Clinical Reference Systems: Pediatric Advisor 10.0

Reactions to various vaccines given to children are listed here. The percentage listed next to each reaction shows the percentage of children who have the reaction.

DIPHTHERIA-TETANUS-PERTUSSIS (DTaP)

Common, harmless reactions

• Pain, tenderness, swelling, or redness at the injection site for 24 to 48 hours (51%)

  Home care: Give your child acetaminophen and put a cold, wet washcloth on the tender area.

• Fever for 24 to 48 hours (47%)

  Home care: Give your child acetaminophen if the fever is over 102 degrees F (38.9 degrees C). The next time your child gets a DTaP shot, start giving acetaminophen in the physician's office and continue the medicine every 4 to 6 hours for 24 hours.

• Painless lump (or nodule) at the injection site 1 or 2 weeks later

  Home care: The lump is harmless and will disappear in about 2 months. Call your physician within 24 hours if it turns red or tender to the touch.

• Mild drowsiness (32%), fretfulness (53%), or poor appetite (21%) for 24 to 48 hours.

Serious reactions

CALL YOUR PHYSICIAN IMMEDIATELY IF the following rare but serious reactions occur:

• Fever over 105 degrees F, or 40.5 degrees C (0.3%)
• Crying for more than 3 hours (1%)
• High-pitched, unusual cry (0.1%)
• Convulsions (0.06%)
• Collapse with shocklike state (0.06%)
• Any other unusual reaction.

MEASLES, MUMPS, RUBELLA (MMR)

Common, harmless reactions (beginning 7 to 10 days after the vaccine)

• Fever of 101 to 103 degrees F (38.3 to 39.5 degrees C) for 2 or 3 days (10%)

  Home care: Give your child acetaminophen if the fever is over 102 degrees F (38.9 degrees C). Call your physician within 24 hours if the fever lasts over 72 hours or is over 104 degrees F (40 degrees C).

• Measles vaccine rash: a mild pink rash, mainly on the trunk (5%)

  Home care: No treatment is necessary. The rash will last 2 to 3 days. Call your physician immediately if the rash changes to purple spots. Call within 24 hours if the rash becomes itchy or the rash lasts more than 3 days.

Serious reactions

CALL 911 IMMEDIATELY IF the following rare but serious reaction occurs: Anaphylactic (severe allergic) reaction to the egg the vaccine. Common symptoms of a severe allergic reaction are hives, shock, wheezing, stridor, and swelling of the mouth or throat beginning within 2 hours of the time your child received the vaccine.

POLIO VACCINE

Common, harmless reactions: None

Serious reactions:

CALL YOUR PHYSICIAN IMMEDIATELY IF the following serious, rare reaction occurs: Paralytic polio occurs in 1 of 3 million people. The symptoms include a stiff neck, muscle tenderness, and weakness. This reaction occurs mainly in immune-compromised children or the adults who care for them, usually within 30 days of when the vaccine was given.

HEMOPHILUS INFLUENZA TYPE B VACCINE (HIB)

Common, harmless reaction: Sore injection site or mild fever (1.5%).

Serious reactions: None reported.

HEPATITIS B VACCINE (Hep B)

Common, harmless reaction: Sore injection site (30%) or mild fever (3%).

Serious reactions: None reported.

INFLUENZA VIRUS VACCINE

Common, harmless reactions

• Pain, tenderness, or swelling at the injection site within 6 to 8 hours (10%)
• Fever of 101 to 103 degrees F, or 38.3 to 39.5 degrees C (18%). Fevers mainly occur in young children.

  Home care: Give your child acetaminophen for pain or fever over 102 degrees F (38.9 degrees C).

Serious reactions

CALL 911 IMMEDIATELY IF the following rare, but serious reaction occurs:

• Anaphylactic (severe allergic) reaction if the child is allergic to the egg in the vaccine. Common symptoms of a severe allergic reaction are hives, shock, wheezing, stridor, and swelling of the mouth or throat beginning within 2 hours of the time your child received the vaccine.

CHICKENPOX VACCINE

Common, harmless reactions.

• The chickenpox vaccine can cause pain or swelling at the injection site for 1 to 2 days.
• Some children may have a fever that begins 2 to 4 weeks after the vaccination and lasts 1 to 3 days.

  Home Care: Never give your child aspirin for any symptom within 6 weeks of receiving the vaccine. (Reye's syndrome has been linked with the use of aspirin to treat fever or pain caused by a virus.) For fever or pain, give acetaminophen.

• A few children develop a mild rash at the injection site or elsewhere on the body. The rash begins 5 to 26 days after the vaccine, looks like a few (2 to 10) chickenpox sores, and usually lasts a few days.

  Home Care: Children with these rashes can go to day care or school. There is no evidence that the vaccine rash is contagious. If the vaccine rash contains fluid, cover it with clothing or a Band-Aid. Avoid school if there are widespread, weepy sores (because this may be real chickenpox).

Serious reactions: None reported.