| Subject | Contents |
| Definition | A vaccine reaction is any injury or condition that has occurred as a result of vaccination by a select number of childhood vaccines.
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| Alternative Names | Vaccine injury |
| Causes, incidence, and risk factors | Vaccines considered capable of producing injury or abnormal conditions such as seizures include DPT (D -- diphtheria , P -- pertussis or whooping cough , T -- tetanus ), MMR (M -- measles, M -- mumps, R -- rubella), and the ORAL Polio vaccine (not the inactivated Polio vaccine given as an injection). The Department of Health and Human Service has found that whole cell (DPT) pertussis containing vaccines have a causal relationship with the following conditions:Anaphylaxis (life-threatening breathing difficulties) Acute encephalopathy ( encephalitis )Shock Unusual shock-like states
The Department of Health and Human Services also has determined that vaccines containing pertussis do NOT have a causal relationship with:
Sudden Infant Death ( SIDS ) Afebrile seizures Infantile spasms Hypsarrhythmia (a characteristic EEG pattern) Autism Attention deficit disorders Learning disabilities Reye's syndromeEpilepsyGuillain-Barre Juvenile diabetes The acellular Pertussis vaccine (DTaP) is now being used to replace the whole-cell Pertussis vaccine used in DTP. DTaP has been shown to decrease the occurrence of serious adverse events.
As the National Childhood Vaccine Injury Act presently stands, the criteria for vaccine-related injuries are:
DPT
Anaphylactic shock occurring within 24 hours Encephalitis occurring by the end of the 3rd day Residual seizure disorder '>seizure disorder with the first seizure occurring by the end of the 3rd day Shock-like state, hypotonia (decreased tone), decreased responsiveness by the end of the 3rd day
MMR
Anaphylactic shock -- children with anaphylactic reaction to egg ingestion should have an allergy consult before considering vaccination with MMR Encephalitis occurring within 15 days of immunization
Polio vaccine (live)
Paralytic polio (nonimmunodeficient individual) within 30 days Paralytic polio (immunocompromised individual) within 6 months
Polio vaccine (inactivated)
Anaphylactic shock '>Anaphylactic shock occurring within 7 days |
| Symptoms | NORMAL REACTION TO DTaP IMMUNIZATION
Mild feverIrritability Localized tenderness and swelling at site of injection
ABNORMAL REACTION TO DTaP IMMUNIZATION
Unrelieved crying High-pitched cry Unusual shock-like syndrome
Unresponsiveness Hypotonia (limp/decreased tone) Marked increase in sleeping time Persistent high fever (104 degrees Fahrenheit or greater) Seizure or convulsion
REACTION TO MMR Measles :
Fever up to 103 degrees about 7-10 days after vaccine administration Measles rash (milder than natural measles) -- low incidence Rubella Transient joint pains ( arthralgia )
REACTION TO Polio vaccines - LIVE (OPV)
Paralytic polio (non-immunodeficient individual) within 30 days Paralytic polio (immunocompromised individual) within 6 months
INACTIVATED (IPV) - the injected form
Anaphylaxis or anaphylactic shock
ABNORMAL REACTION TO HBV (Hepatitis B vaccine)
Anaphylactic shock (plasma-derived version) |
| Signs and tests | Testing is usually unnecessary. |
| Treatment | Treatment depends on the type of symptom observed following immunization. Fever is normally treated with acetaminophen and cool sponge baths. Children with seizures must be seen by a health care provider promptly. Children who develop encephalitis will be hospitalized. |
| Support Groups | |
| Expectations (prognosis) | Very few children who receive standard childhood vaccines develop significant problems following immunizations. For children who develop problems, standard fever care and a call to the health care provider for reassurance often suffice. |
| Complications | Sterile abscess (pus) at site of immunization Other complications are the same as listed under "Symptoms" |
| Calling your health care provider | Call your health care provider if you feel that your child is having an adverse reaction to DPT, MMR, or polio immunizations.
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| Prevention | The incidence of vaccine-related injury is extremely low. Vaccines are available that have decreased reactions including less fever , less swelling at the site of injection, and less vaccine related conditions (as determined by the Department of Health and Human Services). The DtaP (acellular Pertussus) and the Salk (IPV) vaccines are now being used to reduce side effects. Considering the severity of the diseases that childhood immunizations prevent, the risk of the disease FAR exceeds the risk of injury from the vaccine. The Vaccine Adverse Event Reporting System (VAERS) and the National Childhood Vaccine Injury Act were established to track and record reactions to vaccines and help clarify whether reports are anecdotal or there is a consistent pattern of injury associated with a given vaccine. Physicians are required to record complete information about the vaccines they are using and supply this information with reports of injury. |
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