Parent Section

Common issues for parents.

Refer here if

  • You believe your child is having a reaction to a recent immunization
  • Reactions to DTaP (Diphtheria, Tetanus, Pertussis), MMR (Measles, Mumps, Rubella), polio, Hemophilus influenzae type b, Hepatitis A, Hepatitis B, Influenza, Chickenpox (varicella), pneumococcal, meningococcal, Rotavirus and Human Papilloma virus vaccines are covered

Alarming Symptoms

  • Most local swelling, redness and pain at the injection site begins within 24 hours of the shot. It usually lasts 2 to 3 days, but with DTaP can last 7 days.
  • Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.
  • With live vaccines (MMR and chickenpox), fever and systemic reactions usually begin between 1 and 4 weeks.
  • Severe allergic reactions are very rare, but can occur with any vaccine.

When to Call Your Doctor for Immunization Reactions

  • Your child has difficulty with breathing or swallowing.
  • Your child is not moving or very weak.
  • Your child is unresponsive or difficult to awaken
  • Your child looks or acts very sick.
  • Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen.)
  • Fever over 104° F (40° C) and not improved 2 hours after fever medicine.
  • High-pitched, unusual crying present over 1 hour.
  • Crying continuously for over 3 hours.
  • Redness or red streaking around the injection site begins over 48 hours (2 days) after the shot.
  • Redness or red streak around the injection site becomes larger than 1 inch (2.5 cm).
  • You think your child needs to be seen.
  • Fever present for more than 3 days.
  • Fever returns after gone for over 24 hours.
  • Measles vaccine rash (onset day 6 to 12) persists over 3 days.

Home Care Advice for Immunization Reactions

  • All of these reactions mean the vaccine is working.
  • Your child's body is creating new antibodies to protect against the real disease.
  • Most of these symptoms will only last 2 or 3 days.
  • Cold Pack: For initial pain or tenderness at the injection site with any vaccine, apply a cold pack or ice in a wet wash cloth to the area for 20 minutes each hour as needed.
  • Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen by mouth. (See Dosage table)
  • Localized Hives: Apply 1% hydrocortisone cream (no prescription needed) once or twice.
  • Fever with most vaccines begins within 24 hours and lasts 2 to 3 days.
  • For fevers above 102° F (39° C), give paracetamol 10mg/kg every 4 hours (If over 6 months old, okay to give ibuprofen every 6 hours) (See Dosage table)
  • For all fevers: Give cold fluids in unlimited amounts. Avoid excessive clothing or blankets (bundling).
  • All vaccines can cause mild fussiness, irritability and restless sleep. While this is usually due to a sore injection site, sometimes the cause is less clear.
  • Some children sleep more than usual. A decreased appetite and activity level are also common.
  • These symptoms do not need any treatment and will usually resolve in 24-48 hours.
  • Fever lasts over 3 days
  • Pain lasts over 3 days
  • Redness or swelling lasts over 3 days
  • Your child becomes worse

Specific Immunization Reactions

  • Pain or swelling at the injection site for 1 to 2 days (in 19% of children)
  • Mild fever lasting 1 to 3 days begins 17 to 28 days after the vaccine (in 14%). Give acetaminophen or ibuprofen for fever over 102° F (39°C).
  • Never give aspirin for fever, pain or within 6 weeks of receiving the vaccine (Reason: risk of Reye's syndrome - a rare but serious brain disease)
  • Chickenpox-like vaccine rash (usually 2 lesions) at the injection site (in 3%)
  • Chickenpox-like vaccine rash (usually 5 lesions) scattered over the body (in 4%)
  • This mild rash begins 5 to 26 days after the vaccine and usually lasts a few days.
  • Children with these vaccine rashes can go to child care or school. (Reason: for practical purposes, vaccine rashes are not contagious)
  • EXCEPTION: avoid school if widespread, weepy lesions (Reason: probably actual chickenpox).
  • Precaution: if vaccine rash contains fluid, cover it with clothing or Band-Aid.
  • Pain, tenderness, swelling or redness at the injection site (in 25% of children) and lasts for 24 to 48 hours.
  • 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.
  • A large swelling over 4 inches (10 cm) arm can follow the 4th or 5th dose of DTaP occurs in 5% of children. Most children can still move the leg or arm normally.
  • The large thigh or upper arm swelling resolves without treatment by day 3 (60%) to day 7 (90%). This is not an allergy and future DTaP vaccines can be given.
  • No serious reactions reported.
  • Sore injection site or mild fever only occurs in 1.5% of children.
  • No serious reactions reported.
  • Sore injection occurs in 20% of children, loss of appetite in 10%, and headache in 5%.
  • Usually no fever.
  • If these symptoms occur, they usually last 1-2 days.
  • No serious reactions reported.
  • Sore injection site occurs in 30% of children and mild fever in 3% of children.
  • Because fever from the vaccine is rare, any infant under 2 months with a fever following the hepatitis B vaccine should be examined.
  • Pain, tenderness or swelling at the injection site occurs within 6 to 8 hours in 10% of children.
  • Mild fever under 103° F (39.5° C) occurs in 18% of children. Fevers mainly occur in young children.
  • Nasal Influenza (Seasonal or H1N1) Vaccine: Congested or runny nose, mild fever.
  • The measles vaccine can cause a fever (10% of children) and rash (5% of children) about 6 to 12 days following the injection.
  • 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 necessary. Your child is not contagious.
  • No serious reactions
  • Sore injection site for 1 to 2 days occurs in 50%, with limited use of the arm in 15%.
  • Mild fever occurs in 4%, headache in 40% and joint pain in 20%.
  • The vaccine never causes meningitis.
  • There are no reactions except for an occasional sore injection site.
  • No serious reactions reported.
  • Sore injection sites for few days in 80%.
  • Mild redness and swelling at the injection site in 25%.
  • Fever over 100.4° F (38° C) in 10% and fever over 102° F (39° C) in 1% to 2%.
  • No serious reactions.
  • Pain, tenderness, swelling OR redness at the injection site in 15 - 30%.
  • Mild fever under 102° F (39° C) in 15% for 1-2 days.
  • Polio vaccine by injection occasionally causes some muscle soreness.
  • No serious reactions to this oral vaccine.
  • Mild diarrhea or vomiting for 1 to 2 days in 3%.
  • No fever.
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