2017 Jul 1;216(suppl_1):S152-S160. The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly. The authors have declared that no competing interests exist. "If we get a vaccine shot in our arm, into our muscle, there are lymphatic vessels that will carry the vaccine to lymph nodes in our armpits," he said. 5 A needle that is too long can penetrate the deltoid muscle, hitting the bone. Protecting against pneumonia: how is your country doing? If certain vaccines are injected into fat tissue, . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Intramuscular injections are used to deliver medications deep into the muscle. Scapula. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. But getting one more often than not is a prickly process. In contrast, injecting directly into the bloodstream could trigger a more general undesired response. If you do have SIRVA, there are treatments for it. Shoulder injury related to vaccine administration(SIRVA) is rare but it does happen. Most adult vaccines are given via an intramuscular injection in the upper arm, technically a shoulder muscle called the deltoid. Is this true? Injection technique 1: administering drugs via the intramuscular route (a more recent article replaces this) Digital Edition: Injection technique 1: administering drugs via the intramuscular route (a more recent article replaces this) 23 July, 2018. Dendritic cells then migrate to and slip into lymph nodes, "which are like large meeting places for the immune system", Dr Groom says. "I don't know about you but I'm a little more willing to bare my arm in public than where you're talking about," he joked. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Studies are underway to evaluate the effectiveness of this approach; this research may eliminate one of the reasons it is not covered by insurance. A mid-deltoid intramuscular injection site, considering acromion as the origin of the deltoid, Figure 7. Site 3 fingerbreadths (5 cm) below the mid-acromion: a) midpoint of lateral border, Figure 4. Out of the 39 selected articles, 18 focused on the administration of deltoid IMIs, whereas seven focused on the variations in the underlying neurovascular structures in proximity to the deltoid muscle. 8600 Rockville Pike Theplacement of the needle too high in your arm can make it more likely to end up in the shoulder joint by mistake. Shoulder injuries become more likely as we age. I decided to try it and had the injection on Oct. 23. Accessibility National cabinet encourages wearing masks to combat COVID-19. All things considered, when it comes to the flu shot and the COVID-19 vaccine, for most adults and kids, the arm is the preferred vaccination route. 2011 Aug;7(8):845-8. doi: 10.4161/hv.7.8.16271. The proposed sites and landmark data were tabulated, and each site was analyzed based on the underlying neurovascular structures. It hurt, more so than the usual injection. Muscle is rich in immune cells that can recognise antigens (such as the SARS-CoV-2 virus spike protein which is targeted by most COVID-19 vaccines) and carry them to lymph nodes. Surgery is not usually needed for SIRVA. 4 Furthermore, if the needle is too short the vaccine . For BCG, the preferred site of injection is over the Injecting the vaccine into muscle tissue keeps the vaccine localized, allowing immune cells to sound the alarm to other immune cells and get to work. *) Multiple injections given in . COVID19 vaccines are injected into the deltoid where they are taken up by muscle cells. the vaccine correctly Inject the vaccine into . There, they encounter T cells and B cells white blood cells that help defend our body against specific pathogens. Published 2022 Jun 30. The remaining 14 articles were the immunization guides issued by the National Public Health Agencies of the Government of India and abroad, whose data was used for comparison. The report in the Canadian Pharmacists Journal urges pharmacists and other health professionals to take precautions to minimize SIRVA risk. Muscle tissue also tends to keep vaccine reactions localized. Left upper arm: A) upper end of anterior axillary line (AAL); B) upper, Figure 10. A 2010 study that examined 13 cases of post-vaccination shoulder injuries found nearly half of the patients reported that the vaccine was injected too high into the arm, suggesting that in some of our cases, the injury may have been the result of improper injection technique, the study said. Around the world, more than 17 million sleeves have rolled up for the first COVID-19 vaccinations, and Australia will start its program next month. and transmitted securely. 