In July, HRSA proposed adding SIRVA to the programs list of covered injuries. If you are a Home delivery print subscriber, unlimited online access is. -, Batra S, Page B. Shoulder Injury Related to Vaccine Administration and a Growing Challenge: A Focused Review. The authors declare no competing interests. The pain you. I saw a remarkable improvement after the first application, and, a few days later, the rash was gone. Such severe reactions to vaccines are very rare, but they do occur. (. 2023 Feb;46(2):292-294. doi: 10.1007/s00270-022-03319-4. Shoulder injuries become more likely as we age. Read more about cookies here. Many people feel very little after the first shot, but have more side effects after the second coronavirus vaccine shot. The tear is in line with the fibers of my cuff, much like a split in a seam. The powder may have an advantage in keeping this delicate area dry. 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. Is it normal for my shoulder to hurt after a COVID-19 vaccine? Chang SE, Feng A, Meng W, Apostolidis SA, Mack E, Artandi M, Barman L, Bennett K, Chakraborty S, Chang I, Cheung P, Chinthrajah S, Dhingra S, Do E, Finck A, Gaano A, Gener R, Giannini HM, Gonzalez J, Greib S, Gndisch M, Hsu AR, Kuo A, Manohar M, Mao R, Neeli I, Neubauer A, Oniyide O, Powell AE, Puri R, Renz H, Schapiro J, Weidenbacher PA, Wittman R, Ahuja N, Chung HR, Jagannathan P, James JA, Kim PS, Meyer NJ, Nadeau KC, Radic M, Robinson WH, Singh U, Wang TT, Wherry EJ, Skevaki C, Luning Prak ET,Utz PJ. Here's how it works and what to consider before trying it. So please, keep vaccinating! HHS Vulnerability Disclosure, Help 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. Shoulder injury related to vaccine administration (SIRVA) following mRNA COVID-19 vaccination: Report of 2 cases of subacromial-subdeltoid bursitis. Pain, swelling, and tenderness near a joint are the most common signs of bursitis. Treatments that work for some may not work for others. My doctor prescribed 1,800 milligrams of ibuprofen daily. In contrast, only 15% of healthy controls had such antibodies. In 2012, more than 9.6 million Americans sought help from their physicians for shoulder problems, according to the American Academy of Orthopaedic Surgeons. The chances of any of these side effects occurring after vaccination differ according to the specific vaccine . Moya D, Gmez D, Altamirano N, Alfano F, Pereira Corvaln JM, Dobkin F, Menon PH, Patinharayil G. J Orthop. This type of bursitis, also called Haglund deformity, is in the bursa located between the skin of the heel and the Achilles tendon. Since the first COVID-19 vaccine was administered, about 3.5 million people in New York and New Jersey have received their first dose. A third of the patients needed surgery, some of them twice. MRI scans showed, among other things, bursitis and rotator cuff tears in several of the patients. . 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. However, after my Moderna booster shot, I noticed a big change in my bone-on-bone shoulder pain. Army, Ft. Stewart, Georgia, 2012-2015 Since I got the COVID-19 vaccination in that shoulder, I have not been bothered with bursitis. Far-right U.S. news outlet The Epoch Times reported on March 6 that 966 people had died after having the Pfizer or Moderna COVID vaccines. Symptoms can include fever and fatigue, as well as shortness of breath and a very specific type of chest pain. Shoulder Injury Related to Vaccine Administration (SIRVA) An Occupational Case Report. Russo, for example, tried physical therapy, but it didnt work. Keywords: Kneecap bursitis. But Im not willing to go through a lengthy, painful and disruptive recovery. government site. This causes pain and swelling. doi: 10.1177/1715163518790771. As the long-awaited COVID-19 vaccine rollout begins across the country and everyone is eager to get back to normal life, it can be confusing to understand what you can and cannot do once you and those around you are vaccinated. Results were published on September 14, 2021, in Nature Communications. That number is larger when factoring in all the various vaccinations beyond just the flu vaccine. Inactivated vaccines, which are made from killed virus, contain adjuvants, or additional chemicals, that help promote a robust immune response. I can lift my arm, but it hurts. 713-798-4710. All these months later, it still hurts. It is aggravated by a type of walking that presses the soft heel tissue into the hard back support of a shoe. Also called trochanteric bursitis, hip bursitis is often the result of injury, overuse, spinal abnormalities, arthritis, or surgery. -, Atanasoff S, Ryan T, Lightfoot R, Johann-Liang R. Shoulder injury related to vaccine administration (SIRVA) Vaccine. