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Vaccine side effect rates5/1/2023 35, 36 Multiple studies have found no causal link between vaccination and autism, but the falsified report continues to cause parental concern. 8, 11 – 26Īn article linking autism to the MMR vaccine was retracted for fraud, but this misinformation persists and has caused long-lasting public health consequences. Table 1 lists serious adverse reactions to vaccines. 10, 12 Every effort should be made to avoid unnecessarily withholding a disease-preventing vaccine. If the skin test is negative, the vaccine can be readministered under close observation with resuscitation, including epinephrine, readily available. 12 A patient who has an anaphylactic reaction to a vaccine should undergo immediate type allergy skin testing to confirm that the reaction was immunoglobulin E mediated and to determine which vaccine component was responsible. 8, 11 Anaphylactic reactions to vaccines occur in approximately one per 1 million doses. 10 The CDC publishes tables detailing the inactive ingredients or excipients and other potential allergens found in vaccines. 9 Patients with anaphylaxis to egg proteins should not receive the inactivated influenza vaccine and should receive the egg-free trivalent inactivated influenza vaccine instead. 8 Egg allergy is not a contraindication to the MMR vaccine, even though it is derived from chick embryo fibroblast tissue culture. 8, 9 Gelatin is used in some live virus vaccines, such as varicella and MMR these vaccines should not be given to patients with a history of anaphylaxis to gelatin. Therefore, these vaccines are contraindicated in patients with a history of anaphylactic reaction to these antibiotics. Trace amounts of antibiotics, such as neomycin, are present in varicella measles, mumps, and rubella (MMR) and inactivated poliovirus vaccines. 6 For this reason and because antipyretics do not prevent febrile seizures, the Centers for Disease Control and Prevention (CDC) no longer recommends routine prophylaxis before vaccination. 2, 5 Administration of acetaminophen at the time of vaccination or shortly afterward may alleviate some adverse effects, but there may be a decreased antibody response to some vaccine antigens in children who receive antipyretics. 4 Because of this, adolescents should be observed for 15 minutes after receiving these vaccines. 2 Syncope may occur-especially in adolescents-after administration of the human papillomavirus (HPV) vaccine quadrivalent meningococcal conjugate vaccine (MCV4) or tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. 2 One out of 30 children reports up to seven days of swelling of the entire thigh or upper arm after the fourth or fifth dose. 3 The fourth dose of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine is associated with an increased incidence of fever and injection site reactions compared with the first dose (one in four children). 16 mm) decreases injection site reactions. Systemic reactions, including fever, irritability, drowsiness, and rash, may also occur. The Vaccine Adverse Event Reporting System and National Vaccine Injury Compensation Program track adverse events and allow compensation for documented harms from vaccinations.Ĭommon local reactions to vaccines include pain, swelling, and erythema at the injection site. If a recommended vaccine is refused, proper documentation is essential. Physicians should guide parents to credible resources if they are considering vaccine refusal. Although immunization with the human papillomavirus vaccine is recommended for all boys and girls, vaccination rates remain low. The rotavirus vaccine minimally increases the rate of intussusception, whereas other vaccines minimally increase the risk of syncope. Vaccines are associated with local reactions, such as pain and erythema. The measles, mumps, and rubella vaccine is not associated with autism. Thimerosal is currently used only in multidose vials of influenza vaccine, and exposure through vaccines is not associated with adverse neurologic outcomes. Family physicians should be aware of the risks and benefits of recommended immunizations. Because of this, parents are increasingly questioning the necessity of immunizing their children, especially because no vaccine is completely free of adverse effects or the risk of complications. Most vaccine-preventable illnesses are unfamiliar to modern parents. Vaccines are one of the most successful medical advances in modern times.
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