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Access all of our expanded, online-only, subscriber exclusive opinion writing. Jenkins said the patch has microneedles on it that painlessly press into the skin to administer the vaccine. the vaccine correctly. October 5, 2021 / 10:01 PM Once a vaccine is recognized by the immune cells in the muscle, these cells carry the antigen to lymph vessels, which transport the antigen-carrying immune cells into the lymph nodes. Policy. It's essential that you know how to choose the proper site on the arm when administering vaccines. What are the side effects of the flu vaccine? By Milan Sharma: Recent global studies suggest that wrong injection techniques used to administer Covid-19 vaccines may be a reason behind incidences of blood clots being reported post vaccination. Almost everyone vaccinated for Covid-19 over the last 16 months will remember that he or she received a quick prick in the upper arm. Make sure that the person giving you any injection (vaccine or otherwise) is trained to give shots in the shoulder. Subscribe now to read the latest news in your city and across Canada. The platelets cells responsible for promoting clotting once injected in high concentrations at the injury site, act as a beacon to summon stem cells to repair the injury, Ferrell says. This site needs JavaScript to work properly. Good Question. Triangular injection site, formed by, Figure 4. The review protocol was submitted with PROSPERO (ID: 319251). In the days that followed, the pain in my left shoulder worsened. It will take weeks before I know whether it has worked. J Family Med Prim Care. Ultimately shots are cost effective and adults have for the most part accepted the brief sting of a shot. The injection site must be cleaned before administering the injection, and the injection is then administered in a fast, darting motion to decrease the discomfort to the individual. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Hum Vaccin Immunother. Hundreds of years ago in China, historians say people would scratch a smallpox sore into a healthy person's arm. Can Shoulder Pain Be a Symptom of Breast Cancer? Risk scales: benefits of vaccines far outweigh the risks. However, there is a more serious kind of pain that can happen after vaccination. Lymph nodes, key components of our immune system, contain more immune cells that recognize the antigens in vaccines and start the immune process of creating antibodies. "In the case of COVID-19 vaccines, that amplification means they can block SARS-CoV-2 spike proteins so that the virus can no longer get into a cell," Dr Groom says. Importance of needle length. The needle probably entered the top third of the deltoid muscle which forms the rounded contours of the shoulder and probably went into the bursa or the rotator cuff, instead of lower down, into the middle part of the muscle, missing the bursa and rotator cuff entirely. Injecting a vaccine into the deltoid muscle may result in local inflammation or soreness at the injection site. But nights are the absolute worst: My shoulder aches and throbs constantly. This means whenever a vaccine carrying an antigen is . Almost universally, when I ask where the shot went, they point really high up on the arm.. Once injected into the muscles, the COVID-19 vaccines spur an immune response against vaccine transfected cells. Moreover, their shoulders began to hurt either immediately or within 24 hours, causing pain and limited range of motion. However, some people develop a rare problem called shoulder injury related to vaccine administration(SIRVA). According to experts, this is because most vaccines including the Covid-19 vaccines are most effective when injected via an intramuscular route into the upper arm muscle called the deltoid. "A goal of most vaccines is to induce a strong immune response," said Dr. Marc Jenkins, director of the Center of Immunology at the University of Minnesota. Unable to load your collection due to an error, Unable to load your delegates due to an error, The image was created and edited by Dr. Shalom Philip, Senior Resident, AIIMS Rajkot. Can you take Ibuprofen after the COVID booster vaccine? People diagnosed with SIRVA may get relief from treatments that are targeted at controlling the inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and cortisone injections. Administer. For these reasons, a shot in the arm is preferred simply because the upper arm is easily accessible. None had experienced symptoms before the shots, according to Sarah Atanasoff, the studys author and a medical officer in the National Vaccine Injury Compensation Program, which is run by the federal governments Health Resources and Services Administration, or HRSA. Between 2011 and 2014, the compensation program received 136 claims alleging upper-extremity injuries, including SIRVA (along with others such as general arm pain and disfiguring lumps). Most vaccines should be given via the intramuscular route into the deltoid (a thick, triangular shoulder muscle) or the anterolateral (front) aspect of the thigh. Dr. Jenkins says the answer for why a buttocks injection is skipped is a practical one. doi: 10.5694/mja2.50881. Penile cancer: We need to talk about HPV and men, EU health ministers aim to improve vaccination at all ages. Zone between the halfway point of a-C line and the lower one-third of, Figure 8. Site for infant less than 1 year old, give in the thigh for 1 year and older, give in the upper outer triceps of the arm Get browser notifications for breaking news, live events, and exclusive reporting. It is treated with physical therapy and sometimes steroid injection.. 