Question: I’m a 69-year-old male who contracted polio in the early 1950s. My right arm was totally paralyzed from contracting polio. I was diagnosed with PPS about nine years ago. During the diagnosis, I was told that my left arm had serious muscle weakness. At the time, the doctor said my deltoid muscle was roughly 40%. When my primary doctor learned I had problems previously having a flu vaccine administered, he advised me to have my next flu vaccine administered in my thigh. When I requested this, I was told their guidelines strictly state that the vaccine can only be administered in the deltoid muscle of either arm.
Since then the manufacturers of both my flu vaccine and my pneumonia two-dose vaccine have changed their administration procedures to allow the shots to be administered in the thigh.
The problem I now face is that both Pfizer and Moderna state in their administration protocol that their vaccines are to be administered in the deltoid muscle only.
Not wanting to be faced with the possibility of scheduling an appointment for the vaccine, going to receive it, and then being told I can’t get it in my thigh, I have tried calling both vaccine manufacturers but was not able to speak to anyone helpful.
Can you help me with this? Surely there are others who face the same dilemma. Can you delve into this? The thought of not being able to receive the COVID-19 vaccine has my wife and me quite worried. I would greatly appreciate your assistance.
Dr. Maynard: I totally understand your frustration which reflects the difficulty our heavily-regulated health care system has for making simple and appropriate exceptions to usual procedures for people with unique disabling conditions. Vaccines do need to be given intramuscularly but any bulky muscle can be used. I would think the same steps that led to a change in administrative procedures for the other vaccines you mention will need to again occur for the new COVID vaccines. This will of course take a lot of time unless someone in a high-up position learns of it and is willing and able to take action. In the meantime, I would recommend you try to receive the vaccine through your primary physician, who would have the authority to prescribe the vaccine and its delivery method, including location of the injection by simply stating the reason an alternative site is necessary and why the vaccine is urgently needed. This should be no different than physicians prescribing other medications for “off-label indications” (which come from the manufacturer, usually large pharmaceutical companies who must seek FDA approval for their liability protection).
Post-Polio Health (Vol. 37, No. 2, Winter 2021)