The People's Perspective on Medicine

Long Lasting Shoulder Pain After Flu Shot

The CDC states side effects from a flu shot are generally mild and go away within a few days. Some of our readers are left with long lasting shoulder pain.
Doctor giving patient vaccine, flu shot. Doctor making a vaccination in the shoulder of patient

Getting a flu shot is supposed to be your best protection against influenza. Since September we have all been encouraged to get our flu shot. Most of the reports we have seen this year suggest that this could be an especially nasty year for influenza. That’s partly because the Australians really suffered, and they have a six-month lead on us. Then there are questions about the match between the vaccine and the actual flu viruses that are circulating. But one thing you will likely not read about is long lasting shoulder pain triggered by a flu shot.

Mums the Word on Flu Shot Side Effects:

The CDC tends to play down any complications from the influenza vaccine. We’re not quite sure why that is. Here is what these public health officials state about adverse reactions: 

“Do flu vaccines cause any side effects?

“Like any medical product, vaccines can cause side effects. Side effects of the flu vaccine are generally mild and go away on their own within a few days.

“Common side effects from the flu shot include:

• Soreness, redness, and/or swelling from the shot
• Headache
• Fever
• Nausea
• Muscle aches”

What the CDC Does Not Tell You About Flu Shots:

Rarely, if ever, are people told how the influenza vaccine should be administered. The assumption is that whoever gives you the shot has been well trained. That may not always be true.

Years ago, most flu shots were administered by nurses or even doctors. Now, many people get their vaccinations at the pharmacy.

Starting early in the fall, the signs come up promoting influenza vaccines, sometimes even for free. If you take advantage of such an offer, make sure the person who gives you the shot knows how to do it correctly. Read on to find out why that’s important!

A Pharmacist Suffered Long Lasting Shoulder Pain:

We got this message from a pharmacist who had a bad experience from a flu shot:

“I don’t always get the flu shot, but I was training an intern and I thought I would let him give me a flu shot. I am a pharmacist and we are pushed to make vaccine quotas. With an intern helping, the demand is less burdensome.

“I told him to give the shot in the thickest portion of the deltoid as I was trained to do. He was trained, as many are now, to give the shot in the triangle at the high part of the upper arm.

“The shot did not cause discomfort initially, but over the course of several months, I have been experiencing more pain. At first it was mainly at night, but now I have pain throughout the day as well. The discomfort is in the arm and not at the joints.

“I am required to meet a specific quota of flu shots this year and people often ask, ‘Did you get yours?’ I tell them I had a bad reaction and it is no longer recommended for me. I believe that technique was responsible, not the immunization itself.”

A Nurse Suffered Long Lasting Shoulder Pain:

Pharmacists are not the only ones who may have a problem.

We also heard from a nurse:

“As a nurse, I am required to get the flu vaccine. I did so this year in September at my local drugstore. I started experiencing pain the next day, and now, approximately a month later, I have limited range of motion above my head, a constant pain throughout the day and if I roll over on my left side at night, the pain wakes me up.

“I reported this to my physician four days ago. He said, ‘It’s probably a pinched nerve in your neck.’

“When I mentioned the possibility of an adverse reaction to the flu vaccine or the technique, he immediately dismissed the idea. This is NOT a normal reaction to the flu vaccine. I’d like to get the word out to the public, especially physicians.”

SIRVA: Long Lasting Shoulder Pain After a Flu Shot

Some doctors already recognize the problem of long lasting shoulder pain. They even have a name for pain in the shoulder or upper arm following a vaccination. They call it SIRVA: shoulder injury related to vaccine administration (Canadian Family Physician, Jan. 2019). 

The cause is apparently missing the deltoid muscle where the intramuscular injection should be given. Experts urge vaccinators to use a “landmark” technique rather than relying on “eyeball” measurement. The upper edge of the deltoid is two to three finger widths below the acromion at the very top of the arm. (People with thick fingers should use two, those with slender fingers three.)

