Immunization Reactions

Is this your child's symptom

• You think your child is having a reaction to a recent immunization vaccine
• Types of Reactions:
• Reactions at the shot site such as pain, swelling, redness
• General reactionssuch as a fever or being fussy
• Reactions to these vaccines are covered:
• Chickenpox varicella
• DTaP Diphtheria, Tetanus, Pertussis
• Hemophilus influenzae type b
• Hepatitis A
• Hepatitis B
• Human Papilloma virus
• Influenza
• MMR Measles, Mumps, Rubella
• Meningococcal
• Polio
• Pneumococcal and
• Rotavirus

Symptoms of Vaccine Reactions

• Local Reactions. Shot sites can have swelling, redness and pain. Most often, these symptoms start within 24 hours of the shot. They most often last 2 to 3 days. With the DTaP vaccine, they can last up to 7 days.
• Fever. Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.
• Delayed Reactions. With the MMR and chickenpox shots, fever and rash can occur. These symptoms start later. They usually begin between 1 and 4 weeks.
• Anaphylaxis. Severe allergic reactions are very rare, but can occur with any vaccine. They start within 2 hours.

Symptoms

• Shot sites can have swelling, redness and pain. Most often, these symptoms start within 24 hours of the shot. They most often last 2 to 3 days. With the DTaP vaccine, they can last up to 7 days.
• Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.
• With the MMR and chickenpox shots, fever and rash can occur. These symptoms start later. They usually begin between 1 and 4 weeks.
• Severe allergic reactions are very rare, but can occur with any vaccine. They start within 2 hours.

Care Advice for Immunization Reactions

Treatment for Common Immunization Reactions

1. What You Should Know About Common Shot Reactions:
   • Immunizations vaccines protect your child against serious diseases.
   • All of these reactions mean the vaccine is working.
   • Your child's body is making new antibodies to protect against the real disease.
   • Most of these symptoms will only last 2 or 3 days.
   • There is no need to see your doctor for normal reactions, such as fever.
   • Medicine is only needed if your child has pain. Also, use a fever medicine for fever over 102° F 39 ° C.
   • Here is some care advice that should help.
2. Reaction at Shot Site:
   • Cold Pack: For pain at the shot site, use a cold pack. You can also use put ice in a wet washcloth on the sore shot site. Use for 20 minutes as needed.
   • Pain Medicine: To help with the pain, give an acetaminophen product such as Tylenol. Another choice is an ibuprofen product such as Advil. Use as needed.
   • Hives at the Shot Site: If itchy, can put on 1% hydrocortisone cream such as Cortaid. No prescription is needed. Use twice daily as needed.
3. Fever Medicine:
   • Fever with most vaccines begins within 12 hours and lasts 2 to 3 days. This is normal, harmless and possibly helpful.
   • For fevers above 102 F 39 C, give an acetaminophen product such as Tylenol.
   • If over 6 months old, can give an ibuprofen product such as Advil.
   • For all fevers: Give extra fluids. Do not use too many clothes or blankets on your child.
4. General Symptoms From Vaccines:
   • All vaccines can cause mild fussiness, crying and restless sleep. This is usually due to a sore shot site.
   • Some children sleep more than usual. A decreased appetite and activity level are also common.
   • These symptoms are normal. They do not need any treatment.
   • They will usually go away in 24-48 hours.
5. Call Your Doctor If:
   • Redness larger than 1 inch 2.5 cm for first 3 DTaP shots or any other shot
   • Redness larger than 2 inches 5 cm with 4th DTaP
   • Redness larger than 3 inches 7.5 cm with 5th DTaP
   • Pain, swelling or redness gets worse after 3 days or lasts more than 7 days
   • Fever starts after 2 days or lasts more than 3 days
   • You think your child needs to be seen
   • Your child becomes worse

