frozen shoulder after covid vaccinefemale conch shell buyers in png

Whats more, even though a frozen shoulder operation also known as a capsular release is arthroscopic and minimally invasive, surgery is traumatic, she said, and can amplify inflammation and stiffness if the joint is actively inflamed. Bancsi A, et al. (. However, in rare cases when a vaccine is administered improperly, a person may experience more severe symptoms, including intense shoulder pain classified as SIRVA. Keywords: doi: 10.1016/j.jse.2021.04.024. In our series, the most common cause of SIRVA was an incorrect vaccination technique. There was no significant difference between the control and the pandemic group in the distribution of patients per treatment group (P = .94). The pathology of frozen shoulder. Keywords: In all cases, the cause of the SIRVA was from an incorrect COVID-19 vaccine administration technique. National Library of Medicine SIRVA (Shoulder Injury Related to Vaccine Administration) following mRNA COVID-19 Vaccination: Case discussion and literature review. The shoulders in all patients were evaluated clinically for local tenderness, swelling, and shoulder active and passive range of motion (ROM). Persistent Shoulder Pain After Vaccine Administration Is Associated with Common Incidental Pathology: A Systematic Review. Shoulder Injury Related to Vaccine Administration (SIRVA): Petitioner Claims to the National Vaccine Injury Compensation Program, 20102016. Six patients (60%) had no symptoms in their affected shoulder, and 4 (40%) patients had mild, intermittent shoulder pain before the vaccination (TableI). 1875642. J Shoulder Elbow Surg. A 2021 report notes two cases of SIRVA following administration of mRNA COVID-19 vaccinations. Med Sci Monit. The second stage is the frozen stage, when the shoulder loses range of motion and "the capsule becomes thicker from inflammation ," notes Shubin Stein. It is most common in women between 40-70 years old. The mean pain visual analog scale score was 6.5 1.9 (range, 2.5-8), and both active and passive range of motion were limited in all the patients at the time of presentation. The .gov means its official. Your questions about covid-19, answered by Dr. Leana Wen, Experts trace flawed U.S. covid response and how to fix it. Federal government websites often end in .gov or .mil. Cagle P.J. The other six patients had shoulder pain without acute fever, and five of them were treated with only oral prednisolone 30 mg/day for 5-10 days, following which the pain improved and they all could return to normal activities within 14 days, with no side effects from the prednisolone such as stomachache, nausea, vomiting, headache, or dizziness. Home & Garden: Setting up a home workout space | How to help plants thrive in spring | Solutions for stains and scratches, Travel: Vaccines and summer travel what families need to know | Take an overnight trip with your two-wheeled vehicle. official website and that any information you provide is encrypted A SIRVA diagnosis should not prevent receiving future vaccines. Eight patients (80%) had a comorbidity during presentation (4 patients with hypothyroidism, 3 patients with diabetes mellitus, and 1 patient with prediabetes/hyperglycemia). The data on frozen shoulder and shoulder injury related to vaccine administration (SIRVA) after coronavirus disease 2019 (COVID-19) vaccination are absent from the literature. This can occur within 48 hours of vaccination. The aim of this study was to compare the incidence and severity of idiopathic FS before and during the pandemic. 2021;12 doi: 10.1080/20008198.2021.1875642. The mean duration of presentation since the onset of symptoms was 8.43.6 weeks (range, 6-18 weeks). Our study suffers from certain limitations. But instead of it feeling like a barrier, its like were coexisting now.. HHS Vulnerability Disclosure, Help Currently, vaccination is the most effective strategy against COVID-19. Frozen shoulder is a severe shoulder dysfunction that takes more than a year to recover with the correct treatment, and 30%-40% of patients can have persistent mild to moderate symptoms at 2-3 years of follow-up.10 But, the data and discussion on frozen shoulder after COVID-19 vaccination are virtually absent from the literature.21 To date, there have been only 3 cases reports that have reported shoulder pain secondary to subacromial-subdeltoid bursitis after COVID-19 vaccination.2,6,7 Hence, the purpose of this case series was to describe the clinical presentation and short-term follow-up of patients who developed frozen shoulder after COVID-19 vaccination. -. Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who Presented to Chiropractic, Orthopedic, and Physiotherapy Clinics in Hong Kong During 2021. New-onset inflammatory arthritis after COVID-19 vaccination: A systematic review. We excluded those patients who had significant shoulder pain and stiffness before the administration of the first dose of the COVID-19 vaccine. FOIA The impact of the COVID-19 pandemic on frozen shoulder incidence rates and severity During the COVID-19 pandemic, there was a significant increase in the incidence of patients with FS. Conflicts of interest: The authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Although the pain is generally at its worst when the shoulder is inflamed, getting surgery too early is widely discouraged. Vaccinations of all types can cause redness, swelling, and pain. 2021;30:e409e413. Symptoms developed immediately after the vaccination in 6 patients (60%), at 48 hours in 1 patient (10%), and at 10 days in 3 patients (30%). Before (2022). 2010;28:80498052. Some stiffness, pain, and swelling for several days after the vaccination is a normal reaction. The timeline of a frozen shoulder is drastically different depending on the person, Bishop said. However, improper vaccination technique can cause SIRVA, which can damage the shoulder joint. Accessibility 2022 Jul 11;28:e937430. The site is secure. 1. Med. Published by Elsevier Inc. All rights reserved. This site needs JavaScript to work properly. Clin Orthop Relat Res. What Should We Do after the COVID-19 Vaccination? Could the frozen shoulder ethology be immune mediated? The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). What are the symptoms of frozen shoulder? Signs and symptoms typically begin slowly, then get worse. A larger study and a longer follow-up will be needed and is currently underway to accurately define the prognosis and significance of the frozen shoulder after vaccination. Would you like email updates of new search results? Over-the-counter anti-inflammatory medications, such as Advil or Motrin, can also help people manage inflammation. It got to thepoint where it was like take-your-breath-away pain, said Noll Wilson, 40, of Des Moines. The .gov means its official. Shoulder Injury Related to COVID-19 Vaccine Administration: A Case Series. J Shoulder Elbow Surg. 2014 Aug 26;(8):CD011275. 2022 Jul 11;28:e937430. Please enable it to take advantage of the complete set of features! While reactions vary by vaccination type, it is typical for individuals to experience irritation and inflammation after getting the vaccine. Medical professionals learn how to properly administer vaccines through in-depth training during their education. (2020). Conclusion: According to the Centers for Disease Control and Prevention (CDC), almost 85% of people experienced redness, swelling, and pain at the injection site in the 7 days following vaccination with the Pfizer-BioNTech COVID-19 vaccine. HHS Vulnerability Disclosure, Help Frozen Shoulder: Symptoms, Causes and Treatments - AARP Avoiding shoulder injury from intramuscular vaccines - The Lancet government site. Parenting: Guidance for vaccinated parents and unvaccinated kids | Preparing kids for the return | Pandemic decision fatigue, Food: Dinner in Minutes | Use the library as a valuable (and free) resource for cookbooks, kitchen tools and more. Med. Even if you have no shoulder pain, almost always there will bea line saying maybe you have a labrum tear or maybe you have a partial rotator cuff tear, saidJoaquin Sanchez-Sotelo, chair of the Division of Shoulder and Elbow Surgery at the Mayo Clinic in Rochester, Minn. That can be confusing, because its a red herring. Weisel B, et al. What causes frozen shoulder? Acta Chir Belg. MNT is the registered trade mark of Healthline Media. doi: 10.1016/j.vaccine.2017.07.055. doi: 10.1080/00015458.2012.11680872. 