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Additionally, the Fact Sheet for Recipients and Caregivers notes that vaccine recipients should seek medical attention right away if they develop any of the following symptoms after receiving the . One condition that may result is known as shoulder injury related to vaccine administration (SIRVA). The Vaccine Adverse Event Reporting System (VAERS), run jointly by the CDC and the Food and Drug Administration, has received about 1,200 complaints of post-vaccination shoulder-related injuries since 1990, according to the CDC. IE 11 is not supported. This stands for rest, ice, compression, and elevation, Anti-inflammatory and pain medicines, such as ibuprofen or aspirin, Injection of a steroid into the affected area to help decrease pain and swelling, Splints or braces to limit movement of the affected joint. Proper administration technique is important for preventing shoulder injuries., Elisabeth Hesse, MD, MTM&H, EIS Class of 2017, EIS Officer Elisabeth Hesse, MD, MTM&H, shares her research with CDC Health Communications Specialist Brittany Booker, CDC Media Relations Create an account or sign in to continue with your reading experience. Colorized scanning electron micrograph of a cell (red) infected with a variant strain of SARS-CoV-2 virus particles (green), isolated from a patient sample. Epub 2021 Oct 1. Fernndez Martnez AM, Cuesta Marcos MT, Rodrguez Prieto J. Cardiovasc Intervent Radiol. The study was funded by several NIH components, primarily the National Institute of Allergy and Infectious Diseases (NIAID). The most common causes of bursitis are injury or overuse. Bursitis; COVID-19; MRI; SIRVA; Shoulder; Ultrasound; Vaccine. CDC twenty four seven. Shoulder Joint Support & Pain Relief - Shoulder bandage not only provides strong support for the shoulder, but also relieves pain in the . They help us to know which pages are the most and least popular and see how visitors move around the site. Most of the time, this soreness is mild and will go away without treatment in a few days. After taking it for several weeks, my blood pressure rose to 190/106. Disclaimer. To look at this question, researchers screened for a range of autoantibodies in blood samples from almost 150 people hospitalized with COVID-19 and 41 healthy volunteers. New-onset inflammatory arthritis after COVID-19 vaccination: A systematic review. Gradually increase the demands you put on your body. The 1st dose should give you some protection from 3 or 4 weeks after you've had it. At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Arthritis? NIH Research Mattersis a weekly update of NIH research highlights reviewed by NIHs experts. Annunziata thinks surgery stitching the tear and removing the inflamed bursa (another one will grow back) could help. The CDC had information on the recovery of patients in 220 cases; in more than 80 percent of these cases, patients got better on their own. The CDC stated, "It is not recommended you take over-the-counter medicine, such as ibuprofen, aspirin, or acetaminophen, before vaccination for the purpose of trying to prevent vaccine-related side effects. The Vaccine Adverse Event Reporting System (VAERS), run jointly by the CDC and the Food and Drug Administration, has received about 1,200 complaints of post-vaccination shoulder-related. How Long Do the COVID-19 Vaccines Protect You? This location should be above the level of your armpit when your arm is held straight by your side. More work is also needed to understand how autoantibodies contribute to COVID symptoms. It went fine. Most cases are generally mild and go away on their own. Medical Center, Washington, DC, 2009-2010, Work Experience: Division Chief, Disease Epidemiology, Army Public Health Center, These are not serious and will go away on their own. Trop Dis Travel Med Vaccines. The CDC has acknowledged reports of tinnitus post-vaccination, specifically with the Moderna and Pfizer vaccines. Keywords: COVID-19, SIRVA, Bursitis, Vaccine, Shoulder, MRI, Ultrasound Introduction Flu season is here, and recently I got the shot. Rodrigues TS, et al. A systematic review of 41 randomized controlled trials found that miconazole, clotrimazole and nystatin are equally effective as topical treatments for fungus (Journal of the European Academy of Dermatology and Venereology, October 2019). Vaccines linked to heart issue in teens and young adults, CDC investigates rare heart problem in a few young vaccine recipients. This type of bursitis may be caused by lack of stretching before exercise, tight hamstring muscles, being overweight, arthritis, or out-turning of the knee or lower leg. 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. Dull/aching pain at rest and during everyday activities. sharing sensitive information, make sure youre on a federal There is no evidence that proves NSAIDs exacerbate COVID-19. Advisory Committee on Immunization Practices (ACIP). A study based on data collected as part of the National Health and Nutrition Examination Survey estimates that about 15% of American adults take a medication that could raise their blood pressure (JAMA Internal Medicine, Jan. 1, 2022). and transmitted securely. We encountered an issue signing you up. Download the NBC News app for full coverage of the coronavirus outbreak. doi: 10.1177/1758573214560258. Since I got the COVID-19 vaccination in that shoulder, I have not been bothered with bursitis. 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. When that happens, he adds, an acute process can become chronic.. These put extra strain on the lower part of the Achilles tendon. You can review and change the way we collect information below. Despite the increased number of reported myocarditis cases among young people, Shimabukuro said, no major red flags have been identified. 