Specific Immunization Reactions

1. Chickenpox Vaccine:
   • Pain or swelling at the shot site for 1 to 2 days. 20% of children
   • Mild fever lasting 1 to 3 days begins 17 to 28 days after the shot 15%. Give acetaminophen or ibuprofen for fever over 102° F 39°C.
   • Never give aspirin for fever, pain or within 6 weeks of getting the shot. Reason: Risk of Reye syndrome, a rare but serious brain disease.
   • Chickenpox-like rash usually 2 red bumps at the shot site 3%
   • Chickenpox-like rash usually 5 red bumps scattered over the body 4%
   • This mild rash begins 5 to 26 days after the shot. Most often, it lasts a few days.
   • Children with these rashes can go to child care or school. Reason: For practical purposes, vaccine rashes are not spread to others
   • Exception: Do not go to school if red bumps drain fluid and are widespread. Reason: can be actual chickenpox.
   • Caution: If vaccine rash contains fluid, cover it with clothing. You can also use a bandage such as Band-Aid.
2. DTaP or DT Vaccine:
   • The following harmless reactions to DTaP can occur:
   • Pain, tenderness, swelling and redness at the shot site are the main side effects. This happens in 25% of children. It lasts for 3 to 7 days.
   • Fever in 25% of children and lasts for 24 to 48 hours
   • Mild drowsiness 30%, fretfulness 30% or poor appetite 10% and lasts for 24 to 48 hours.
   • Large swelling over 4 inches 10 cm arm can follow the later doses of DTaP. The area of redness is smaller. This usually occurs with the 4th or 5th dose. It occurs in 5% of children. Most children can still move the leg or arm normally. The area of redness is smaller.
   • The large thigh or upper arm swelling goes away without treatment by day 3 60% to day 7 90%.
   • This is not an allergy. Future DTaP vaccines are safe to give.
3. Hemophilus Influenza Type B Vaccine Hib:
   • No serious reactions reported.
   • Sore injection site or mild fever only occurs in 2% of children.
4. Hepatitis A Vaccine:
   • No serious reactions reported.
   • Sore injection occurs in 20% of children.
   • Loss of appetite occurs in 10% of children.
   • Headache occurs in 5% of children.
   • Most often, no fever is present.
   • If these symptoms occur, they most often last 1-2 days.
5. Hepatitis B Virus Vaccine HBV:
   • No serious reactions reported.
   • Sore shot site occurs in 30% of children and mild fever in 3% of children.
   • Fever from the vaccine is rare. Any baby under 2 months with a fever after this shot should be examined.
6. Influenza Virus Vaccine:
   • Pain, tenderness or swelling at the injection site occurs within 6 to 8 hours. This happens in 10% of children.
   • Mild fever under 103° F 39.5° C occurs in 20% of children. Fevers mainly occur in young children.
   • Nasal Influenza Vaccine: Congested or runny nose, mild fever.
7. Measles Vaccine:
   • The measles shot can cause a fever 10% of children and rash 5% of children. This occurs about 6 to 12 days after the shot.
   • Mild fever under 103° F 39.5°C in 10% and lasts 2 or 3 days.
   • The mild pink rash is mainly on the trunk and lasts 2 or 3 days.
   • No treatment is needed. The rash cannot be spread to others. Your child can go to child care or to school with the rash.
   • Call Your Doctor If:
     • Rash changes to blood-colored spots
     • Rash lasts more than 3 days
8. Meningococcal Vaccine:
   • No serious reactions.
   • Sore shot site for 1 to 2 days occurs in 50%. Limited use of the arm occurs in 15% of children.
   • Mild fever occurs in 5%, headache in 40% and joint pain in 20%
   • The vaccine never causes meningitis.
9. Mumps or Rubella Vaccine:
   • There are no serious reactions.
   • Sometimes, a sore shot site can occur.
10. Papillomavirus Vaccine:
    • No serious reactions.
    • Sore injection site for few days in 80%.
    • Mild redness and swelling at the shot site in 25%.
    • Fever over 100.4° F 38.0° C in 10% and fever over 102° F 39° C in 2%.
    • Headache in 30%.
11. Pneumococcal Vaccine:
    • No serious reactions.
    • Pain, tenderness, swelling or redness at the injection site in 20%.
    • Mild fever under 102° F 39° C in 15% for 1-2 days.
12. Polio Vaccine:
    • Polio vaccine given by shot sometimes causes some muscle soreness.
    • Polio vaccine given by mouth is no longer used in the U.S.
13. Rotavirus Vaccine:
    • No serious reactions to this vaccine given by mouth.
    • Mild diarrhea or vomiting for 1 to 2 days in 3%.
    • No fever.

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

And remember, contact us if your child develops any of the "Call Us" symptoms.

Author and Senior Reviewer: Barton D. Schmitt, M.D.