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  • Select from over 100 symptoms to read more about managing your child's illness.

    Is Your Child Sick? TM


    Immunization Reactions

    Is this your child's symptom?

    • Reactions to a recent immunization (vaccine)
    • Most are reactions at the shot site (such as pain, swelling, redness)
    • General reactions (such as a fever or being fussy) may also occur

    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.

    Vaccine Free App

    • Vaccines on the Go app from Children's Hospital of Philadelphia
    • This free app can answer any vaccine questions you may have
    • It is fact-based and up-to-date

    When to Call for Immunization Reactions

    When to Call for Immunization Reactions

    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

    Call Doctor or Seek Care Now

    • Age less than 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 being gone 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

    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

    Call Doctor or Seek Care Now

    • Age less than 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 being gone 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

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

    Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

    Copyright 2000-2018. Schmitt Pediatric Guidelines LLC.