Share Tips for Managing Pain After IM Vaccinations

The COVID-19 vaccine rollout will put more focus on helping patients manage a sore arm after IM immunization.

Advise patients that arm soreness or pain is expected for a couple days after any IM vaccine...including COVID-19 doses.

Don't suggest using acetaminophen or NSAIDs as "premeds"...but don't defer vaccination if patients already took them.

Premedicating might decrease the immune response, based on a hodgepodge of evidence...mostly with routine vaccines in kids. But there aren't good data on whether this reduces vaccine efficacy.

Save acetaminophen or NSAIDs for AFTER vaccination if needed. Remind patients that these work quickly to treat symptoms if they occur.

Recommend using the arm, not resting it, postvaccination.

Also suggest applying a cool compress for pain if needed.

But don't rely on topicals (arnica, diclofenac, salicylates, etc). There's no evidence that these help reduce pain after immunization.

Use our checklist, Vaccine Administration Strategies, for other ways to limit pain, proper administration technique, and more.

See our chart, Communicating About COVID-19 Vaccination, for other possible COVID-19 vaccine side effects...and how to manage them.

Key References

  • https://ismp.org/resources/prevent-shoulder-injuries-during-covid-19-vaccinations (3-2-21)
  • Can Fam Physician 2019;65(1):40-2
  • www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html (3-2-21)
  • www.immunize.org/technically-speaking/20181023.asp (3-2-21)
  • www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html (3-2-21)
Hospital Pharmacist's Letter. March 2021, No. 370302



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