Injury Guide
SIRVA (Shoulder Injury Related to Vaccine Administration)
A shoulder injury — not a nerve injury — that can follow a shot given in the upper arm, with pain and reduced range of motion that don't fade like ordinary soreness.
By VaccineInjuries.org Editorial Team · Last reviewed
Good to know: Mild soreness where a shot was given is common and usually passes within days. SIRVA is different and uncommon. Most people who get vaccinated in the arm never develop it.
This guide is general information, not medical or legal advice. If you have symptoms, please talk to a doctor.
What is SIRVA?
SIRVA stands for shoulder injury related to vaccine administration. It describes shoulder pain and limited range of motion that begin soon after a vaccine is given into the upper arm. The federal Vaccine Injury Table explains that these symptoms are thought to result from vaccine or needle trauma reaching the bursa and other structures around the shoulder joint, which causes inflammation.
SIRVA is a musculoskeletal injury, involving tendons, ligaments, and bursae, rather than a nerve injury. That distinction matters: a nerve problem in the arm after a vaccine, such as brachial neuritis, is evaluated differently.
Your doctor may record the injury using a more specific shoulder diagnosis. For a claim, what matters is the overall picture in the medical records, including when the pain started. Under the Table, the Court considers the entire medical record.
Typical symptoms
- Pain in the shoulder of the arm that received the shot
- Reduced range of motion, such as trouble lifting the arm, reaching overhead, or reaching behind the back
- Pain and stiffness that persist instead of fading over a few days
- Symptoms limited to the shoulder where the vaccine was given
When symptoms typically start
For a Table SIRVA claim, the regulation requires that pain begin within 48 hours of vaccination. Because timing is central, the earliest medical note that records your shoulder pain, and when it began, carries a lot of weight.
Is SIRVA on the Vaccine Injury Table?
Yes. Shoulder Injury Related to Vaccine Administration is listed on the Vaccine Injury Table for nearly every vaccine category that is injected, with the same time period for each:
| Vaccine | Time period for first symptom |
|---|---|
| Vaccines containing tetanus toxoid (e.g., DTaP, DTP, DT, Td, or TT) | ≤48 hours. |
| Vaccines containing whole cell pertussis bacteria, extracted or partial cell pertussis bacteria, or specific pertussis antigen(s) (e.g., DTP, DTaP, P, DTP-Hib) | ≤48 hours. |
| Vaccines containing measles, mumps, and rubella virus or any of its components (e.g., MMR, MM, MMRV) | ≤48 hours. |
| Vaccines containing polio inactivated virus (e.g., IPV) | ≤48 hours. |
| Hepatitis B vaccines | ≤48 hours. |
| Haemophilus influenzae type b (Hib) vaccines | ≤48 hours. |
| Varicella vaccines | ≤48 hours. |
| Pneumococcal conjugate vaccines | ≤48 hours. |
| Hepatitis A vaccines | ≤48 hours. |
| Seasonal influenza vaccines | ≤48 hours. |
| Meningococcal vaccines | ≤48 hours. |
| Human papillomavirus (HPV) vaccines | ≤48 hours. |
| Any new vaccine recommended by the Centers for Disease Control and Prevention for routine administration to children and/or pregnant women, after publication by the Secretary of a notice of coverage | ≤48 hours. |
“SIRVA manifests as shoulder pain and limited range of motion occurring after the administration of a vaccine intended for intramuscular administration in the upper arm.”— 42 CFR 100.3(c)
- The Table definition requires all four of these: no history of pain, inflammation, or dysfunction of that shoulder before the vaccine that would explain the symptoms; pain within the time period; pain and reduced range of motion limited to the shoulder where the shot was given; and no other condition that would explain the symptoms.
- The regulation states that SIRVA "is not a neurological injury." Abnormal nerve testing points away from Table SIRVA, though it may support a different claim.
- SIRVA is not listed for rotavirus or oral polio vaccines, which are not given as shots in the arm. COVID-19 vaccines are not covered by the VICP; those claims go to the CICP.
- If the facts don't fit the Table definition, an off-Table claim may still be possible, but it requires proof that the vaccine caused the injury.
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 date, the vaccine given, and which arm
- The first medical notes documenting shoulder pain and when it started (urgent care, primary care, pharmacy follow-up, or patient portal messages)
- Orthopedic evaluations and any imaging reports, such as MRI or ultrasound
- Physical therapy records, including range-of-motion measurements
- Records of injections, surgery, or other treatment for the shoulder
- Earlier records showing that shoulder had no prior problems
- Notes on how the injury affects work, sleep, and daily tasks
Frequently asked questions
Is a sore arm after a shot the same as SIRVA?
No. Mild soreness where a shot was given is common and usually fades within a few days. SIRVA refers to shoulder pain and reduced range of motion that begin within 48 hours of the vaccine and persist, and it has a specific definition in the Vaccine Injury Table.
Which vaccines list SIRVA on the Vaccine Injury Table?
SIRVA is listed for nearly every injected vaccine category covered by the VICP, including seasonal flu, tetanus-containing vaccines such as Tdap and Td, HPV, hepatitis A and B, pneumococcal conjugate, and meningococcal vaccines. It is not listed for rotavirus or oral polio vaccines. COVID-19 vaccines are not part of the VICP.
Does SIRVA have to last a certain amount of time to qualify?
The VICP generally requires that the effects of an injury last more than six months after vaccination, or result in inpatient hospitalization and surgical intervention, or result in death. Whether a particular shoulder injury meets that requirement depends on the medical records.
What if I had shoulder problems before the vaccine?
The Table definition requires no prior history of pain, inflammation, or dysfunction in that shoulder that would explain the symptoms after the vaccine. Earlier shoulder issues do not automatically rule out a claim, but they can make a Table claim harder, so the earlier records would be reviewed closely.
Related articles
- What Is SIRVA and Can It Qualify for Compensation?
- Can a Flu Shot Injury Qualify for VICP Compensation?
- Are Tdap and Td Vaccines Covered by the VICP?
- Is the HPV Vaccine (Gardasil) Covered by the VICP?
- Are Pneumococcal Vaccines Covered by the VICP?
- What Is the Difference Between a Table Injury and an Off-Table Injury?
- What Injuries Qualify for Vaccine Compensation?
- What Medical Records Do I Need for a Vaccine Injury Claim?
Sources
Official regulations and government health sources used for this guide:
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