Children's Hospital Colorado

Immunization Reactions

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  • 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 reactions (such as a fever or being fussy)
  • Reactions to these vaccines are covered:
  • Chickenpox (varicella) virus
  • DTaP (Diphtheria, Tetanus, Pertussis)
  • Hemophilus influenzae type b
  • Hepatitis A virus
  • Hepatitis B virus
  • Human Papilloma virus
  • Influenza virus
  • MMR (Measles, Mumps, Rubella)
  • Meningococcal
  • Polio virus
  • Pneumococcal
  • Rotavirus
  • Tuberculosis (BCG vaccine)

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 3 to 5 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.

Call 911 Now

  • Trouble breathing or swallowing
  • Not moving or very weak
  • Can't wake up
  • You think your child has a life-threatening emergency

Go to ER Now

  • Hard to wake up

Call Doctor Now or Go to ER

  • Age under 12 weeks old with fever. (Caution: Do NOT give your baby any fever medicine before being seen)
  • Fever over 104° F (40° C)
  • High-pitched crying lasts more than 1 hour
  • Crying nonstop lasts more than 3 hours
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Redness or red streak starts more than 48 hours (2 days) after the shot
  • Redness around the shot becomes larger than 3 inches (7.5 cm)
  • Fever lasts more than 3 days
  • Fever returns after gone for more than 24 hours
  • Measles vaccine rash (starts day 6 to 12 after shot) lasts more than 4 days
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Redness or red streak around shot is larger than 1 inch (2.5 cm)
  • Redness, swelling or pain is getting worse after 3 days
  • Fussiness from vaccine lasts more than 3 days
  • You have other questions or concerns

Self Care at Home

  • Normal immunization reaction

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.
    • Pain, redness and swelling are normal where the shot was given. Most symptoms start within the first 12 hours after the shot was given. Redness and fever starting on day 1 of the shot is always normal.
    • 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 redness or 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 starts after 2 days (48 hours)
    • Redness becomes larger than 2 inches (5 cm)
    • Pain 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 14 to 28 days after the shot (10%). 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. Diphtheria, Tetanus, Pertussis (DTaP) 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 usually starts within the first 12 hours. Redness and fever starting on day 1 of the shot is always normal. 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) 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 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. The nasal spray version of the flu vaccine is not recommended for the 2016-2017 flu season (CDC). Reason: not effective.
  7. Measles Vaccine (part of MMR):
    • 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 (part of MMR):
    • 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 90%.
    • Mild redness and swelling at the shot site (in 50%).
    • 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.
  14. BCG Vaccine for Tuberculosis (TB):
    • Vaccine used to prevent TB in high-risk groups or countries. It is not used in the US or most of Canada. Note: This is different than the skin test placed on the forearm to detect TB.
    • BCG vaccine is given into the skin of the right shoulder area.
    • Timing: Mainly given to infants and young children.
    • Normal reaction: After 6 to 8 weeks, a blister forms. It gradually enlarges and eventually drains a whitish yellow liquid. The blister then heals over leaving a scar. The raised scar is proof of BCG protection against TB.
    • Abnormal reaction: Abscess (infected lump) occurs in the shoulder or under the arm. Occurs in 1% of patients.
    • Call Your Doctor If:
      • Blister turns into a large red lump
      • Lymph node in the armpit becomes large

Disclaimer

The information contained in these topics is not intended nor implied to 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.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

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