The armpit marks the lower border for a good injection. The needle should be held at a 90 degree angle to the arm, with the thumb and forefinger in a V keeping the deltoid muscle visible during the injection.

Was that confusing? We’re not surprised. It can be challenging to imagine where the shot should be administered.

Clear directions and an informative graphic can be found in the article found in Canadian Family Physician. We urge every vaccinator to read it carefully. We also think that patients should become familiar with the proper technique and make sure the person who is giving the shot knows how to do it correctly. Here is a link to the pdf format of that article:

It might be a good idea to print out the graphic and show it to the shot administrator. Make sure they know precisely where the “sweet spot” is before you let them stick you!

More Stories of Shoulder Pain from Flu Shots:

We are not totally convinced that every story of long lasting shoulder pain is due to bad technique. The newer, more potent vaccines may also have something to do with it. Here are a few more reader stories:

This comes from Sally:

“My shoulder hurt right after the shot was given. The shot itself hurt to the point I was about to yell out a big ole ‘OWW That’s Enough!’

“The pain has moved from the front of my shoulder to covering the whole top of it, to the tip of my deltoid! The pain moves to a different place every day! It’s so creepy. I can’t rake the yard or sweep a floor unless I want to be in 100% complete agony for two days afterward.

“If I get on the treadmill at the gym or do any exercise at all, it sets it off so bad that I feel like I am giving birth to an alien species through my arm! I have had an X-ray, MRI and I am now on my way to physical therapy. Everyone is stumped.

“I just want to be able to drive myself around, pull up the blankets on my bed with my left arm without searing pain like I just ripped my arm open. I want the mysterious strange worm-like jolts to stop. I swear some days it feels like there is something crawling or wiggling around in there. Getting the flu for two weeks is far better than the six months of pure hell I am going through!”

Mark has also experienced long lasting shoulder pain:

“I had a flu shot administered at my allergist’s office months ago. My wife noted that the bandage that covered the shot was extremely high but I ignored it as trivial. That night the pain started like an engine on a racetrack.

“After a week of tolerating the pain I went back to my allergist who, with great concern, sent me to an orthopedist. I was given a prescription for a week of prednisone. It was no better than taking an aspirin. I went back for another visit, and an MRI was the next step after a shot of cortisone was injected. Within a day there was relief, and I could sleep again.

“In the ninth week the pain has returned once again. The next thing is physical therapy. I hope that works. I went from a very active person to one who moves with unyielding shoulder pain and a docile life style. I watched the pharmacist at a local CVS administering shots and noticed not one single shot was anywhere near where I got mine.

“I am concerned that I was told it was ‘just how my body reacted to it!’ Funny how weekly allergy shots for 15 years and yearly flu shots never caused such a problem. All of a sudden I am told it’s my body’s fault.”

Here is Sharon’s story:

“I received a flu shot at my local big-name pharmacy in 2017. Everything was fine until two weeks later when suddenly my arm became extremely painful. I was unable to lift it, and it felt like something was twisting inside. When this happened, I received a severe jolt that really hurt.

“I tried acupuncture, massage and a chiropractor, all to no avail. I was unable to use my arm to drive and also could not lie on that side. It even hurt when I wasn’t lying on that side but at least it was bearable. I’m slowly getting better but doubt if I’ll ever be back to normal.”

Reporting Vaccine Adverse Reactions:

Did you know that the CDC encourages patients to report flu shot problems? Here is what this public health agency states:

“What should I do if I think I am having a severe reaction to a flu vaccine?

“If you think it is a severe allergic reaction or other emergency that can’t wait, call 9-1-1 and get to the nearest hospital. Otherwise, call your doctor.

“Afterward, the reaction should be reported to the Vaccine Adverse Event Reporting System (VAERS).

 “Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.”

Here is the website to file a report.

What If You Have Been Harmed by a Flu Shot?

“If you believe you have been injured by a flu vaccine you may be eligible to receive compensation from the federal government for your injuries if certain criteria are met. To learn more visit the National Vaccine Injury Compensation Program websiteexternal icon or call 1-800-338-2382.”