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. You can help prevent bursitis by doing things like warming up before exercise or sports, increasing activity slowly, padding joints, taking rest breaks often, and stopping activities that cause pain. 2022 Aug 12;40(34):4964-4971. doi: 10.1016/j.vaccine.2022.06.002. The condition, called myocarditis, is usually mild, but a handful of patients remain hospitalized. Shoulder injury related to vaccine administration and other injection site events. But rare and serious complications may occur. Treatment may include: R.I.C.E. However, you may sometimes experience more severe side effects related to vaccination in the upper arm, including intense shoulder pain and limited range of motion. This site needs JavaScript to work properly. This is the body's natural response, as it's working hard to build immunity against the disease. But why do the vaccines sometimes cause these unpleasant symptoms, and are they cause for concern? Martn Arias LH, Sanz Fadrique R, Sinz Gil M, Salgueiro-Vazquez ME. To our knowledge, this study is the first attempt to determine the risk of deltoid bursitis following flu vaccination. Shoulder injury related to vaccine administration. By padding these areas, bursae (plural for bursa) decrease friction, rubbing and inflammation. If needed, surgery can be done to remove the bursa. Shoulder injury related to vaccine administration: case series of an emerging occupational health concern. The most common side effects from vaccination, including the COVID-19 vaccines and boosters, are mild. To learn more about such medications, as well as drugs to control high blood pressure and nondrug approaches, you may wish to review our eGuide to Blood Pressure Solutions. The Pes Anserine bursa is located between the shin bone and the three tendons of the hamstring muscles, on the inside of the knee. BA: Hiram College, 2005 Bursitis can happen in any bursa in the body, but there are some common types of bursitis, including: Retromalleolar tendon bursitis. Magnetic resonance imaging (MRI). My orthopedist says I have subacromial bursitis, which is chronic inflammation and excess fluid buildup in the bursa (a thin, lubricated sac that prevents friction between a bone and surrounding soft tissue) separating the acromion bone at the top of the shoulder from the rotator cuff. The bursa becomes infected with bacteria. Authorities are investigating this and similar cases. doi: 10.1016/j.vaccine.2017.07.055. Bethesda, MD 20894, Web Policies Its caused by things like injury, disease, or shoes with rigid back support. This attaches the calf muscles to the heel. One of the doctors suggested I take ibuprofen for a few days. -, Bancsi A, Houle SKD, Grindrod KA. To date, there has never been an epidemiologic study to determine how often deltoid bursitis occurs after vaccination. and deltoid bursitis, or frozen shoulder, characterized by shoulder pain and loss of motion.. Autoantibodiesimmune system proteins that mistakenly target the bodys own tissuesmay underlie some of this variation. Former President Jimmy Carter entered hospice care at home, the Carter Center announced over the weekend. (2019). 2022 Jun 30;95(2):217-220. eCollection 2022 Jun. 2021 Sep 14;12(1):5417. doi: 10.1038/s41467-021-25509-3. Normally, fewer than 100 cases would be expected for this age group. Until definitive links are made, health officials overwhelmingly recommend Covid-19 vaccinations for everyone ages 12 and older. We ask you to keep your comments relevant and respectful. To date, there has never been an epidemiologic study to determine how often deltoid bursitis occurs after vaccination. The application period for EIS Class of 2024 is now open through June 5, 2023. and lower their collar, exposing only the top of the deltoid, says Marko Bodor, a California orthopedist who authored a 2006 report that described vaccination-related shoulder injuries in two of his patients. Further investigation is needed, however, to confirm whether the vaccination was the cause of the heart problem. The researchers found that about half of the people hospitalized with severe COVID-19 had at least one type of autoantibody circulating in their bloodstream. Researchers say antidepressants are effective in treating mental health symptoms, but they don't appear to be effective in easing chronic pain. Can Pharm J (Ott) 2018;151(5):295299. Shoulder Elbow. Photograph of the patient receiving her first dose of the COVID-19 vaccine (Oxford-AstraZeneca,, Subacromial-subdeltoid bursitis on the right, Subacromial-subdeltoid bursitis on the right shoulder 8 weeks after the COVID-19 vaccination. By the time I got home, I couldnt lift my arm out to the side., Elizabeth Cassayre, 81, a retired schoolteacher from Napa, Calif., developed frozen shoulder that plagued her for months after getting her flu shot at a grocery store about 10 years ago. Shoulder problems are incredibly common, says Christopher Annunziata, head orthopedic physician for the Washington Redskins, whom I went to see after the pain did not go away. Now, physicians, Injections of spinal disc tissue into the spine may relieve pain associated with degenerative disc disease, according to preliminary results of a. Bodor uses ultrasound imaging to target precise sites for cortisone injections, which cured Cassayre after several months of ineffective physical therapy. The vast majority of the cases were sent home following a visit to a hospital as of the end of May. A SIRVA diagnosis should not prevent receiving future vaccines. FOIA Chronic bursitis may involve repeated attacks of pain, swelling, and tenderness. Some have experienced side effects even when shots are correctly administered, said David Carney, a Philadelphia attorney who specializes in vaccine-injury cases. Wood CT, et al. 2010;28(51):80498052. What makes SIRVA different from other shoulder injuries is its association with vaccination. 