VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_23-vv-01052
Package ID: USCOURTS-cofc-1_23-vv-01052
Petitioner: Mary Ditzian
Filed: 2023-07-10
Decided: 2025-12-02
Vaccine: Tdap
Vaccination date: 2022-02-04
Condition: shoulder injury related to vaccine administration (SIRVA)
Outcome: entitlement_granted_pending_damages
Award amount USD: 

AI-assisted case summary:
On July 10, 2023, Mary Ditzian filed a petition alleging that a tetanus-diphtheria-acellular pertussis (Tdap) vaccination administered on February 4, 2022 caused a shoulder injury related to vaccine administration. The public rulings identify her as an adult but do not state an exact age.

The main dispute was whether pain began within 48 hours. Ms. Ditzian and family members described throbbing left shoulder pain beginning after the shot, continued pain and reduced range of motion, and practical problems such as difficulty using the shoulder to carry a pan. The first medical treatment came more than six months after vaccination, when records described left shoulder pain for several months, decreased range of motion since the Tdap shot, and later MRI for seven months of shoulder pain. Chief Special Master Corcoran found on March 31, 2025 that Table onset was established despite the delay in seeking care.

After the onset ruling, respondent confirmed that he had no objection to entitlement on grounds other than Table onset. On December 2, 2025, the Chief Special Master found that the record satisfied all Table SIRVA and Vaccine Act requirements, including no prior shoulder history, pain and reduced range of motion limited to the vaccinated shoulder, receipt of a covered Tdap vaccine in the United States, six-month residual effects, and no prior civil award. Ms. Ditzian was found entitled to compensation; damages remain pending.

Theory of causation field:
Adult petitioner; Tdap vaccine February 4, 2022; Table SIRVA. ENTITLEMENT GRANTED, damages pending. Onset disputed because first care was over six months later, but petitioner/family declarations and later medical records tied left shoulder pain/ROM loss to the Tdap shot; no alternative onset records. SM Corcoran found Table onset March 31, 2025 and full entitlement December 2, 2025. Petition filed July 10, 2023.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_23-vv-01052-0
Date issued/filed: 2025-05-02
Pages: 8
Docket text: PUBLIC ORDER/RULING (Originally filed: 03/31/2025) regarding 20 Findings of Fact & Conclusions of Law. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 1 of 8
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-1052V
MARY DITZIAN, Chief Special Master Corcoran
Petitioner,
v. Filed: March 31, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Sarah Christina Duncan, U.S. Department of Justice, Washington, DC, for Respondent.
FACT RULING ON ONSET1
On July 10, 2023, Mary Ditzian (“Petitioner”) filed a petition for compensation under
the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”), alleging that she suffered a Table shoulder injury related to vaccine
administration (“SIRVA”) as a result of a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine administered to her on February 4, 2022.3 Pet. at 1, ECF No. 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
For the reasons discussed below, I find it more likely than not that the onset of
Petitioner’s shoulder pain occurred within 48 hours of vaccination, as alleged.
1 Because this Ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2018).
3 Petitioner alternatively alleges that her SIRVA was caused-in-fact by the subject vaccination. See Pet.