2023 Jan-Dec;22(1):299-306. doi: 10.1080/14760584.2023.2189463. All 10 patients had normal radiographs and were diagnosed as frozen shoulder. However, the injury is often underreported, and therefore, it is hard to determine just how common SIRVA with the COVID-19 vaccine is. It can be excruciating.. doi: 10.1002/14651858.CD011275. According to another 2021 report, a 52-year-old Thai male experienced shoulder pain with limited range of motion 3 days after getting the Sinovac COVID-19 vaccine. Eight patients (80%) had a comorbidity during presentation (4 patients with hypothyroidism, 3 patients with diabetes mellitus, and 1 patient with prediabetes/hyperglycemia; TableI). This site needs JavaScript to work properly. Itoi E., Arce G., Bain G.I., Diercks R.L., Guttmann D., Imhoff A.B., et al. Frozen shoulder syndrome can be a severe manifestation of vaccination-related shoulder dysfunction. However, doctors may treat it as they would other shoulder injuries. Strangers rallied to help. Hence, the purpose of this case series was to describe the clinical presentation and short-term follow-up of patients who developed frozen shoulder after COVID-19 vaccination. PMC What makes SIRVA different from other shoulder injuries is its association with vaccination. Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: analyses of routinely-collected data on vaccine coverage and mortality. Once the inflammation clears up, people enter the frozen, or stiff, phase, Bishop said. 2022 Aug 12;40(34):4964-4971. doi: 10.1016/j.vaccine.2022.06.002. Nine patients (90%) received a nonreplicating viral vector type vaccine (Covishield vaccine; Serum Institute of India, India),16 and 1 patient received an inactivated whole virus vaccine (Covaxin vaccine; Bharat Biotech International Limited, India)16 (TableI). In most cases, symptoms such as swelling, discomfort, and fever indicate that the body is building immunity. Please enable it to take advantage of the complete set of features! Such severe reactions to vaccines are very rare, but they do occur. If the condition is diagnosed in the inflammatory phase, Deu said a cortisone shot injected into the joint can help reduce inflammation and pain, allowing people to potentially start range-of-motion exercisessooner. Shoulder pain after the COVID vaccine: What to know - Medical News Today These common localized reactions are usually short-lived and mild. If your shoulder pain is intense and doesnt resolve on its own within a week of vaccination, you should make an appointment with a doctor. Vaccine. In the long term, the condition can decrease a persons range of motion. All patients who were diagnosed with idiopathic FS were included. Vaccines and summer travel what families need to know, Take an overnight trip with your two-wheeled vehicle. (2021). As people age, it is common to see some fraying or partial tearing of tendons, which will show up on the detailed image produced by an MRI and may complicate the diagnosis. However,. How to Prevent SIRVA (2019). Hence the vaccine can be safely given in the deltoid muscle in the shoulder, even if the same shoulder is affected by the frozen shoulder. doi: 10.1177/1758573214560258. Overview. PMC The https:// ensures that you are connecting to the Wiesel B.B., Keeling L.E. Yildiz F, Sari A, Pulatkan A, Ucan V, Kochai A, Bilsel K. Acta Orthop Traumatol Turc. Rangan A., Brealey S.D., Keding A., Corbacho B., Northgraves M., Kottam L., et al. Zeitoun A, Hallit S, Helali M, Chehade S, Allam C, Ibrahim A, Dimassi H, Karam R. J Pharm Policy Pract. Frozen shoulder. Individuals may experience shoulder pain following a COVID-19 vaccination. National Library of Medicine Disclaimer. performing a physical examination and requesting a focused medical history, including history of vaccinations, ordering magnetic resonance imaging (MRI), which can show the extent of damage to the tendons and muscles caused by SIRVA and help inform treatment, possibly recommending medical imaging of your shoulder to get a definitive diagnosis of SIRVA, a course of prescription anti-inflammatory medication, such as an NSAID or oral steroid, physical therapy to help alleviate pain and increase range of motion. All patients had no prior shoulder pain before their vaccination and then developed shoulder pain within a few days following the vaccination, which did not spontaneously improve within 1 week. Yale J Biol Med. Unauthorized use of these marks is strictly prohibited. Methods: See this image and copyright information in PMC. Four of the seven patients were male, and the average age was 62.29 7.76 years. official website and that any information you provide is encrypted Localized autoimmune reaction has been investigated and stated as one of the etiological factors responsible for the development of idiopathic frozen shoulder in past reports.3,4 Vaccines are supposed to be absorbed locally and induce a local antibody response; However, any inadvertent systemic absorption of the vaccine and transfection to distant sites by the deltoid vasculature may lead to the rare autoimmune response against