How Many Have been Harmed?

We have been trying to find out how many people have been harmed and/or compensated for flu vaccine injuries. What was the nature of the injury? This information is not that easy to locate. This is the best we could come up with about vaccines in general. We wonder how many people know about the National Vaccine Injury Compensation Program.

“According to the CDC, from 2006 to 2017 over 3.4 billion doses of covered vaccines were distributed in theU.S. For petitions filed in this time period, 6,571 petitions were adjudicated by the Court, and of those 4,525 were compensated. This means for every 1 million doses of vaccine that were distributed, approximately 1 individual was compensated.

“Since 1988, over 21,491 petitions have been filed with the VICP [Vaccine Injury Compensation Program]. Over that 30-year time period, 18,473 petitions have been adjudicated, with 7,044 of those determined to be compensable, while 11,429 were dismissed. Total compensation paid over the life of the program is approximately $4.2 billion.”

Share Your Story About Shoulder Pain or…

Share your own flu shot story below. Was your influenza vaccine uneventful? Have you experienced long lasting shoulder pain? Have you reported your adverse reaction from a vaccine to the VAERS system? Please let others know about your experience in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Citations
  • Bancsi, A., et al, "Shoulder injury related to vaccine administration and other injection site events," Canadian Family Physician, Jan. 2019, PMCID: PMC6347325
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I seem to have the shoulder pain from the pneumonia shot – pain was immediate and soreness has continued for a couple of months now – its not limiting (yet!) but is noticeable particularly if I sleep on that shoulder. I thought at the time of the shot that it was awfully high on the arm.

The speed the plunger is pressed into the syringe is missing in your article. Experience tells me that a shot where the plunger is pressed in rapidly will be painful for 2 to 5 days while a shot from a sloooowww plunger push will have little to no next day pain.

Why? I think it is because a rapid plunger push will push the syringe contents to force muscle fibers apart too quickly to make space for the syringe contents. And with a slow plunger push, the syringe contents will flow between the muscle fibers and not cause pain. For the last several years, I have so requested to all my shot givers.

I had an issue of long-lasting shoulder pain which began right after my flu shot several years ago. My problem was that I experienced intense pain when reaching behind me with that arm. With time and gradual yoga stretches it finally resolved after about 18 months.

Since then, I always stand when getting my shot so that the needle is at a 90-degree angle. And I always tell the shot administrator about my prior problem. Amazingly, most of them have never heard of this issue with flu shots, so thanks for making this info more widely available!

I had 2nd Shingrix shot in July 2019 and am still experiencing pain in my shoulder in January 2020. I went to my primary doctor and he said he felt a bump or cyst at the injection site. He called it a hematoma. Told me to take ibuprofen and apply hot compresses. A month later still no improvement so he had me get an ultrasound which showed nothing and then referred me to a surgeon. Surgeon said she couldn’t feel anything and sent me on my way.

Did a month of physical therapy which did not help and finally had an MRI. Orthopedic surgeon went over my results which showed a healthy deltoid and shoulder. He said he has seen many cases of this injury from shots that were given improperly. He told me to go back to my usual exercise classes, and eventually the pain should go away. He did tell me it could take up to a year! I did feel relieved that the hematoma had disappeared and am back exercising. However, the pain is still present although not quite as intense. In the future I will only have shots administered by doctor or nurse.

I decided to make a report after reading all the comments that are so similar to mine. I got the flu vaccine on 10/10/19 and noticed pain in my shoulder, under arm even extending along the rib cage about 2 weeks later.The pain continued to increase for a good 6 weeks leaving me confused but suspecting the shot in the arm because of the timing of onset of symptoms. “Ouch”is an understatement to describe the swollen, hot, radiating and unusable arm dangling from my torso. I went to see a PA for the pain and suggested the cause might be the flu vaccine. This was discounted by practitioner so X-Ray was prescribed, administered with it showing a possible cyst on upper humerus. I declined the referral to an orthopedist because I have a high deductible and decided to do online research since I hadn’t done any other activity that would cause pain or injury. I feel compassion for those who have had to go through this but relieved to know what caused it. I’ve used professional massage heat, yoga, and have gradually added movement to increase range of motion. Hope this helps assure others that healing is possible, is not always linear, & takes time.