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 2 of 8
I. Relevant Procedural History
Shortly after initiating her claim, Petitioner filed her vaccine administration record,
medical records, and several witness declarations, followed by a statement of completion.
ECF Nos. 6-8. Respondent thereafter determined that this matter was not appropriate for
compensation. ECF No. 15. Respondent filed his Rule 4(c) Report in defense of this case
on June 15, 2024. Respondent’s Report, ECF No. 16.
Respondent contends that the medical records do not support the conclusion that
the onset of Petitioner’s pain occurred within 48 hours of vaccination. Respondent’s
Report at 5. Specifically, Petitioner did not attempt to seek care for shoulder-related pain
until nearly seven months post vaccination – and then waited an additional month before
seeking in-person treatment. Id. Additionally, Respondent argues the affidavits from
Petitioner, her family members, and coworkers should be “given minimal weight” as they
were all written for the purpose of litigation, more than a year post vaccination, and are
otherwise not supported by the contemporaneous medical records. Id. The onset dispute
is now ripe for consideration.
II. Authority
Pursuant to Vaccine Act Section 13(a)(1)(A), a petitioner must prove, by a
preponderance of the evidence, the matters required in the petition by Vaccine Act
Section 11(c)(1). “Medical records, in general, warrant consideration as trustworthy
evidence. The records contain information supplied to or by health professionals to
facilitate diagnosis and treatment of medical conditions. With proper treatment hanging in
the balance, accuracy has an extra premium. These records are also generally
contemporaneous to the medical events.” Cucuras v. Sec’y of Health & Hum. Servs., 993
F.2d 1525, 1528 (Fed. Cir. 1993).
Accordingly, where medical records are clear, consistent, and complete, they
should be afforded substantial weight. Lowrie v. Sec’y of Health & Hum. Servs., No. 03-
1585V, 2005 WL 6117475, at *20 (Fed. Cl. Spec. Mstr. Dec. 12, 2005). However, this rule
does not always apply. In Lowrie, the special master wrote that “written records which
are, themselves, inconsistent, should be accorded less deference than those which are
internally consistent.” Lowrie, 2005 WL 6117475, at *19.
The United States Court of Federal Claims has recognized that “medical records
may be incomplete or inaccurate.” Camery v. Sec’y of Health & Hum. Servs., 42 Fed. Cl.
381, 391 (1998). The Court later outlined four possible explanations for inconsistencies
between contemporaneously created medical records and later testimony: (1) a person’s
2

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 3 of 8
failure to recount to the medical professional everything that happened during the relevant
time period; (2) the medical professional’s failure to document everything reported to her
or him; (3) a person’s faulty recollection of the events when presenting testimony; or (4)
a person’s purposeful recounting of symptoms that did not exist. La Londe v. Sec’y of
Health & Hum. Servs., 110 Fed. Cl. 184, 203-04 (2013), aff’d, 746 F.3d 1335 (Fed. Cir.
2014). The Court has also said that medical records may be outweighed by testimony
that is given later in time that is “consistent, clear, cogent, and compelling.” Camery, 42
Fed. Cl. at 391 (citing Blutstein v. Sec’y of Health & Hum. Servs., No. 90-2808, 1998 WL
408611, at *5 (Fed. Cl. Spec. Mstr. June 30, 1998)).
A special master may find that the first symptom or manifestation of onset of an
injury occurred “within the time period described in the Vaccine Injury Table even though
the occurrence of such symptom or manifestation was not recorded or was incorrectly
recorded as having occurred outside such period.” Section 13(b)(2). “Such a finding may
be made only upon demonstration by a preponderance of the evidence that the onset [of
the injury] . . . did in fact occur within the time period described in the Vaccine Injury
Table.” Id.
The special master is obligated to fully consider and compare the medical records,
testimony, and all other “relevant and reliable evidence contained in the record.” La
Londe, 110 Fed. Cl. at 204 (citing § 12(d)(3); Vaccine Rule 8); see also Burns v. Sec’y of
Health & Hum. Servs., 3 F.3d 415, 417 (Fed. Cir. 1993) (holding that it is within the special
master’s discretion to determine whether to afford greater weight to medical records or to
other evidence, such as oral testimony surrounding the events in question that was given
at a later date, provided that such determination is rational).
III. Relevant Factual Evidence
I make this finding after a complete review of the record to include all medical
records, declarations, and additional evidence filed, and in particular the following:4
• Petitioner received the subject vaccine on February 4, 2022, during a visit
with her primary care provider (“PCP”). Ex. 2 at 1.
• Petitioner contends that “[w]hen [she] arrived home from the tetanus
vaccination, [she] told [her] husband [] that [her] left shoulder was
surprisingly sore.” Ex. 1 ¶ 8. More so, “[w]ithin two days of the vaccination,
[she] began to have throbbing pain in [her] left shoulder.” Id. ¶ 9. Petitioner
4 While I have reviewed all the evidence filed to-date in this case, only evidence related to onset will be
discussed herein, though other facts may be provided as necessary.
3