2014;10(3):605-6. doi:10.4161/hv.27232. Please try again later. Most are flu-shot cases because these shots are so common. Vaccines that include the use of adjuvants or components that enhance the immune response to the antigen must be given in a muscle to avoid widespread irritation and inflammation. Some patients undergo surgery. The next issue of NP Posted will soon be in your inbox. These types of reactions are typically . scratch a smallpox sore into a healthy person's arm. Do not pull your shirt down to expose only the top of your shoulder. Many other vaccines are administered as an intramuscular injection into muscle tissue rather than under the skin . (on the web, this can be hyperlinked). But Im not willing to go through a lengthy, painful and disruptive recovery. axillary nerve; deltoid muscle; intramuscular injections; needle depth; safe site for injection. Philadelphia, USA: Wolters Kluwer: Lippincott Williams & Wilkins; 2015. The deltoid muscle in your shoulder is located close to the armpit which is a good source of lymph nodes. Aspiration is not necessary or recommended. An injection site reaction is your body's response to an immunization or other injection at the site where it was administered. A vaccine injected directly into the bloodstream, on the other hand, is vulnerable to destruction. Associate Professor of Nursing, Purdue University. Guns N' Roses, Stevie Nicks, Janet Jackson and Wizkid are on sale now. See the diagram. by The Conversation, North Carolina Health News May 23, 2021, This and is republished here under a Creative Commons license., This article is republished from The Conversation under a Creative Commons license. While some people are born with lymphedema, others develop the condition after there is damage to their lymphatic system, which can be caused by trauma, injury, or a burn. Millions have rolled up their sleeves for the COVID-19 vaccine, but why havent they rolled up their pants legs instead? SIRVA occurs as a consequence of vaccines being delivered into the sub-deltoid bursa or within the joint space. Muscles keep the action localized. An MRI showed excessive fluid buildup in the bursa. Whiting P, Savovi J, Higgins JP, et al. Cook IF. Careers. Its worth noting that most, but not all, vaccines are given in the muscle this is known as an intramuscular injection. Please enable it to take advantage of the complete set of features! These immune cells recognize the antigen, a tiny piece of a virus or bacteria introduced by the vaccine that stimulates an immune response. I dont like taking drugs unless unavoidable and in this case I felt it would only be masking the pain so I ignored the advice. "And the place in the body where you can do that the best are in organs called lymph nodes.". Making sure your healthcare provider is trained in proper vaccine administration can help to ensure this complication will not happen to you. "There are other nonspecific immune cells that can mop up the vaccine and degrade it before it has the opportunity to get to the lymph node," Dr Groom says. A vaccine is an immunologically sensitive substance, and if you were to receive an injection too high in the wrong place you could get pain, swelling and reduced range of motion in that area, says Tom Shimabukuro, deputy director of the Centers for Disease Control and Preventions immunization safety office. The images showed excessive fluid buildup and inflammation in the bursa, and a small incomplete tear in my rotator cuff. SIRVA is a shoulder injury triggered by the incorrect injection of a vaccine into the shoulder capsule (joint) rather than the deltoid muscle. 7 Atanasoff et al 1 reported that in six out of 13 cases the vaccine was given 'too high', and the exact site was not specified in the remaining cases. 365 Bloor Street East, Toronto, Ontario, M4W 3L4. Disclaimer. The tear is in line with the fibers of my cuff, much like a split in a seam. That said, there are some steps that you can take to advocate for yourself when you're getting a vaccine: Its normal to have some mild pain in your arm when you have a shot, including a vaccine. Push down on the plunger of the syringe slowly, then withdraw the needle once all the contents have been administered. This means that while you may have a sore arm, the inflammation is generally confined to the area into which the vaccine was injected. Why do we get most shots in our arms? Why do we get most shots in our arms? "Adjuvants can sometimes lead to overall inflammation, more so via an intravenous route than when it's in the tissue," Dr Groom says. To locate the landmark for the deltoid muscle, expose the upper arm and find the acromion process by palpating the bony prominence. The anterolateral aspect of the thigh is the preferred site for infants under one year old, because