Review: Review ArticleShoulder Injury Related to Vaccine AdministrationWiesel, Brent B. MD; Keeling, Laura E. MDAuthor Information From the Department of Orthopaedics, MedStar Georgetown University Hospital, Washington, DC. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Wiesel and Keeling. Journal of the American Academy of Orthopaedic Surgeons: September 1, 2021 - Volume 29 - Issue 17 - p 732-739 doi: 10.5435/JAAOS-D-21-00021 Metrics Abstract Shoulder injury related to vaccine administration (SIRVA) is a rare yet increasingly recognized complication of immunization. Although a medicolegal term rather than a true diagnosis, SIRVA was introduced in 2010 by the Vaccine Injury Compensation Program after an increase in claims filed for vaccine-related shoulder injury. Patients typically present with severe pain and limited range of motion within 48 hours of vaccination and may experience notable functional limitations. Although the underlying pathophysiology is incompletely understood, the existing literature suggests that SIRVA results from the inflammatory response produced when the vaccine is injected into tissues containing a preexisting antibody. Current treatment modalities include physical therapy, corticosteroid injections, and antiinflammatory medications. In some cases, surgery may be required to treat underlying pathology, such as rotator cuff or biceps tendinopathy. Although the available literature indicates modest improvement in patients with SIRVA undergoing treatment, current data are limited to case series. Larger, high-quality studies are needed to determine the natural history and optimal treatment of this increasingly prevalent condition. Copyright 2021 by the American Academy of Orthopaedic Surgeons.