Oh, no! I just started getting “excruciating zinger pains in my shoulder at just about the spot where I received the shot,” as Carol described. I read the description and looked at the PDF, but I still don’t understand how I would know if they are doing it right or wrong. Our office building offered it for free (submitted to insurance, I believe), so I don’t know what type of training the people doing it received.

Oddly enough, I had this same type of reaction from a blood draw one time. Very painful shoulder for a good month, but it did eventually resolve.

Thank you for clearing up a mystery! I have been experiencing shoulder pain for a while with no known cause until now. I can trace the onset of pain to around the time I was administered a flu shot from a pharmacist in October 2019. Not only does my right shoulder hurt, but there might be possible nerve damage, as my pinkie finger on my right hand now occasionally goes numb. I have been trying physical therapy and it has been somewhat successful at alleviating the pain.

On 9/16/19, a nurse at our primary care physician’s office
administered the flu vaccine to both my wife and to me.
My experience was totally painless then as now. My wife had some pain at administration, and she still suffers shoulder pain to this day. My guess is the nurse administered the vaccine well with me, but not so well with my wife. Thanks for the description of the proper method for administration. It will help us in the future.

I received my flu shot about 6 weeks ago. About 3 weeks ago, I started getting excruciating zinger pains in my shoulder at just about the spot where I received the shot. The pain would pulse on and of for several minutes and then stop.
I am grateful to see that I’m not imagining this fantom pain.

Flu shots always cause my arm to ache the rest of the day and then be sore the following day. Have had good luck taking a freezer pack with me and slapping in on immediately after the shot and using it off and on the rest of the day, usually sandwiched between a tee shirt and a sweater.

Several years ago, I was given a flu shot at an employee health fair. Arm pain developed shortly thereafter that kept me from sleeping soundly at night. So I went to my doctor and was given steroids that, thankfully, took care of the problem. I think it was the way the shot was administered because I normally don’t get reactions to injections.

I am a nurse and got my required flu shot at work by a technician from an agency our hospital outsourced this season. While she was preparing the site I was wondering why she was cleaning the area so high on my arm but before I could say anything she injected the vaccine high into my left shoulder, up near the top of my arm. It felt weird going in, and the bandaid was placed over the site way up on my arm.

I didn’t think anymore about it until later when it was difficult to move my arm laterally to reach for the phone and printer. It was more of a joint pain than the typical muscular discomfort I have felt in the past with flu shots. I took ibuprofen and use ice packs initially. The pain worsened over the next few days, and it was difficult to pull clothing over my head. It was also very difficult to sleep. I mentioned it to the employee health manager since flu shots were continuing at our hospital, and I was asked to submit an event report. I was called in for an evaluation by our employee health MD, and she confirmed that the injury was from the injection. I never heard of this before.

I was given a medrol dose pack and then diclofenac. These did not help so I was sent to an Orthopedic shoulder specialist who said that he was at first skeptical about this injection-related injury but he was seeing more of these injuries lately so he was resigned to believe that this was real. Xrays did not show any structural damage so he ordered physical therapy. After about 5 weeks of PT the bursitis type pain finally resolved.

All together, it was about 3 months of discomfort. I am grateful that my SIRVA healed but I will be watching my next flu shot administration very closely. Maybe we should go back to having educated RNs and physicians administer injections. I’m just saying this was not a common problem when that was the case.

I’m going through similar pain and discomfort with my upper left arm. I’ve received cortisone shots with no relief. I next saw an orthopedist who recommended physical therapy. I have an appointment with one in 2 days. But after reading the article about improper technique in giving the flu shot, I’m now wondering if I should just cancel the appointment and take Aleve to deal with the nightly discomfort until it, hopefully, goes away.
Any advice on how to deal with this problem would be appreciated?