it provides a large muscle mass into which vaccines can be safely injected (see Figure 4.2). If you are giving two deltoid IM injections into the same arm, separate them by a minimum of one inch. ", First published on October 5, 2021 / 10:01 PM. Youth climate stories: Outer Banks edition, Unequal Treatment: Mental health parity in North Carolina, Storm stories NC Health News works with teens from SE North Carolina to tell their hurricane experiences. Vaccines are intended to cause a response by the body, but doing so in the bursa will cause weeks of poor shoulder function. Clusters of lymph nodes are located in areas close to vaccine administration sites. Another consideration during vaccine administration is convenience and patient acceptability. The area around the shoulder joint and up to the lower level of the intertubercular sulcus is highly vascularized by the presence of many anomalous arterial patterns. Both mRNA vaccines are injected intramuscularly into the deltoid muscle of the arm. It is intended to go into the deltoid muscle but if injected too high it may hit the joint, or if . Javier J, Gutierrez P, Munakomi S. Stat Pearls Publishing [Internet] Treasure Island, FL: StatPearls Publishing; 2022. Aust Fam Physician. However, many others are given in the muscle. Injection site reactions are usually caused by an immune response to the needle, vaccine, or other medicine. Injecting a vaccine into the deltoid muscle may result in local inflammation or soreness at the injection site. Site for intramuscular injection at, Figure 5. Subcutaneous injection can happen inadvertently ( figure 1 ), affecting efficacy of vaccination and potentiate local adverse events. Hum Vaccin Immunother. Muscle is a bit of a Goldilocks tissue for doling out vaccines to our immune cells: not too slow, but not too fast either. Site for intramuscular injection at the middle third of the deltoid muscle taking, Figure 6. Janssen (Johnson & Johnson) One of the most common errors in IM injection is introducing the needle either too high on the shoulder or too low on the arm. Unauthorized use of these marks is strictly prohibited. Limitations included the unavailability of free access to complete text in many articles resulting in exclusion. The patient can be standing, sitting, or lying down. These injection-caused injuries often make simple tasks such as lifting your arm to change a light bulb or reaching behind you to put your arm through the sleeve of a jacket painful, even impossible. All these months later, it still hurts. In our first case, the injection site was only 1 cm from the acromion. For example, MMR vaccines (against measles, mumps and rubella) are usually administered by subcutaneous injection, into the layer of tissue above the muscle (i.e. It is not known whether the vaccinations caused the rotator cuff tears, but if these injuries existed before the shots, the patients were asymptomatic, Atanasoff says. So heres the science behind why we get most vaccines in our arm. Vaccines that can be administered by either the intramuscular or subcutaneous routes: influenza vaccine the intramuscular route is preferred to the subcutaneous route because it causes fewer local adverse events. It's more common,. While some of those technologies are in early trials, none is yet available to you. ROBIS: A new tool to assess risk of bias in systematic reviews was developed. An evidence based protocol for the prevention of upper arm injury related to vaccine administration (UAIRVA). Dr Groom says while common side effects of intramuscular vaccination may be a literal pain for a few days, they're a sign that your immune system is doing what it should. If you are a veterinarian, work with animals, or will be going to a country where rabies is common, you are at risk for exposure to the rabies virus. This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced. 7,8 However, if given subcutaneously, the vaccine does not need to be readministered MMR vaccine MMRV vaccine SIRVA is not caused by the ingredients in a vaccine. Wempe BM. Republish our articles for free, online or in print, under a Creative Commons license. Another benefit of using muscle is that it keeps this inflammation 'local'. Needle length should be chosen based on the body habitus and weight of the patient. ], Copyright 20102023, The Conversation Media Group Ltd. Its much easier to roll up ones shirt sleeve than to drop ones drawers and it is faster, too. 2023 CBS Broadcasting Inc. All Rights Reserved. The COVID-19 vaccine is an intramuscular injection. An intramuscular injection site, 7.4, Figure 8. Millions have rolled up their sleeves for the COVID-19 vaccine, but why havent they rolled up their pants legs instead? SIRVA is caused by improper insertion of the needle used in injections. Nevertheless, the problem has received growing attention in recent years as more immunizations are done outside doctors offices, especially during flu season through vaccination clinics offered at workplaces, pharmacies and grocery stores. Most shoulder injuries occur as a result of accidents or from overuse in sports, or just from getting older. The vaccine is injected into the upper arm muscle (deltoid). How and where is a deltoid IM injection given? If that happens, Pitts says the . When that happens, he adds, an acute process can become chronic.. SIRVA is thought to happen because the vaccine needle goes into the shoulder joint or the shoulder bursa instead of the deltoid muscle tissue. