Onset of Frozen Shoulder Following Pneumococcal and Influenza Vaccinations

OBJECTIVE: Adhesive capsulitis has been suggested as an adverse effect of vaccine administration into the shoulder area. The purpose of this case series is to report 3 cases of acute onset of adhesive capsulitis following pneumococcal and influenza vaccines. CLINICAL FEATURES: Patients reported painful shoulder and limited motion following routine vaccination. After clinical examination, a diagnosis of adhesive capsulitis was noted. INTERVENTION AND OUTCOME: All 3 patients were treated conservatively with physical therapy (active ranges of motion and active-assisted motion), nonsteroidal anti-inflammatory drugs, and activity modification with eventual resolution of symptoms. CONCLUSION: Reports implicating vaccination with adhesive capsulitis are rare. This case series raises the awareness of pneumococcal and influenza vaccinations as possible causes of adhesive capsulitis that appear to respond to standard treatment. Although vaccines are of tremendous importance in the prevention of serious illness, we emphasize the importance of administering them at the appropriate depth and location for each patient.