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 4 of 8
explained that her shoulder pain and range of motion (“ROM”) continued to
get worse “[a]s time passed[.]” Id. She stated that over-the-counter
medications (Tylenol and Advil) provided no relief, with heating pads
providing temporary relief. Id. Petitioner also noted that “[s]ometime in the
summer of 2022, [her] daughter-in-law . . . noticed that something was
wrong with [Petitioner’s] left shoulder.” Id. ¶ 11.
• Petitioner’s daughter-in-law submitted a witness declaration on Petitioner’s
behalf, and in it states that during the summer of 2022, she was taking
educational vaccination classes through her job as a pharmacy technician.
Ex. 16 ¶ 5. She thus learned that a vaccination can be incorrectly
administered, resulting in an inflammatory injury or atypical shoulder pain.
Id. During her visit with Petitioner on August 20, 2022, she noticed
something was wrong, and Petitioner said that “she had had left shoulder
pain for months.” Id. ¶ 6. According to the daughter-in-law, Petitioner was
not sure what caused her pain, but “she said that she had gotten a Tdap
shot right before her left shoulder pain started.” Id. ¶ 7. The daughter-in-law
told Petitioner to seek medical care. Id. ¶ 9.
• On August 26, 2022 – more than six months post-vaccination – Petitioner
called her PCP’s office requesting a referral to physical therapy (“PT”) “to
address shoulder pain.” Ex. 3 at 69. Her PCP returned her call on August
29, 2022, instructing Petitioner to be seen in-person prior to receiving a
referral to PT. Id. at 68.
• Almost a month later, on September 20, 2022, Petitioner saw her PCP
complaining of “[l]eft shoulder pain for several months [with w]orsening
symptoms.” Ex. 3 at 74. Petitioner also reported “[d]ecreased [ROM] since
receiving [the] Tdap [vaccination on] 2/4/22.” Id. She stated she had been
using over-the-counter Advil/Tylenol and a heating pad “with minimal
improvement.” Id. An examination showed decreased ROM and Petitioner
was diagnosed with adhesive capsulitis. Id. at 74-75.
• The next day, Petitioner had an initial PT evaluation. Ex. 4 at 14. Petitioner’s
primary complaint was noted to be “[left] shoulder pain in the lateral arm that
started after getting tetanus shot on 2/4/22.” Id. She also stated she “had
achiness from the shot and then the symptoms never improved.” Id. Upon
examination, Petitioner exhibited pain plus reduced ROM and strength,
which her treater felt was consistent with adhesive capsulitis. Id. at 16.
4

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 5 of 8
• Petitioner underwent an MRI of the left shoulder on September 27, 2022.
Ex. 5 at 18. The reason for the examination was listed as “shoulder pain for
7 months with very truncated [ROM] esp[ecially] in terms of rotation,
adhesive capsulitis.” Id.
• On October 7, 2022, Petitioner saw an orthopedic surgeon and reported
that her left shoulder pain “began in 2/2022 after a tetanus shot.” Ex. 6 at 9.
She noted that her pain later progressed to stiffness in the shoulder. Id.
Petitioner showed diminished ROM on examination. Id. at 10. The
orthopedist assessed Petitioner with adhesive capsulitis, and she received
a steroid injection the following week. Id. at 11-12. Petitioner thereafter
attended 58 PT sessions, through April 20, 2023, approximately 14.5
months post vaccination. See Ex. 9 at 10-12; see also Ex. 7 at 7.
• One of Petitioner’s coworkers has submitted a witness declaration on
Petitioner’s behalf, attesting that “[s]ometime before President’s Day last
year [2022], [the coworker] remember[ed] picking up something heavy and
needing help.” Ex. 12 ¶ 5. Typically, Petitioner would help the coworker, but
“in that instance, [Petitioner] told her she could not help [] because her left
shoulder was hurt.” Id.
• Another one of Petitioner’s coworkers submitted a witness declaration
stating that “[a] couple of months after Christmas 2021, [Petitioner] started
to ask [the coworker] for help lifting heavy items or carrying things [] at work.”
Ex. 13 ¶ 7. Further, “[s]ometime in February 2022 or March 2022,” Petitioner
required this coworker’s help after dropping a hot pan “since her left
shoulder was weak so she could not carry the pan.” Id. ¶ 8.
• A third coworker of Petitioner’s also submitted a witness declaration and
appears to recall a similar event, stating that “[s]ometime in February 2022,
[Petitioner] almost dropped food because she could not carry a food tray
with her left arm.” Ex. 14 ¶ 7. The coworker recalled this event because she
had to reach for the handle on the steaming tray to help Petitioner. Id.
• Additionally, a fourth coworker attests that “[s]ometime after the New Year
and most likely in February 2022, [Petitioner] expressed to [the coworker]
that she needed help in fulfilling certain duties that required the use of her
left arm.” Ex. 15 ¶ 7. According to this coworker, Petitioner could not recall
a specific trauma that led to this pain, “[a]lthough she recently said that she
had had a tetanus shot.” Id. ¶ 8.
5

