By Dr Robert Arlt MD, Consultant Paediatrician
After vaccinations some patients develop side effects. Different vaccines have different side effects, most of which are mild.
Most side effects experienced by patients are local to the injection site. The symptoms include pain, swelling or redness. These occur commonly within a few hours of the injection and are usually mild and self-limiting.
Systemic adverse reactions include fever, muscle ache, irritability, headache and loss of appetite. The timing of these systemic reactions varies greatly, depending on the type of vaccine. Some may start within a few hours whereas others appear seven to ten days after a vaccination.
Serious allergic reactions to vaccines are extremely rare. About one person out of a million may have a serious allergic reaction. Signs of a serious allergic reaction include difficulty breathing, hoarseness, wheezing, hives, paleness, weakness, a fast heartbeat, dizziness and swelling of the throat. If the reaction is treated quickly, you will recover fully.
Doctors and nurses who give immunisations are trained to deal with allergic reactions. If you show any of these serious side effects, or if you are worried, contact your doctor, go to the nearest Accident and Emergency Department or with serious reactions (i.e. if your throat/breathing is affected) dial 999 for an ambulance.
Patients sometimes faint after a vaccination. Sitting or lying down after administration of vaccination can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, have vision changes or ringing in the ears.
Side effects linked to specific vaccines
Inactivated vaccines contain non-infectious material, and cannot cause an infection.
DTaP IPV Hib (Diphtheria, Tetanus, acellular Pertussis, Haemophilus influenzae type b)
Restlessness, vomiting, tiredness and poor appetite can occur one to three days after the shot.
Fever and local reactions occur more often after the fourth and fifth doses. The fourth or fifth dose can cause swelling of the entire injected arm or leg, for one to seven days.
Seizures, persistent crying (3 hours or more) and a very high fever are a rare side-effect.
Side effects include flu-like symptoms, red or itchy eyes, general itching, usually beginning soon after the shot and lasting one or two days.
There may be a small increased risk of Guillain-Barré Syndrome after inactivated flu vaccine. This risk has been estimated at one or two additional cases per one million people vaccinated.
Young children who get the flu shot along with pneumococcal vaccine (PCV13), and/or DTaP containing vaccine might be slightly more likely to have a seizure caused by fever. Inform your doctor if your child has ever had a seizure.
HPV Cervarix and HPV Gardasil (Human Papillomavirus)
Side effects include high fever, nausea, vomiting, diarrhoea, or abdominal pain; more frequent fainting and benign seizures.
Meningococcal ACWY (Nimenrix)
As many as half the people who receive meningococcal vaccines can develop redness or pain on the site of injection for 1 or 2 days.
Serogroup B Meningococcal (Meningitis B) (Bexsero)
About a half of the people who get group B meningococcal vaccine have mild unspecific side-effects, specifically fever lasting three days.
PCV13 (pneumococcal) (Prevenar 13)
Occasional restlessness, irritability, drowsiness
Rabies vaccine (Verorab, Rabies Vaccine BP)
Dizziness, hives, pain in the joints and fever
Tdap vaccine (Combined Tetanus, Diphtheria & Pertussis) (Boostrix)
Rarely rash and swollen glands, nausea, vomiting, diarrhoea and stomach ache.
Swelling of the entire arm where the injection was given happens in about one in five hundred cases.
Very rarely bleeding and redness in the arm on the site of injection will occur.
Hepatitis A, Hepatitis B, Typhoid, Td IPV (Adult Tetanus & Diphtheria + Polio) (Revaxis), Japanese Encephalitis (Ixiaro) and PSV23 (Pneumovax)
No specific side-effects
These vaccines contain weakened component of the infectious material.
Flu vaccine (live) (Fluenz nasal)
Reactions may resemble a very mild case of flu. In children and adolescents you may get wheezing, abdominal pain, vomiting, or diarrhoea.
Varicella (Chickenpox) (Varivax)
A mild rash, usually a couple of blisters, can appear up to a month after vaccination. It is possible for these people to infect other members of their household who are highly immune-compromised.
Seizures caused by fever and pneumonia are very rare.
Fever, mild rash and swelling of glands in the cheeks or neck, will sometimes occur within 5-12 days after the injection. They occur less often after the second dose.
Temporary pain and stiffness in the joints happen mostly in teenage or adult women.
Seizure (jerking or staring) caused by fever happen in about one out of three thousand doses.
Temporary low platelet count, which can cause a bleeding disorder and happens in about one in thirty thousand doses.
Yellow Fever (Stamaril)
Severe allergic reactions to a vaccine component are more frequent in Yellow Fever than with other vaccines (about 1 person in 55,000). Severe nervous system reactions are possible (1 in 125,000).
Severe illness with organ failure occurs in about 1 in 250,000. More than half the people who suffer from organ failure will die. Severe nervous system reactions and organ failure have never been reported after a booster dose.
Intussusception is a type of bowel blockage that is treated in hospital and could require surgery. It occurs naturally in some babies, and most frequently after a rotavirus infection. There is also a small risk of intussusceptions from rotavirus vaccination, usually within a week after the 1st or 2nd vaccine dose.
The shingles vaccine can cause chickenpox in less than 1 in 10000.
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