Do I Have to Get the Covid Vaccine in My Arm?

Most people will roll up their sleeves for the injection, but some may want to consider an alternate body part.

By Christina Caron

By now most people are familiar with how the Covid-19 vaccine is typically administered: a quick jab to the upper arm. But there is a lesser known place on the body where the vaccine has also been approved for injection: the thigh.

While getting the vaccine in the thigh is rare, there are some groups of people who may want to consider it. If you fall into one of the categories below and think you would be better off getting the Covid-19 vaccine in your thigh instead of your arm, it’s best to discuss it first with your doctor.

Which adults might want to get a shot in the thigh?

People with a history or risk of lymphedema in both arms.

Lymphedema is a chronic and painful condition that causes swelling in parts of the body. It can develop in breast cancer patients, for example, who require surgery to remove lymph nodes from under the arm. Removal of the lymph nodes disrupts the flow of lymph, the extra fluid from tissues that would normally drain through the lymphatic system into the bloodstream, causing the fluid to back up and the breast, torso or arm to swell on the affected side.

In both the Moderna and Pfizer-BioNTech clinical vaccine trials, some participants experienced swollen lymph nodes at the armpit or the neck region two to four days following vaccination, on the same side where the shot was administered in the arm. This is a normal short-term side effect that means the body is responding to the vaccine. In the case of Moderna, the median duration of swelling was one to two days, and it lasted an average of 10 days in those receiving Pfizer-BioNTech.

For patients with lymphedema or at risk for lymphedema, however, this side effect could be concerning. If someone has lymphedema in both arms or if a patient is at risk of lymphedema in both arms, then some medical institutions are recommending that their patients get the Covid-19 vaccine in the thigh as a precautionary measure. The concern is that the vaccine could either make the arms swell even more or, for those who are at risk of lymphedema, create worrisome symptoms where there were none.

The immune response might also be less efficient if the shot is administered in an arm without lymph nodes or one that has impaired lymphatic drainage.

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