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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) and general reactions (such 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
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| Call 911 Now (your child may need an ambulance) If |
- Trouble breathing or swallowing
- Not moving or very weak
- Can't wake up
- You think your child has a life-threatening emergency
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| Call Your Doctor Now (night or day) If |
- Your child looks or acts very sick
- Hard to wake up
- 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
- You think your child needs to be seen urgently
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| Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If |
- You think your child needs to be seen, but not urgently
- 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
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| Call Your Doctor During Weekday Office Hours If |
- You have other questions or concerns
- 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
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Parent Care at Home If |
- Normal immunization reaction
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Causes & Health Information
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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
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Treatment for Common Immunization Reactions
- What You Should Know:
- 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 child's doctor for normal reactions.
- 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.
- 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 acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
- Hives at the Shot Site: If itchy, can put on 1% hydrocortisone cream. No prescription is needed. Use twice daily as needed.
- Fever:
- 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 acetaminophen. If over 6 months old, can give ibuprofen. See Dose Tables.
- For all fevers: Give extra fluids. Do not use too many clothes or blankets on your child.
- General Reaction:
- 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.
- 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)
- Your child becomes worse
Specific Immunization Reactions
- 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 or a Band-Aid.
- DTaP or DT Vaccine:
- The following harmless reactions to DTaP can occur:
- Pain, tenderness, swelling and redness at the shot site is the main side effect. 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.
- Hemophilus Influenza Type B Vaccine (Hib):
- No serious reactions reported.
- Sore injection site or mild fever only occurs in 2% of children.
- 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.
- 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.
- 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.
- 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
- 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.
- Mumps or Rubella Vaccine:
- There are no serious reactions.
- Sometimes, a sore shot site can occur.
- 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%.
- 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.
- 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.
- 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.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/1/2012
Last Revised: 12/15/2012
Content Set: Child Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.