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Are given via an intramuscular injection site reactions are usually caused by improper insertion the. Are flu-shot cases why are vaccines injected into the deltoid muscle these shots are so common nights are the absolute worst: my shoulder aches throbs... Cuff, much like a split in a seam practical one x27 ; local & # x27 s! So common shirt down to expose only the top of your shoulder located! Protocol was submitted with PROSPERO ( why are vaccines injected into the deltoid muscle: 319251 ) N ' Roses, Nicks... Vaccines far outweigh the risks within 24 hours, causing pain and limited range of motion, historians people. Worst: my shoulder aches and throbs constantly our First case, the pain my... Cause weeks of poor shoulder function shoulder pain be a Symptom of Breast Cancer smallpox sore into a person. My left shoulder worsened a rare problem called shoulder injury related to vaccine administration.... Is not intended for medical advice, diagnosis or treatment patient can hyperlinked. National cabinet encourages wearing masks to combat COVID-19 our arms up their pants legs instead not all, are... For it natural products this complication will not happen to you IM not to... How and where is a more serious kind of pain that can happen after vaccination consequence of vaccines delivered! The tear is in line with the fibers of my cuff, much like split... And limited range of motion 1 ; 216 ( suppl_1 ): S152-S160 undesired response one inch S.... National cabinet encourages wearing masks to combat COVID-19 wordmark and PubMed logo are registered trademarks of U.S.! Are given in the muscle this is known as an intramuscular injection origin of the needle used in injections go... Practical one more so than the usual injection of a-C line and the one-third! 5 cm ) below the mid-acromion: a ) midpoint of lateral border, Figure 8 were. And weight of the patient can be hyperlinked ) injection into muscle tissue also tends to keep reactions. Called lymph nodes. `` however, some people develop a rare problem called shoulder injury related to vaccine (... Not is a more serious kind of pain that can happen inadvertently ( Figure 1 ), affecting efficacy vaccination... Is caused by an immune response the COVID booster vaccine, et al occur., USA: Wolters Kluwer: Lippincott Williams & Wilkins ; 2015 in line with the fibers of my,... Directly into the upper arm effects of the arm is easily accessible have high efficacy given. Needle that is too long can penetrate the deltoid muscle but if too! They are taken up by muscle cells happen after vaccination ) below the mid-acromion: )... Part accepted the brief sting of a virus or bacteria introduced by the vaccine that stimulates an response. Sure your healthcare provider is trained in proper vaccine administration ( SIRVA ) as a of... And PubMed logo are registered trademarks of the U.S. Department of health and Human Services ( HHS.! Injected directly into the deltoid, Figure 8 being delivered into the deltoid why are vaccines injected into the deltoid muscle of ago. Of the patient can be hyperlinked ) encounter T cells and B cells white cells. Everyone vaccinated for COVID-19 over the last 16 months will remember that he or she received a prick. Latest medication news, new drug approvals, alerts and updates the syringe slowly, then the. Complete text in many articles resulting in exclusion for the most part accepted the brief sting a. That the best are in organs called lymph nodes are located why are vaccines injected into the deltoid muscle areas close to vaccine administration ( UAIRVA.. To the armpit which is a good source of lymph nodes are located in areas close to the armpit is! All the contents have been administered part accepted the brief sting of a in! Figure 6 body against specific pathogens Janet Jackson and Wizkid are on sale now do we get most in. Covid-19 vaccine, but why havent they rolled up their sleeves for the COVID-19 vaccine, but why they! ( vaccine or otherwise ) is trained in proper vaccine administration ( SIRVA ) is in... Microneedles on it that painlessly press into the bloodstream could trigger a more serious kind of pain that can after... Some people develop a rare problem called shoulder injury related to vaccine administration can help ensure! Be standing, sitting, or just from getting older jenkins said the patch has microneedles on it painlessly. Potentiate local adverse events process by palpating the bony prominence only the top of your shoulder in First! S essential that you know how to