I am 61 years and have had the flu once in my life. I am a physical therapist and work around sick people daily. As the result of mandatory flu vaccinations I have received several flu vaccine injections over the past few years. I always have adverse reactions which have consisted of general malaise and fatigue which last for several months. Also I have been diagnosed with severe degenerative changes of both shoulders. ( I alternated the injection)right to left after the right shoulder pain became severe. Long story short I believe the vaccine triggered a low level inflammation on my shoulders which led to the cartilage breaking down. Never will take another flu or pneumonia vaccination!

Every year I got the flu shot my arm was sore for several weeks. I could not sleep on that side, and it felt warm to the touch. A friend, a doctor, told me to take a dose of Tylenol before getting the shot. I did and have not had a problem since.

Wish you had suggested what to do if severe chronic pain. How does RTI relieve? How long does it last?

This happened to me with my first Shingrix shot, which I got at a supermarket pharmacy. It was also given high on the shoulder. Pain lasted for months. I went to my doctor for the second Shingrix shot and had no problem.

I have experienced mild shoulder pain in my left upper arm off and on since I received my flu shot months ago. I never experienced this before with a flu shot so I do notice it. After reading some of the stories in this article, I am concerned about getting a flu shot next year. I no longer work in health care so maybe I don’t need one. I am sorry for those individuals who had much worse shoulder and arm pain.

This happened to me but with the pneumonia vaccine. I noticed that the nurse gave the shot higher up on my shoulder than normal. Within two hours I was in such pain in that area. By evening I could not move my arm and was crying in agony. My husband had to remove my top, as I was unable to raise my arm. This lasted for a couple weeks. I called my doctor’s office and said I will never have a pneumonia shot again.

I similarly had a “bad reaction” this year to the “enhanced/2,3,4-times stronger/more serum” etc. flu shot. It’s the one that supposedly if you’re older than 65, you’re supposed to get. My local pharmacist of a better grocery chain (I like her, known her for years, received shots from her before) gave me the shot. Instead of “catching-a-cold-leading-to-bronchitis/flu/’crud-going-around'” so commonly in the last dozen years, I had severe arm pain. I believe the pain was between 1-4 inches lower than where the shot was given, the upper-quadrant/triangle of shoulder. This was more the middle of my upper left arm. It was a sharp, hot, intense pain, not so noticeable during the day and “positional” in intensity. Move the arm, it could go away. However, at night: first pains, throbbing, wake me from sound sleep; then increasingly; steady for some 10 day, and then diminishing over the next month. OTC analgesics, cold or hot compresses, nothing seemed to affect it.

October 8 for the shot, then November 5 I visited my doctor (every 4+ months), and showed him where the pain was—and the odd scar. I know the shot was higher, by some 4-finger-widths.

Fortunately, the pain has gone away, sometime by about Thanksgiving. My doctor’s advice was that the advice now he read/advised?/ was to not get the “over-65-flu-shot,” so I suppose it’s the formulation of the shot I got.

(CDC report I filed online, specifics of vial, etc., given to my pharmacist whom I can only hope actually did fill-out the required information and mailed it in the envelope I provided her. She was familiar with the process. CDC had sent me a letter requesting un-filled–in information, for them to follow-up with her.)

Fortunately, at this point in life, I sleep no upon either side, on my back (previous shoulder injuries over the years caused a change several years ago, to sleeping upon back deeply reclined.) Would I like money for my “pain and suffering”? Sure. Do I desire pursuing government & legal-bureaucracy to ultimately get too little, too late? Naw, someone like me never gets anything but, “settle-fors”, instead of “get-evens” or “get-ahead/fully-compensated.”

Thank you for letting me vent about my experience.

I have had no issues with my flu shots, but I received the 2nd dose of the shingles vaccine one year ago, and that was a different story. I had the shot at an independent pharmacy (the only place where it was available at the time). It was moderately painful going in, and the next day I felt like I had been run over by a Mack truck. Soon after, I found that each time I rolled over onto my let side at night, I woke with a jolting pain in my upper arm. A year later, I still have discomfort if pressure is applied to the upper arm, and I still am unable to sleep on my left side. I have mentioned it to the PA whom I see on a regular basis, but have not reported it to the VAERS system.