2021 Jun 15;7(1):18. doi: 10.1186/s40794-021-00142-6. . That isn't a requirement, and you can get vaccinated sooner if you want to . These cookies may also be used for advertising purposes by these third parties. We report a case of subacromial-subdeltoid bursitis after COVID-19 vaccination, related to the unintentional injection of vaccine solution into the bursa resulting in a robust immune-mediated inflammatory reaction. 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. -. 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). Bursitis is inflammation of a bursa, a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. In 2012, the Institute of Medicine reported that the injection of a vaccine can cause deltoid bursitis, a type of shoulder injury that can include severe inflammation and pain. Information regarding COVID-19 and vaccines are continually evolving, new details may be available since this content was developed. Learn how long COVID-19 vaccines may protect you, including data from Moderna, Pfizer-BioNTech, Johnson & Johnson, AstraZeneca, and NovaVax vaccines. Meloxicam may be used to relieve pain and inflammation associated with several different medical conditions, trauma, or surgery. Bldg. Having rejected surgery, Ive decided to try something else, safe but still regarded in some circles as experimental. Federal government websites often end in .gov or .mil. But it didnt go away. 2005-2023 Healthline Media a Red Ventures Company. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Please enable it to take advantage of the complete set of features! doi: 10.1177/2165079920952765. Elbow bursitis is caused by the inflammation of the bursa located between the skin and bones of the elbow (the olecranon bursa). It should be 2 to 3 fingerbreadths (the width of your fingers when held together) down from your acromion process the bony part of your shoulder above your deltoid muscle. Arthroscopic surgical management of shoulder secondary to shoulder injury related to vaccine administration (SIRVA). redness, swelling or bruising at and around the injection site. Scientists estimate that the first rounds of COVID-19 vaccines administered between December 2020 and December 2021 prevented 20 million deaths in 1 year. The Centers for Disease Control and Prevention (CDC) recommends a range of vaccines for most people to help prevent dangerous diseases. The CDC will hold a meeting of its Advisory Committee on Immunization Practices on June 18 to further look at the evidence and assess the risk of myocarditis following vaccination. They can vary across different age groups. This can lead to inflammation of the bursa located where the tendon attaches to the heel. It's unclear how many patients were admitted to the hospital, or, for example, were discharged following a visit to the emergency room. Relief has been temporary. NIH Research Matters People react differently after being vaccinated. I got it in the other arm, and I did not take my eyes off the needle. Bookshelf Full coverage of the coronavirus outbreak. During the 2016-2017 flu season, included in this study of vaccine-related bursitis, vaccination prevented 72,000 hospitalizations and 5200 deaths. Bursitis is a condition in which there is inflammation of a bursa. This inflammation results from local soft-tissue trauma or strain injury. It's true that if someone has a history of a severe allergic reaction to any ingredient in the vaccine, they should not receive it. Office of Communications and Public Liaison. Most cases of SIRVA appear to be caused by poor needle placement by the person administering the vaccine or a localized reaction to the vaccine serum. Most people also need a booster dose to help improve the protection from the first 2 doses of the vaccine. Healthline Media does not provide medical advice, diagnosis, or treatment. . Of those, we identified 16 cases of bursitis that started within two days of vaccination. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. References:New-onset IgG autoantibodies in hospitalized patients with COVID-19. These usually last from a few hours to a few days after vaccination. Shoulder injury related to vaccine administration: Diagnosis and management. I have not an uninterrupted, pain-free nights sleep in nearly a year. Some experience long-lasting pain, especially if the shot is administered too high on the arm. