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Not all reactions that occur during the vaccination sequence are unexpected
and/or characterized as adverse events. Some reactions are expected in normal individuals and require no specific
treatment. Symptomatic therapy and reassurance suffice.
Normal Systemic Symptoms
At about one week post-vaccination, one expects to see systemic symptoms in many vaccinees. Fever, malaise,
soreness at the vaccination site, myalgia, local lymphadenopathy, and intense erythema ringing the vaccination
site can be expected.
Normal Local Reactions
Normal local reactions that are not considered adverse events can include:
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Local satellite lesions, which are normal in appearance |
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Lymphangitis |
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Considerable local edema |
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What appears to be bacterial cellulitis, but is simply intense inflammation accompanying the vaccination
(viral cellulitis) |
For further information and photographs of normal and variants of normal reactions, please see the
General section and Normal Variants section of the
Normal Reactions page. For information on revaccination reactions, please visit the
Revaccination section of the Normal Reactions page.
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Differentiating Cellulitis and Lymphangitis from Bacterial Infection
Viral cellulitis and lymphangitis/lymphadenitis due to vaccinia must be differentiated from
bacterial infection of the site. In bacteria superinfection, the vaccination
site has either vesicles and pus (staphylococcal infections) or a heaped up eschar characteristic of Group A Beta-hemolytic
streptococcal infections. Infection with anaerobic or enteric bacteria may be more difficult to distinguish since both produce
local tissue necrosis and can resemble a severe normal vaccination reaction. Cultures of the site may help to distinguish
bacterial from vaccinia infection. |