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 6 of 8
• Finally, Petitioner’s husband submitted a witness declaration, stating in it
that “[w]hen [Petitioner] returned home after the vaccination, she told [him]
something was wrong with her left shoulder.” Ex. 17 ¶ 8. Petitioner’s
husband noted that “by the summer of 2022[,]” Petitioner continued
“complaining of ongoing left shoulder pain.” Id. ¶ 11.
• No other medical record or affidavit/witness declaration evidence regarding
the onset of Petitioner’s post vaccination shoulder injury has been filed.
IV. Finding of Fact Regarding Onset
A petitioner alleging a SIRVA claim must show that she experienced the first
symptom or onset within 48 hours of vaccination (42 C.F.R. § 100.3(a)(XIV)(B) and
3(c)(10)(ii) (QAI criteria)).
As stated above, Respondent contends that Petitioner’s medical records do not
support that the onset of her pain occurred within 48 hours of vaccination. Respondent’s
Report at 5. But the totality of the evidence is favorable to Petitioner on this issue. The
aforementioned medical records, coupled with Petitioner’s filed witness declarations,
establish that Petitioner consistently reported to treaters an onset close-in-time to
vaccination, and that she indeed was experiencing symptoms in the relevant timeframe.
See, e.g., Ex. 3 at 74; Ex. 4 at 14; Ex. 5 at 18-19; Ex. 6 at 9; Exs. 1, 12-17.
Although it does cast doubt on Petitioner’s claim, the fact that Petitioner delayed
seeking treatment for approximately six-and-a-half months (until August 26, 2022) does
not by itself preclude a finding of Table onset. There is no requirement that a Program
claimant prove Table onset with evidence that was generated within the severity
timeframe, let alone within the two-day onset period. And similarly-lengthy delays have
not always resulted in a finding that onset is not met. See, e.g., Tenneson v. Sec’y of
Health & Hum. Servs., No. 16-1664V, 2018 WL 3083140, at *5 (Fed. Cl. Spec. Mstr. Mar.
30, 2018), mot. for rev. denied, 142 Fed. Cl. 329 (2019) (finding a 48-hour onset of
shoulder pain despite a nearly six-month delay in seeking treatment); Williams v. Sec’y
of Health & Hum. Servs., No. 17-830V, 2019 WL 1040410, at *9 (Fed. Cl. Spec. Mstr.
Jan. 31, 2019) (noting a delay in seeking treatment for five-and-a-half months because a
petitioner underestimated the severity of her shoulder injury).
The fact that Petitioner could not attend an in-person visit for an additional month
after reaching out to her PCP likewise does not harm her Table onset claim. This is not a
case where the petitioner had intervening medical visits without mentioning shoulder-
related pain. There are no records supporting an alternative onset finding. And as I have
6

Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 7 of 8
previously noted, SIRVA petitioners often put off seeking shoulder-related care based on
the reasonable assumption that the pain is normal and will resolve on its own over time,
especially since patients are often told by medical providers at the time of vaccination to
expect some soreness and pain. This appears to have been the case here, with Petitioner
explaining she thought her aching pain left over from the vaccination would resolve with
home remedies. See, e.g., Ex. 1 ¶¶ 8-11.
In addition, although the filed medical record is limited in this case, the records that
do exist nonetheless establish that Petitioner affirmatively and repeatedly linked her
shoulder pain to the subject vaccine – beginning with the September 20th treatment
encounter, at which time she reported “[l]eft shoulder pain for several months [with
w]orsening symptoms” and, specifically, “[d]ecreased [ROM] since receiving [the] Tdap
[vaccination on] 2/4/22.” Ex. 3 at 74. This reporting provides support for Table onset.
Other subsequent medical records describe onset with similar particularity. See, e.g., Ex.
4 at 14 (a September 21, 2022 complaint of “[left] shoulder pain in the lateral arm that
started after getting tetanus shot on 2/4/22.”); Ex. 6 at 9 (an October 7, 2022 report of left
shoulder pain that “began in 2/2022 after a tetanus shot.”).
Even with less specificity, the remaining entries in the medical records support an
onset close-in-time to the subject vaccination. See, e.g., Ex. 5 at 18 (a September 27,
2022 reason for MRI listed as “shoulder pain for 7 months”). More so, such entries
corroborate the ample and consistent contentions made in Petitioner’s witness affidavits
that Petitioner’s pain began in February 2022 – thus supporting an onset soon after
vaccination. See Exs. 12-17. This evidence – coupled with the many witness statements
filed in the matter – preponderate in Petitioner’s favor.
Of course – a delay of treatment that temporally matches the Act’s severity
timeframe, as here, is strong evidence that the claimant’s pain was not sufficiently severe
to compel her to seek treatment more rapidly. This fact will impact any pain and suffering
award issued in this case – and Petitioner must therefore act accordingly in calculating
damages to be requested.
Conclusion and Scheduling Order
I encourage the parties to promptly attempt an informal resolution of this claim
before expending any further litigative resources on the case. If at any time informal
resolution (of either settlement or proffer) appears unlikely, given that the claim has been
pending in SPU for over one year (having been assigned in November 2023), the parties
should re-propose a method for moving forward, i.e., with a proposed briefing schedule
or otherwise stating how they wish to proceed.
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Case 1:23-vv-01052-UNJ Document 22 Filed 05/02/25 Page 8 of 8
Accordingly, by no later than Wednesday, April 30, 2025, the parties shall file a
joint status report confirming the date on which Petitioner conveyed, or intends to convey,
a reasonable settlement demand and supporting documentation for Respondent’s
consideration. If applicable, the status report may also state whether Respondent
wishes to file an amended Rule 4(c) report and stating how much time is needed to
submit said report.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
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DOCUMENT 2: USCOURTS-cofc-1_23-vv-01052-1
Date issued/filed: 2026-01-07
Pages: 4
Docket text: PUBLIC ORDER/RULING (Originally filed: 12/02/2025) regarding 28 Ruling on Entitlement. Signed by Chief Special Master Brian H. Corcoran. (cr) Service on parties made.
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Case 1:23-vv-01052-UNJ Document 30 Filed 01/07/26 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 23-1052V
MARY DITZIAN, Chief Special Master Corcoran
Petitioner,
v. Filed: December 2, 2025
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Jeffrey S. Pop, Jeffrey S. Pop & Associates, Beverly Hills, CA, for Petitioner.
Sarah Christina Duncan, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On July 10, 2023, Mary Ditzian (“Petitioner”) filed a Petition for compensation
under the National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2
(the “Vaccine Act”), alleging that she suffered a Table shoulder injury related to vaccine
administration (“SIRVA”) as a result of a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine administered to her on February 4, 2022.3 Pet. at 1, ECF No. 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
Respondent opposed compensation of Petitioner’s Table claim – solely objecting
to onset. Rule 4(c) Report, ECF No. 16. But on March 31, 2025, I subsequently issued
1 Because this Ruling contains a reasoned explanation for the action taken in this case, it must be made
publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic Government
Services). This means the Ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2018).
3 Petitioner alternatively alleges that her SIRVA was caused-in-fact by the subject vaccination. See Pet.