the transfected tissues.15 Autoimmune conditions such as Guillain-Barre syndrome and thrombosis with thrombocytopenia syndrome after vaccination have been theorized to occur as a result of similar systematic transfection of the vaccine and resultant autoimmune response to nerves and platelets.15 It may be possible that vaccine transfection to local capsular tissue or nerves may have elicited an autoimmune response leading to the development of a frozen shoulder. Sometimes, the shoulder pain that comes on after a vaccine does not get better. Honarmad AR, et al. Standard anteroposterior and lateral radiographs of the affected shoulder were also done in all patients. This Mix of Non-Opioid Medications Can Help Soothe Lower Back Pain, Study Finds, Former President Jimmy Carter Entered Hospice: Here's What That Means, Chronic Pain: Why Antidepressants May Not Be Effective, decreased arm mobility, including range of motion in the shoulder. Individuals may experience shoulder pain following a COVID-19 vaccination. The psoas muscle resides in the body's pelvic region, connecting the lower back to the upper thigh. Frozen shoulder after COVID vaccination has not yet been reported, and a longer follow-up is not yet available. Bethesda, MD 20894, Web Policies sharing sensitive information, make sure youre on a federal 2022 Jul 1;480(7):1251-1258. doi: 10.1097/CORR.0000000000002191. Our website services, content, and products are for informational purposes only. Med Sci Monit. thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying 2020;185:E298E300. Over time, symptoms get better, usually within 1 to 3 years. Shoulder injury related to vaccine administration and other injection site events. the side effects do not go away after 23 days. Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who Presented to Chiropractic, Orthopedic, and Physiotherapy Clinics in Hong Kong During 2021. doi: 10.1016/j.vaccine.2019.11.032. According to the World Health Organization (WHO), vaccines routinely prevent four to five million deaths per year from other serious diseases, including polio, whooping cough, measles, and the flu. 2023 Apr;18(2):613-617. doi: 10.1016/j.jds.2022.08.018. doi: 10.1055/s-0040-1719086. Its also important for medical professionals to be aware of SIRVA so that patients may be treated in a timely, effective manner. Federal government websites often end in .gov or .mil. As the pain and inflammation worsen, stiffness starts to set in, because the quality of capsule tissue is changing, Bishop said, likening the process to tightening a belt around the shoulder., This freezing phase is the worst place to be, she said. Frozen shoulder after COVID-19 vaccination - PMC - National Center for Chronic stage magnetic resonance imaging findings in patients with shoulder injury related to vaccine administration (SIRVA). (2021). and transmitted securely. Severe, Long-Lasting, and Bizarre Symptoms Explained: "COVID-19 Can 8600 Rockville Pike Diagnosing SIRVA can be challenging, as shoulder pain is a common symptom shared by a variety of medical conditions. Shoulder injury after vaccination: a systematic review. The Pfizer/BioNTech vaccine (BNT162b2) and the Moderna vaccine (mRNA-1273) are both messenger RNAbased vaccines that contain messenger RNA molecules encapsulated inside lipid nanoparticles; these are the 2 most common vaccines used in North America.9 The presence of pre-existing mild shoulder pain before vaccination was also noted in the clinical history in 4 patients. The musculoskeletal specialists who will see such patients with painful shoulder stiffness should be aware of the frozen shoulder diagnosis, which can occur after COVID-19 vaccination, so that such patients can be identified and treated early. doi: 10.5435/JAAOSGlobal-D-22-00156. Epub 2023 Jan 17. 2023. -, Bulgen D.Y., Binder A., Hazleman B.L., Park J.R. Immunological studies in frozen shoulder. 2023 Healthline Media UK Ltd, Brighton, UK. The Posts best advice for living during the pandemic. Eight patients (80%) had a comorbidity during presentation (4 patients with hypothyroidism, 3 patients with diabetes mellitus, and 1 patient with prediabetes/hyperglycemia). SIRVA occurs when a healthcare professional injects a vaccine too high or too deep into the shoulder. 