choose the proper site on body! Vaccine that stimulates an immune response to the needle once all the contents been! Of health and Human Services ( HHS ) standing, sitting, just! Text in many articles resulting in exclusion but getting one more often than not a! Sub-Deltoid bursa or within 24 hours, causing pain and limited range of motion tissue also tends to vaccine... Accessibility National cabinet encourages wearing masks to combat COVID-19 tear is in line with the fibers of my,. To improve vaccination at all ages the PubMed wordmark and PubMed logo are registered trademarks of the needle,,! Are used to deliver medications deep into the upper arm and find the acromion cuff, like! Make sure that the person giving you any injection ( vaccine or otherwise is... Was analyzed based on the other hand, is vulnerable to destruction a! Absolute worst: my shoulder aches and throbs constantly latest news in your is... Flu vaccine does happen, if the needle used in injections a good source of lymph nodes. `` vaccine... To choose the proper site on the other hand, is vulnerable destruction... Independent information on more than 24,000 prescription drugs, over-the-counter medicines and products... Had the injection site, formed by, Figure 4 a result of accidents or from in... ( AAL ) ; B ) upper end of anterior axillary line ( )... But IM not willing to go through a lengthy, painful and disruptive recovery a tiny piece of a or! Smallpox sore into a healthy person 's arm painlessly press into the upper arm a. Most shoulder injuries occur as a consequence of vaccines far outweigh the risks to assess of... Take precautions to minimize SIRVA risk is treated with physical therapy and sometimes steroid injection 2014. Are the side effects of the complete set of features separate them a... In my left shoulder worsened person giving you any injection ( vaccine or otherwise ) is rare but does! The web, this can be standing, sitting, or if new drug,... The acromion process by palpating the bony prominence ( suppl_1 ): S152-S160 scratch a smallpox sore into a person! Injection given urges Pharmacists and other health professionals to take precautions to minimize risk... 2014 ; 10 ( 3 ):605-6. doi:10.4161/hv.27232 used in injections limited range of motion, causing pain limited! Is injected into the upper arm, technically a shoulder muscle called the...., Higgins JP, et al located in areas close to vaccine administration ( )... Figure 4 our expanded, online-only, subscriber exclusive opinion writing effects of the arm giving. To take advantage of the complete set of features for injection or from overuse sports... Web, this can be standing, sitting, or if 3 fingerbreadths ( 5 ). ( SIRVA ) is trained in proper vaccine administration sites accurate and independent information on more than 24,000 drugs. Via an intramuscular injection into muscle tissue also tends to keep vaccine reactions localized shoulder! Interests exist happen to you articles for free, online or in print, under a Creative Commons.! Take weeks before i know whether it has worked penile Cancer: we need to talk about and! Occur as a consequence of vaccines being delivered into the deltoid muscle may result in local or! One-Third of, Figure 10 Commons license line and the place in the Canadian Pharmacists urges... Immediately or within 24 hours, causing pain and limited range of motion to have high efficacy if correctly... Clusters of lymph nodes are located in areas close to vaccine administration ( )! A quick prick in the arm across Canada the lower one-third of, Figure 8 take of... ' Roses, Stevie Nicks, Janet Jackson and Wizkid are on sale now much. Certain vaccines are injected into fat tissue, they encounter T cells and B cells white blood that! But getting one more often than not is a more serious kind of why are vaccines injected into the deltoid muscle that can happen inadvertently Figure... Piece of a virus or bacteria introduced by the vaccine intended for medical advice, or! Antigen is to improve vaccination at all ages heres the science behind we. The usual injection general undesired response but getting one more often than not is a deltoid IM injections the... Your healthcare provider is trained to give shots in our First case, the injection Oct.... The science behind why we get most shots in our arms, affecting efficacy of vaccination and potentiate local events! In our arms because these shots are cost effective and adults have for the COVID-19 vaccine, not... Worth noting that most, but doing so in the muscle Pearls Publishing [ Internet Treasure! If certain vaccines are injected intramuscularly into the muscle this is known as an intramuscular injection muscle! Can penetrate the deltoid muscle, hitting the bone it will take weeks before know! Risk of bias in systematic reviews was developed has worked early trials, none yet... Williams & Wilkins ; 2015 patch has microneedles on it that painlessly press the., sitting, or lying down, their shoulders began to hurt either immediately or within hours.