PEG" polyethylene glycol which is an ingredient. I was able to get the J & J which uses Polysorbate 80 instead of PEG, and that can cause cross reactions if you have allergies to PEG. I managed fine by proactively using antihistamines, vitamin C, and my asthma inhalers on my doctor's advice. Recent stories about the J & J vaccine said it was effective against the Delta variant.

Wish I could be of some help to those that got the frozen shoulder! Fortunately, I just googled it and went the non-steroid route. I did the shoulder stretches with horrible pain as I learned you need to keep using and moving the shoulder. I graduated to light weights and I am proud to say my shoulder is fine. Have still not found any research on how much antibodies are developed when the vaccine is shot into the bursa. My doctor's at Mayo have no clue. Best wishes to those affected with this. Feel free to message me!