Local symptoms of the limb in which the vaccination is administered

Local reactions may occur after any vaccine. The reactions are common with tetanus, diphtheria, pertussis and pneumococcal vaccines.

Local symptoms of the limb include 

  • feeling of warmth
  • redness
  • swelling
  • pain
  • itching
  • skin rash.

The majority of the local symptoms of the limb in which the vaccination was administered are mild. They usually appear within two days and disappear in a few hours or days. An extensive local reaction is slower to disappear.

A local reaction may be associated with

  • general symptoms such as fever and a feeling of illness
  • locally enlarged lymph nodes
  • increase in blood inflammatory markers

A strong local reaction often mistakenly resembles a bacterial inflammation, although its pathogenetic mechanism is nearly always immunological. Bacterial infection at the vaccination site is very rare.

Tissue irritation caused by a needle or immunising agent

The aluminium salt contained by the vaccine may cause irritation if the vaccine contract agent intended to the muscle travels to subcutaneous tissue.

Good injection technique and the right choice of instruments, such as a correctly sized needle, reduce local reactions.

Sterile abscess

Vaccines using aluminium salts as contrast agents can cause subcutaneous abscesses. 

This kind of abscess is usually observed weeks, sometimes even months after vaccination. It is usually sterile. 

No antibiotic treatment is needed even if the content seems purulent. Sometimes the abscess bursts by itself. Showering and monitoring suffice as treatment.

You should pay attention to the injection technique. Even with a good injection technique, some vaccine agent may end up in the subcutaneous tissue. This increases the likelihood of developing a subcutaneous lump.

High antibody level

The higher the number of vaccine doses given, the more likely the vaccine recipient is to get protective antibodies. 

The body has learned to defend itself against the disease prevented by the vaccine. In connection with the vaccination, previously formed antibodies enter the injection site and trigger a local immunological reaction.

Suspected allergic reaction on the limb in which the vaccination was administered

Even an extensive local reaction in limb in which the vaccination was administered does not usually mean allergy. 

Redness, heating, swelling and itching on the injection site may cause concern about an immediate allergic reaction. A person may even have a rash, even if there is no issue of hypersensitivity to the vaccine or one of its ingredients.

For example, a tetanus booster may trigger an immunological reaction, but this is not allergy.

Delayed hypersensitivity may occur if a skin reaction is detected in the limb several days after vaccination. 

A delayed allergic reaction does not increase the risk of anaphylaxis during the following vaccination and does not prevent further vaccinations.

Treating local symptoms

Provide instructions on symptomatic treatment.

  • Anti-inflammatory analgesics, such as ibuprofen or naproxen, control and treat the reaction.
  • Cortisone cream can help soothe itchy skin. Antihistamine can also be used.
  •  A cooling bandage relieves heat and swelling.

Even if the local reaction is severe, it does not require antibiotic treatment. It is nearly always an immunological inflammatory reaction.

Follow-up vaccinations after local symptoms

You can nearly always give the follow-up vaccinations as normal. Even an extensive local reaction or rash on the limb that was injected usually does not prevent vaccination.

Young children need vaccines even if they have had an extensive reaction. 

In practice, 5-in-1 vaccine (DTaP-IPV-Hib) and the 4-in-1 vaccine (DTaP-IPV) included the national vaccination programme must be always given. The diseases that these vaccines prevent can be life-threatening to a child with inadequate immunisation.

Everyone needs personal vaccination protection against tetanus, for example. Vaccinating others does not protect the child.

If the child has had a strong reaction to a previous dose, provide instructions on preventive antipyretic and pain medication. If necessary, the medication can be continued for a few days.