Case 1:23-vv-01052-UNJ Document 30 Filed 01/07/26 Page 2 of 4
Findings of Fact and Conclusions of Law determining that Petitioner had established
Table onset based on the existing record. See ECF No. 20; see also 42 C.F.R. §
100.3(c)(10)(ii). I ordered the parties to attempt an informal resolution of this claim, and
in providing an update on those discussions, to report if at any time Respondent wished
to file an amended Rule 4(c) Report. Id. at 7-8.
Though the parties made an effort to settle this case thereafter, they were
ultimately unsuccessful. ECF Nos. 21, 23-27. Respondent has not since filed an amended
Rule 4(c) Report, but has confirmed that he “is not objecting to entitlement on any other
grounds” than Table onset.4 Informal Comm., docketed Dec. 2, 2025. The parties thus
requested I make a formal ruling on entitlement and order briefings regarding damages.
See id.
I. Legal Standards and Analysis
The most recent version of the Table, which can be found at 42 C.F.R. § 100.3,
identifies the vaccines covered under the Program, the corresponding injuries, and the
time period in which the particular injuries must occur after vaccination. Section 14(a).
Pursuant to the Vaccine Injury Table, a SIRVA is compensable if it manifests within 48
hours of the administration of a covered vaccine. 42 C.F.R. § 100.3(a)(VII)(C). The criteria
establishing a SIRVA under the accompanying Qualifications and Aids to Interpretation
(“QAI”) are as follows:
Shoulder injury related to vaccine administration (SIRVA). SIRVA manifests
as shoulder pain and limited range of motion occurring after the
administration of a vaccine intended for intramuscular administration in the
upper arm. These symptoms are thought to occur as a result of unintended
injection of vaccine antigen or trauma from the needle into and around the
underlying bursa of the shoulder resulting in an inflammatory reaction.
SIRVA is caused by an injury to the musculoskeletal structures of the
shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is not a neurological
injury and abnormalities on neurological examination or nerve conduction
studies (NCS) and/or electromyographic (EMG) studies would not support
SIRVA as a diagnosis (even if the condition causing the neurological
abnormality is not known). A vaccine recipient shall be considered to have
suffered SIRVA if such recipient manifests all of the following:
4 The communications herein are quoted directly from the aforementioned email informal communication
from Respondent’s counsel.
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Case 1:23-vv-01052-UNJ Document 30 Filed 01/07/26 Page 3 of 4
(i) No history of pain, inflammation or dysfunction of the affected shoulder
prior to intramuscular vaccine administration that would explain the alleged
signs, symptoms, examination findings, and/or diagnostic studies occurring
after vaccine injection;
(ii) Pain occurs within the specified time frame;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g. NCS/EMG or clinical evidence of radiculopathy,
brachial neuritis, mononeuropathies, or any other neuropathy).
42 C.F.R. § 100.3(c)(10) (2017).
I have already found in Petitioner’s favor on onset, and her success in meeting the
remaining QAI requirements is not disputed. See, e.g., Rule 4(c) Report at 5-8; Informal
Comm., docketed Dec. 2, 2025. Respondent has stated no other objections to
compensation, and I find that those requirements have been preponderantly satisfied.
The record does not suggest that Petitioner had a history of shoulder pain or any other
condition that would explain her post-vaccination symptoms. See 42 C.F.R. §
100.3(c)(10)(i), (iv) (first and fourth QAI criteria). She exhibited reduced ROM, and her
pain and ROM limitations were limited to the vaccinated shoulder. See, e.g., Ex. 3 at 74-
75; Ex. 4 at 14-16; Ex. 6 at 9-10; see also 42 C.F.R. § 100.3(c)(10)(iii) (third QAI criterion).
The statutory requirements applicable to all claims, Table or causation-in-fact, are
also preponderantly established. Petitioner received a covered Tdap vaccine in the United
States. See Ex. 2 at 1; see also Section 11(c)(1)(A) (requiring receipt of a covered
vaccine); Section 11(c)(1)(B)(i) (requiring administration within the United States or its
territories). She experienced residual effects of her alleged injury for more than six
months. See, e.g., Ex. 3 at 37-43, 69, 74; Ex. 9 at 10-12; see also Section 11(c)(1)(D)(i)
(the Vaccine Act’s six-month severity requirement). And she states that she has never
received an award or settlement of a civil action for the injury, nor has she filed a civil
action. See Pet. ¶¶ 83-84; see also Section 11(c)(1)(E) (lack of prior civil award). Thus,
Petitioner has satisfied all requirements for entitlement under the Vaccine Act.
3

Case 1:23-vv-01052-UNJ Document 30 Filed 01/07/26 Page 4 of 4
Conclusion
Based on the entire record in this case, I find that Petitioner has provided
preponderant evidence satisfying all requirements for a Table SIRVA and all other
Vaccine Act requirements are met. Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
4