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In general, the presence of a vaccination and the appearance of the rash suffice to make a clinical diagnosis and no further studies are required.
The vesicular and papular eruptions may be diagnostically problematic,
depending on the extent and evolution of the individual lesions,
as they may be mistaken for generalized vaccinia or accidental autoinoculation.
The lesions of generalized vaccinia and inadvertent inoculation
tend to occur later and to be devoid of massive erythematous reactions
and each evolves in a manner similar to primary vaccinations.
Occasionally, virologic studies may be required to rule out viral infection.
Appropriate allergic and immunologic studies may help to gain a better understanding of their pathogenesis.
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