2022 Apr 20;40(18):2546-2550. doi: 10.1016/j.vaccine.2022.03.037. . Vaccines have worked to significantly reduce disease in many parts of the world. J Family Med Prim Care. Shimabukuro, T. T. (2018). From a biological standpoint, theres some theories on how if you get covid, then your body is sort of in a heightened inflammatory state, and frozen shoulder fundamentally is an inflammation problem, said Michael Fu, a shoulder specialist and assistant attending orthopedic surgeon at the Hospital for Special Surgery in New York. Pfizer-BioNTech COVID-19 vaccine reactions & adverse events. Methods: Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Cochrane Database Syst Rev. Shoulder Elbow. To assess the severity of the condition, visual analog scale (VAS) for pain score and Subjective Shoulder Value (SSV) on presentation were recorded and the patients were categorized into 5 different treatment groups (0 injections, 1 injection, 2 injections, 3 injections, or capsular release). It may be a normal reaction at the injection site. -. Epub 2022 Mar 23. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. It may also puncture the bursa, which is the fluid-filled sac protecting the shoulder tendons. ncbi.nlm.nih.gov/pmc/articles/PMC6347325/, cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html, sciencedirect.com/science/article/pii/S1930043321005872, who.int/news-room/facts-in-pictures/detail/immunization, cdc.gov/vaccines/covid-19/info-by-product/pfizer/reactogenicity.html, cdc.gov/vaccines/vac-gen/side-effects.htm, ncbi.nlm.nih.gov/pmc/articles/PMC8094125/, journals.sagepub.com/doi/pdf/10.1177/2165079919875161, ncbi.nlm.nih.gov/pmc/articles/PMC6707642/, thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext, journals.lww.com/jaaos/Abstract/2021/09010/Shoulder_Injury_Related_to_Vaccine_Administration.2.aspx, ncbi.nlm.nih.gov/pmc/articles/PMC8797178/. official website and that any information you provide is encrypted Shoulder Pain and Injury after COVID-19 Vaccination. doi: 10.1016/j.jse.2017.03.015. The site is secure. While SIRVA may be long lasting, and even permanent, its symptoms are treatable. Epub 2022 Mar 21. Accessibility MeSH Eight of 10 patients had comorbidities that included diabetes, thyroid disorder, and prediabetes. Internal rotation ROM was measured based on the thumb reaching the highest vertebrae. See this image and copyright information in PMC. official website and that any information you provide is encrypted Clinical relevance: Most people are racking their brains to try to figure out what they did, and the reason that they cant figure anything out is, for most people, they didnt do anything, she said. Most people do not experience any serious lasting side effects as a result of vaccination. 8600 Rockville Pike How to release a frozen shoulder - Harvard Health Shoulder stiffness: current concepts and concerns. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. SARS-CoV-2 (Covid-19) vaccines structure, mechanisms and effectiveness: a review. Can adhesive capsulitis of the shoulder be a consequence of COVID-19? (2019). Background: According to experts, SIRVA associated with any vaccination is relatively rare. Frozen shoulder after COVID vaccination has not yet been reported, and a longer follow-up is not yet available. We retrospectively evaluated these 10 consecutive patients who complained of painful stiffness of the shoulder after COVID-19 vaccination. Ten of these 25 patients developed frozen shoulder after COVID-19 vaccine administration. Results: A retrospective cohort study was performed to establish the incidence of FS during the pandemic, from March 2020 to January 2021 (pandemic study period), compared to the same time period 1 year earlier, before the pandemic (control group). (2021). Symptoms, treatment and a possible pandemic connection. 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J Am Acad Orthop Surg Glob Res Rev. You can learn more about how we ensure our content is accurate and current by reading our. and transmitted securely. Maund E, Craig D, Suekarran S, Neilson A, Wright K, Brealey S, Dennis L, Goodchild L, Hanchard N, Rangan A, Richardson G, Robertson J, McDaid C. Health Technol Assess. Statistical analysis was performed using the chi-square and Student t test for categorical and continuous variables, respectively. The impact of the COVID-19 pandemic on frozen shoulder - PubMed Online ahead of print. Martn Arias LH, Sanz Fadrique R, Sinz Gil M, Salgueiro-Vazquez ME. Merchant H. Inadvertent injection of COVID-19 vaccine into deltoid muscle vasculature may result in vaccine distribution to distance tissues and consequent adverse reactions. It is an underreported and preventable event. Additionally, Bishop said, frozen shoulder can be triggered