Injury Guide
Brachial Neuritis
A nerve injury involving the brachial plexus, usually starting with deep shoulder and arm pain followed by weakness. It is on the Table for tetanus-containing vaccines.
By VaccineInjuries.org Editorial Team · Last reviewed
Good to know: Brachial neuritis is uncommon, and it can also occur after infections, surgery, or with no known trigger. Most people vaccinated with Tdap or Td never experience it.
This guide is general information, not medical or legal advice. If you have symptoms, please talk to a doctor.
What is brachial neuritis?
Brachial neuritis is a disorder of the brachial plexus, the network of nerves that runs from the neck through the shoulder and into the arm. Doctors may also call it brachial plexopathy or Parsonage-Turner syndrome, which MedlinePlus describes as a rare inflammatory or post-viral brachial plexus disease.
The Vaccine Injury Table describes it this way: a deep, steady, often severe aching pain in the shoulder and upper arm usually comes first, and it is typically followed in days or weeks by weakness in the affected arm muscles. Unlike SIRVA, brachial neuritis is a nerve injury. The Table notes it can appear on the same side as the injection, the opposite side, or both arms.
Typical symptoms
- Deep, steady, often severe aching pain in the shoulder and upper arm
- Weakness in arm or shoulder muscles that follows the pain, often days or weeks later
- Numbness or other sensory changes (usually less noticeable than the weakness)
- Shrinking (atrophy) of affected muscles over time
When symptoms typically start
For a Table claim after a tetanus-containing vaccine, the first symptom must begin 2 to 28 days after vaccination (the exact wording is below). Pain in the arm and shoulder is typically the first symptom.
Is brachial neuritis on the Vaccine Injury Table?
Yes, for one vaccine category. Brachial neuritis is listed on the Vaccine Injury Table for vaccines containing tetanus toxoid, which includes Tdap, Td, DTaP, DT, and TT:
| Vaccine | Time period for first symptom |
|---|---|
| Vaccines containing tetanus toxoid (e.g., DTaP, DTP, DT, Td, or TT) | 2-28 days (not less than 2 days and not more than 28 days). |
“This term is defined as dysfunction limited to the upper extremity nerve plexus (i.e., its trunks, divisions, or cords).”— 42 CFR 100.3(c)
- The Table definition requires: arm and shoulder pain as a presenting symptom within the time period; weakness; exam findings (and nerve studies, if done) consistent with a brachial plexus problem; and no other condition that would explain the symptoms.
- If weakness is limited to muscles supplied by a single nerve, nerve conduction studies and EMG localizing the injury to the brachial plexus are required for the diagnosis.
- After vaccines that don't contain tetanus toxoid, brachial neuritis is not on the Table. A claim would be off-Table and would need proof of causation.
New to these terms? Read the difference between Table and off-Table injuries.
Filing deadlines
Both federal programs have strict deadlines. Missing one can end a claim, even a strong one, so it helps to write down key dates early.
VICP (most routine vaccines)
- Injury claims: generally within 3 years after the first symptom or manifestation of onset or of the significant aggravation of the injury.
- Death claims: within 2 years of the death and within 4 years of the first symptom of the injury that led to the death.
- Table changes: if the Vaccine Injury Table is changed in a way that newly covers an injury, a claim may be filed within 2 years of the change for injuries up to 8 years before it.
CICP (COVID-19 vaccines and other countermeasures)
- Generally within 1 year of the date the vaccine or other covered countermeasure was given.
- HRSA notes that a letter of intent can be submitted to help meet the deadline while records are gathered.
- The CICP does not pay attorneys' fees.
Severity requirement (VICP):the effects of the injury generally must have lasted more than 6 months, or resulted in inpatient hospitalization and surgical intervention, or resulted in death. Reporting a reaction to VAERS is not the same as filing a claim. See HRSA's VICP eligibility rules and CICP filing process, or our guide to vaccine injury filing deadlines.
Records that matter
You don't need to have everything gathered before asking questions. These are the records that typically help show what happened and when:
- Vaccination record showing the vaccine (for example, Tdap or Td), date, and arm
- The first notes documenting shoulder and arm pain and when it began
- Neurology evaluations describing the pattern of weakness
- Nerve conduction studies and EMG reports
- MRI or other imaging used to rule out neck or shoulder causes
- Physical or occupational therapy records
- Follow-up records showing recovery or lasting weakness
Frequently asked questions
Is brachial neuritis on the Vaccine Injury Table?
Yes, for vaccines containing tetanus toxoid, such as Tdap, Td, DTaP, DT, and TT. The first symptom must begin not less than 2 days and not more than 28 days after vaccination, and the case must meet the Table's definition.
How is brachial neuritis different from SIRVA?
Brachial neuritis is a nerve injury involving the brachial plexus, usually with pain followed by weakness, and it can affect either arm or both. SIRVA is an injury to the structures of the shoulder joint, limited to the arm that received the shot, with pain starting within 48 hours.
Do I need nerve tests?
Sometimes. Under the Table definition, if weakness is limited to muscles supplied by a single nerve, nerve conduction studies and EMG localizing the injury to the brachial plexus are required. Your doctor decides which tests are medically appropriate.
What if I had a flu shot, not a tetanus shot?
Brachial neuritis is listed on the Table only for vaccines containing tetanus toxoid. After other covered vaccines, a claim would generally be off-Table and would need proof that the vaccine caused the injury.
Related articles
Sources
Official regulations and government health sources used for this guide:
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