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Then, when I got my COVID vaccinations, it totally disappeared and has not come back.. COVID vaccines are being given in the upper arm- in the deltoid muscle because it is one of the strongest muscles of the body. The MHRA follows international standards of safety. Climbing stairs is very painful. One condition that may result is known as shoulder injury related to vaccine administration (SIRVA). Bruising and swelling may develop soon after the injury. Overall, 226 cases of myocarditis or pericarditis after vaccination in people younger than age 30 have been confirmed, Dr. Tom Shimabukuro, deputy director of the CDC's Immunization Safety Office, said during a presentation to a Food and Drug Administration advisory group. There have been rare cases of inflammation of the heart (myocarditis) reported after COVID-19 vaccination. Publication types Case Reports (Feb. 25, 2023) By now, most are likely aware of the swirling controversy surrounding the safety and efficacy, for which the CDC vouches, of the COVID-19 vaccines. In a separate study that looked at COVID vaccination, none of the healthy volunteers developed autoantibodies. Joint Symptoms You Can't Ignore. A SIRVA diagnosis can involve a medical professional: SIRVA can be painful and even debilitating, but treatment is available. For an optimal experience visit our site on another browser. Zeitoun A, Hallit S, Helali M, Chehade S, Allam C, Ibrahim A, Dimassi H, Karam R. J Pharm Policy Pract. 2017;35(37):48704876. Marlene Cimons writes frequently for The Washington Post on health, science and environmental issues. Septic bursitis. Studies are underway to evaluate the effectiveness of this approach; this research may eliminate one of the reasons it is not covered by insurance. I have arthritis in my right knee. I had an MRI in May. Workplace Health Saf. Corticosteroids, such as Kenalog or Celestone that you take orally for severe pain and inflammation. Careers. There is no single way to treat shoulder injuries, regardless of how they occur. Honarmad AR, et al. Experts say that after getting the COVID-19 vaccine, your immune response - the process in which your body builds antibodies to protect you against the virus - is basically the same whether. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The agency noted that 95 of the cases were serious and required hospitalization. COVID-19 Resource Center; Bursitis Submitted by covid-admin on Sun, 08/16/2020 - 19:46. Aug. 10, 2022 While research has revealed that children and adults hospitalized with COVID-19 are more susceptible to developing long COVID symptoms, a new study found that children infected . Some experience. Absolute numbers of long-haulers aren't known, but a recent survey in the U.K. found about 13% of people who had COVID-19 continued to have symptoms three months after their initial infection.. I had no symptoms before the shot, and pain has persisted since. As soon I got the shot, it hurt so bad, I jumped, says Debby Russo, 60, of Eagleville, Pa., who got a flu shot in 2011 at a pharmacy. Schools are stepping up to vaccinate them. says. The U.S. Food and Drug Administration on Monday warned of an increased risk of Guillain-Barre, a rare neurological disorder, following the Johnson & Johnson vaccine after 100 preliminary cases of the syndrome were reported among the 12.5M doses administered. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. The mechanisms behind the production of such autoantibodies arent yet clear. Comments may take up to an hour for moderation before appearing on the site. Shoulder Pain and Injury after COVID-19 Vaccination. Covid cases are rising among teens. Despite 10 dermatologist appointments to get rid of it, I thought I was stuck with it. 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. 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. An August 2021 report from U.S. health officials found that, with 187 million people in the U.S. getting at least one dose, the vaccine benefits are far greater than the risks. Szari S, et al. That can sometimes cause a problem termed SIRVA, shoulder injury related to vaccine administration. Test Widget. Clipboard, Search History, and several other advanced features are temporarily unavailable. The bursa is not infected. Vaccine. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Its okay when I go running, but it bothers me when I swim. Meloxicam works by blocking the effects of the enzymes cyclooxygenase (COX)-1 and COX-2 which prevents prostaglandin synthesis. (2021). Swelling and redness if the inflamed bursa is close to the surface of the skin. The symptoms of bursitis may resemble other medical conditions or problems. Some of those pieces might resemble human proteins enough to trigger the production of autoantibodies. Id had it for several years before that. Wong W, et al. doi: 10.1016/j.vaccine.2010.10.005. 2015;7(2):100103. Would you like email updates of new search results? Vaccination injection site adverse reactions are usually mild and transient, and post-vaccination musculoskeletal symptoms, such as myalgia and arthralgia, are very common. Accessibility Bethesda, MD 20892-2094, Probiotic blocks staph bacteria from colonizing people, Engineering skin grafts for complex body parts, Links found between viruses and neurodegenerative diseases, Bivalent boosters provide better protection against severe COVID-19. The ideal placement for a vaccine in the upper arm is in the central and thickest part of the upper arms deltoid muscle. Others experience so-called long COVID, symptoms that persist long past recovery from the initial stages of illness.