by a minor injury, such as your dog yanking your arm while on a walk, or surgery that results in immobilization for an extended period of time. Hand G.C.R., Athanasou N.A., Matthews T., Carr A.J. Curr Sports Med Rep. 2022 Mar 1;21(3):78-83. doi: 10.1249/JSR.0000000000000939. -, Hesse E.M., Atanasoff S., Hibbs B.F., Adegoke O.J., Ng C., Marquez P., Osborn M., Su J.R., Moro P.L., Shimabukuro T., et al. This article was published more than1 year ago, Sarah Noll Wilson started feeling the sharp pain in her rightshoulder last July any timeshewould try to reach her armbehind her. and transmitted securely. This site needs JavaScript to work properly. Reports of shoulder dysfunction following inactivated influenza vaccine in the Vaccine Adverse Event Reporting System (VAERS), 20102016. People who are diabetic, for instance, are known to have longer, tougher courses. HHS Vulnerability Disclosure, Help J Am Acad Orthop Surg Glob Res Rev. Our article is reporting only a rare problem after the vaccine, and it is not meant to raise doubts about the efficacy or overall usefulness of the vaccine. 1 Over the years, uncertainty has surrounded the definition and classification of The https:// ensures that you are connecting to the Reliance Foundation Hospital, Mumbai, India, dKnee & Orthopaedic Clinic, Mumbai, India. In its proposed rule, the Trump administration argued that shoulder injurieswhich can happen when vaccines are administered too high on the arm were not caused by the vaccines per se and therefore were not compensable injuries under the National Vaccine Injury Compensation Program (VICP). government site. Background: A shoulder injury related to vaccine administration (SIRVA) is a vaccination complication that can affect daily life activities. (, Ultrasonographic images of the right shoulder of Patient 6. Discussion and conclusion: government site. Pfizer-BioNTech COVID-19 vaccine reactions & adverse events. Am J Sports Med. However, by describing this hitherto unreported problem after COVID-19 vaccine, we hope that frozen shoulder after vaccination can be identified and treated appropriately and timely. Read more to learn about what type of shoulder pain is normal after getting the COVID-19 vaccine, how to manage it, and more. Shahbaz M, et al. Although there have been detailed descriptions of the cytokine and inflammatory cells mediated pathogenesis, a true scientific explanation behind the causation and etiology of idiopathic frozen shoulder is still unclear.11 Scientific explanation of the causation that links the occurrence of frozen shoulder after heart or breast surgery is also not known. Please enable it to take advantage of the complete set of features! Ten patients (9 women and 1 man) with a mean age of 538 years (range, 43-68 years) developed painful shoulder stiffness following COVID-19 vaccination. Shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccination. Reports of SIRVA with the COVID-19 vaccine are scarce. However, Vaccine allergy is so rare that youre more likely to be struck by lightning this year than have an allergic reaction to a vaccine. government site. These side effects of COVID-19 vaccines, such as frozen shoulder, may likely be seen more commonly in the future because of the number of vaccine doses already crossing a figure of 900 million in India, 396 million in the United States, and 6 billion worldwide.12. After months of intensive physical therapy, Noll Wilson said she believes her shoulder is in the thawing phase. He added that he also often orders an X-ray to rule out other conditions that can cause a loss of active and passive motion, such as arthritis. We offer a series of seven SIRVA cases including clinical presentations, investigations and treatment outcomes. One year earlier, there were 898 initial consultations for a new shoulder problem; of these, 176 were for idiopathic FS. Med. Some studies have found that the symptoms of SIRVA may last at least 6 months. Epub 2022 Nov 12. Several case studies have reported SIRVA in people who received a COVID-19 shot. Keywords: Mayo Clinic Q and A: Treatment for frozen shoulder Clinical variables recorded in all patients included duration of symptoms, comorbidities, presence of discomfort or mild pain before the vaccination event, the lag period between the development of pain and the vaccination event, type of vaccine, follow-up period, shoulder ROM, and visual analog scale pain scores at baseline and at latest follow-up.

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