Pneumonia vaccine can be administered in thigh if necessary

DEAR DR. ROACH: I have a badly torn rotator cuff on my left shoulder, so that arm is basically a constant problem.

In January 2017, my physician suggested that I would benefit from the pneumonia vaccine and that it would take two applications, one year apart, to complete. I agreed to have the vaccine, which was administered into my upper left arm. Ever since then, I have had pain in the muscle area and at times do not have use of that arm. I have talked with the nurse, the physician assistant and also with my orthopedic doctor about this problem. They all have given me blank looks and no answer to the situation. Do you have any suggestion or remedies for this? Should I have the second injection? — M.P.

ANSWER: I think the problem is the torn rotator cuff and that it was exacerbated by your reaction to the vaccine.

The rotator cuff is a group of four muscles that keep the arm in place in the shoulder during movement of the arm. If the rotator cuff is damaged, either by inflammation or from a mechanical tear, the arm will not move normally. Complications, including a frozen shoulder, are common.

I suspect that the temporary sore arm from a vaccine immobilized your arm long enough that you developed further inflammation in the shoulder. Although I have seen cases where the vaccine is given near a nerve and causes temporary numbness or pain, it should not last for longer than a few days — certainly not weeks or months. A sore arm for a day or two is a typical reaction to a pneumonia vaccine. However, even a day of not using your arm can reduce mobility in someone with a rotator cuff tear.

My advice is to speak to the orthopedic doctor about the torn rotator cuff, but I would not get the second pneumonia vaccine in the bad arm. It can be injected into the good arm; or, if you have rotator cuff problems on the other side, too (many people do), the pneumonia vaccine also may be given in the thigh. The pneumonia vaccine saves lives.

Dr. Roach regrets he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, Fla., 32803. Health newsletters may be ordered from www.rbmamall.com.