Is it usual for vaccine injection site to hurt again during infection?

  • #1
somegrue
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I got my first COVID infection sometime last weekend (best guess). Mild symptoms kicked in Monday evening (in retrospect). Spent most of yesterday in bed with fever chills, a bit worse and longer-lasting than the aftereffects of the earlier COVID vaccinations. Test this morning confirmed COVID. At this point, it's already subsided sufficiently that I wouldn't be able to tell it apart from background hayfever.

What was unexpected was that the other aftereffect of the shots, the local irritation of the injection site, also recurred now.

Is that usual, and I just hadn't been aware of it? How come that happens?
 
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  • #2
How long ago did you get the COVID vaccination? Was it in your right or left deltoid? Have you had multiple COVID vaccinations? If so, how far apart?

Also, did you have any other aches or pains in other parts of your body when this happened?
 
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  • #3
Remember, too, that correlation is not causation. Out of the absolutely massive population of all people getting COVID, one or more might also have an unrelated problem in the location where they got their shot.
 
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  • #4
berkeman said:
How long ago did you get the COVID vaccination? Was it in your right or left deltoid? Have you had multiple COVID vaccinations? If so, how far apart?
Spring '21 (Janssen), Autumn '21 (Pfizer), Spring '22 (Moderna). All in the left (non-dominant) deltoid. Needless to say, I have no real idea how closely they were spaced, so I had no way of telling if what hurt yesterday was one or all of those.

berkeman said:
Also, did you have any other aches or pains in other parts of your body when this happened?
Other than possibly mild muscle ache and fatigue all over, nothing COVID-related, AFAI can tell.

Bruzote said:
Remember, too, that correlation is not causation. Out of the absolutely massive population of all people getting COVID, one or more might also have an unrelated problem in the location where they got their shot.
Hm. This had the same quality of sensation as the one after the shots, which is not quite the same as, say, an insect bite. So it'd have to be at least three coinciding coincidences - place, time, quality. That seems a stretch, huge sample size notwithstanding.
 
  • #5
somegrue said:
Is that usual, and I just hadn't been aware of it? How come that happens?
First time I ever heard such a thing, and a fast search could not turn up anything either.
I would consider to report the case, regardless the (lucky lack of) severity of the infection itself.
 
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  • #6
Rive said:
First time I ever heard such a thing, and a fast search could not turn up anything either.
I tried googling before posting, but failed to come up with search terms that distinguished this from descriptions of the initial vaccination reaction, and those swamped the results to the point that I quickly gave up.

I only thought of the term "recur" while posting, though, and should have re-run the search with that addition. Which I did just now, and which gave me this as the top result (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242441/):

Recurrent injection‐site reactions after incorrect subcutaneous administration of a COVID‐19 vaccine said:
[...]

In this case, the first SARS‐CoV‐2 vaccine dose was accidentally injected subcutaneously due to incorrect anatomical location and high patient BMI. The significant skin reactions at the original injection site following SARS‐CoV‐2 infection and re‐vaccination, respectively, are most likely caused by immunological reactivity towards vaccine antigens trapped in the subcutaneous tissue. As RBD is contained in the vaccine and N‐protein is not, the patient’s primary immune response was most likely raised against the vaccine, while both vaccine and virus antibodies were identified at follow‐up.

[...]

Not precisely the same scenario, and none of the various risk factors apply to me, that I can see, but the fundamental mechanics described in the excerpt may still makes sense.

Thanks for the nudge! :)
 
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  • #7
somegrue said:
Which I did just now, and which gave me this as the top result (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242441/):
Nice find! At least that makes some sense from a biological point of view. Any chance your last vaccination may have ended up Sub-Q instead of IM?
 
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  • #8
berkeman said:
Nice find! At least that makes some sense from a biological point of view. Any chance your last vaccination may have ended up Sub-Q instead of IM?
As I said, none of the risk factors they mention apply, so I can't imagine it having been that cut and dry in my case. What I can easily imagine is a tiny amount of vaccine getting deposited or transferred sub-q during withdrawal of the needle. Maybe that's enough?

In fact, now that I think about it more, I do remember at least one of the medics complaining that my deltoid wasn't properly relaxed - likely caused by an earlier all-day bike ride, which commonly leave my shoulders and arms a bit stiff. Would it make sense for a tensed muscle to push out some of the fluid, sort of like a compressed sponge? I think the reason they complained was that they were worried the needle wouldn't go in properly or would be more painful, but none of that happened, as far as I was able to tell. Still, doesn't rule out the potential for other complications.

I also had somewhat different reactions to the different vaccinations, which I assumed had to do with the different vaccines. Which, again, is probably true but doesn't rule out that there were other factors as well.

And again I say, thanks for the nudge! :)

ETA: Oh, also, there was no bleeding whatsoever afterwards each time, which I think they said was a little bit unusual. Could that have any bearing?
 
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  • #9
emii said:
Yes, recurrent injection site irritation is a common symptom of COVID infection. because our immune system's reacts to the virus
Can you post links to the literature where you are seeing this? With a normal IM injection for the vaccination, there is no virus at the injection site left years later (modulo the sub-Q issue found by the OP above).
 
  • #10
I had heard about people experiencing prolonged or repeated episodes of inflammation at the vaccination site, but couldn't really make much sense of it. However apparently it does happen and it may i fact be quite common. We know that even though the mRNA from the vaccine, primarily acts on the local tissue, its effects are short lived, but it has become clear that the spike protein may persist for quite some time. This means that exposure to the virus or another vaccine could reactivate a local reaction, its even earned a name, Covid Arm or Moderna arm. It is more common following the Moderna vaccine, and in women who have a more reactive immune system It might also reflect a delayed allergic reaction.

Its usually described as a single isolated reaction, but Covid is particularly good at causing longer term immune problems and reactivating a whole range of immune mediated problems and viral infections. I thought it was interesting that even the scar of a BCG vaccination can become inflamed. While the depth of the injection may be significant, that seems more likely to be an issue in the vaccine's effectiveness.

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07973-4
https://portal.findresearcher.sdu.d...vaccination-scars-after-vaccination-with-mrna
 
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