Parsonage-Turner Syndrome following axillary nerve injury from an intramuscular injection of COVID-19 vaccine and proposal of the intradermal route as an alternative route of vaccination

A case of Parsonage-Turner syndrome (brachial plexus neuropathy) occurred following intramuscular (IM) injection of mRNA COVID-19 vaccine into the deltoid muscle. The symptoms were highly suggestive of the needle hitting the anterior branch of the axillary (circumflex) nerve which set up a sequence of distressful events including instant severe pain and palsy of upper limb muscles lasting up to six months. To avoid such adverse events, the intradermal (ID) route is proposed as an alternative to IM injection as no nerve runs in the skin. Review of studies showed that the ID route is the most extensively used route in vaccination. With rare exceptions, it is considerably more effective than the IM route so that smaller doses can be used. When correctly placed in the skin layer, no other structure could be damaged. However, vaccine development is no longer led by physicians and scientists but controlled by pharmaceutical executives who tend to favor the IM route, so that most vaccines today are built on IM trials. Deviation to the ID route incurs extra trials, more expenses and less profit. Yet, to ignore the plight of the unfortunate few who suffer from IM-induced debilitating events is to add fuel to the ongoing trend of vaccine hesitancy. It is hoped, that the authorities should step in and lend support to this issue.