IM Injection Reactions

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Hey all -

New to the forum - nice to meet everyone!

I work in a private practice MD office with 1 other RN, 2 MAs, and 4 doctors. Recently (within the last 1-2 months), several of our patients have had pretty severe reactions to IM injections - severe pain and immobility in the injected arm being the main one. I know we expect some soreness, but this goes far beyond the expected reaction. Today, a patient reported severe pain in the arm along with some systemic symptoms - cold sweats, fever, and some tightness under the chest.

This has been occurring mainly with the Pneumovax 23; the last report that includes systemic symptoms was from a TDAP booster.

Our vaccines are stored in a small refrigerator. The temperature is checked daily. We have all reviewed IM injection technique and confirmed that everyone is giving the injections properly. None of the vaccines are near their expiration dates.

My question to you ladies & gentlemen - has anyone ever heard of/had this experience? If so, was a cause identified? We're theorizing that it has something to do with the temperature of the vaccines during transport, but are kind of at a loss at this point... any insight anyone could offer would be great. I'm starting to get paranoid that we're all giving IM injections wrong (even though I know we're not)!

Thanks all.

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