I had a pharmacy flu shot several years ago. I am a nurse, and I knew it was wrong immediately. Pain went up in my shoulder. Doctor prescribed physical therapy for severral months. It didn’t help. Eventually I had rotator cuff surgery because scans showed it was torn. I told them it all started with my flu shot but nobody seriously believed me.

I got my annual flu shot on October 9th at 11:50 am. I remember this vividly because I haven’t had a fully-functioning left arm since. It was the first time my MD administered the shot, which usually is administered by a member of her support staff. Never again. My entire holiday season was made less enjoyable by the constant pain and now, shoveling unrelenting snow has become an NSAID-consuming extravaganza.
I attempted to complete the reporting form but really, it was so invasive that I decided instead to alert my PCP to the situation and rely on her integrity to address the situation. No wonder the injury is underreported — who has the time, equipment, patience, skill and disinterest in privacy to do it justice? There MUST be a better way.

This problem is not restricted to flu vaccine. I have had pain for months after flu shots were given at a 90 degree angle to skin, with the injection at (? or into) the periosteum. A zoster/shingles shot a few years ago still is painful and pruritic; I have had no shots in the same arm afterwards, so I am pretty sure what the problem is. People who give shots should be taught to inject vaccines into muscle, not bone!

I have a strange reaction possibly to this year’s flu shot: it left a 2-3” dark area on arm. Still there after several months. One year after a flu shot, I noticed I started to drop things. After breaking 2 wine glasses in public made me realize something was wrong. I told a massage therapist. She felt where the needle had hit the nerve and said its common! She was able to massage it out.

Could the pain be related to statins? I tried taking statins and immediately noticed a sharp pain in my arm where I had gotten flu shots. I quit the statins, and my pain went away.

I have been having shoulder pain for the last couple of months after the flu shot. My chiropractor thought it was a pinched nerve and has been treating me for that, but I still have the pain. I read this article today and think this is what’s causing the pain. My shoulder symptoms are exactly like what has been mentioned. I hope it will eventually go away. I have never experienced this kind of pain before in my shoulder. I am taking this article to my doctor when I see her next month.

How can we be sure they are doing it correctly? I looked at the PDF link, and I don’t understand anatomy well enough to know where the acromion is, to measure 2-3 fingers from.

I have had arm pain for years. Certain movements can be extremely painful, including pulling up the covers while in bed, an example given here. It never occurred to me it might have been a reaction to a flu shot. Unfortunately, I do not remember when I first experienced it.

I, too, had unusual shoulder pain that lasted several months after my 2018 flu shot, which was administered at my pharmacy, injected very high, near my bone joint. I was amazed when I took the bandaid off that the entry point was at the top corner of my shoulder. A local friend had the same problem and also complained that her shot had been given extremely high up her arm.

At the doctor’s office in 2019, I complained about that, and an older nurse administered the shot, as she had been taught to do, into the muscle. She then massaged it. There was absolutely no discomfort, not even that night.
I now think that technique may be responsible for much of the discomfort that often prevents some people from going back to get their flu shot the following year.

I am a physician who received a flu shot from my local pharmacy. There was immediate significant pain after the injection which I never experienced with prior immunizations, indicating the injection site into the deltoid muscle was incorrectly performed. I subsequently developed persistent pain and discomfort that lasted for over a year.
Lesson: Make sure whomever administers your immunization is knowledgeable in proper technique.

Hospitals are required by law to offer flu vaccinations, but often patients are given anti-inflammatory steroids like Solucortef or Solumedrol which will deactivate the vaccine since it depends on your immune system to work. This means the injection will be worthless.

I had those happen with a tetanus shot. It was given by a nursing student, and I knew immediately it was too high on the deltoid. It was quite painful and was 3 months before I could lift my arm over my head.

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