Vaccine
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Route of
infection
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Signs & Symptoms
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Possible Complications from
the disease
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Reported
new cases
in King
County, WA
(2001)
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Immediate risks from vaccine (for
long term risks review info at links
above).
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Hep B
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Primarily blood &
blood products and
sexual
transmission.
Household contacts
may transmit by
sharing razors or
toothbrushes via
saliva, although this
form of transmission
is rare.
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A disease of the liver potentially without symptoms when first
infected. The likelihood of early symptoms increases with the
person's age. Symptoms may include yellow skin or eyes,
tiredness, stomach ache, loss of appetite, nausea, and joint pain.
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The younger the person, the greater the
likelihood of staying infected (chronic Hep
B) and having life-long liver problems,
such as scarring of the liver and liver
cancer as well as being contagious to
others.
Babies who are born to mothers with Hep
B may die from liver scarring or liver
cancer (1 in 4) unless treated with vaccine
at a slightly accelerated schedule and
immunoglobulin within 12 hours of birth.
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43 (all ages)
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Mild fever, unsettled, swelling or soreness at the
site of injection generally within 4 hours: common.
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DTaP
Diphtheria
Tetanus
Pertussis
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Diphtheria: direct
contact with bodily
secretions or with
objects that have
been in contact with
bodily secretions.
Tetanus:
contamination of
wound from soil,
street dust, animal
feces. Also from
animal bites.
Pertussis: airborne
respiratory
secretions
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Diphtheria: sore throat, slight
fever, chills; membrane
develops over throat that can
impede breath.
Tetanus: Muscles of jaw and
neck become “locked”; muscle
rigidity; spasms of respiratory
muscles. Usually presents with
a descending pattern, starting
with trismus or lockjaw,
followed by stiffness of the
neck, difficulty in swallowing,
and rigidity of abdominal
muscles. This patient is
displaying a bodily posture
known as "opisthotonos" due to
Clostridium tetani exotoxin.
Pertussis: cold symptoms
followed by 4-6 weeks of
violent coughing with whooping
sound on inspiration after
coughs, vomiting from
coughing, and/or choking spells
in infants.
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Diphtheria:
Myocarditis.
Transitory paralysis of the limbs, muscles
of respiration, throat, or eye.
Death: 1 in 10.
Note that partial immunizations can lead to
more severe infections.
Tetanus:
Death (3 in 10).
Pertussis:
Complications are mostly in babies under 1
year.
Pneumonia (up to 1 in 10).
Convulsions (1 in 50).
Lung collapse.
Encephalopathy (1 in 250).
Death (about 10-15 deaths per year due to
pertussis in the U.S.).
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Diphtheria only
occurs a few
times each year
in the U.S.
Risk of tetanus
is about 1 in
600,000.
Tetanus is
present in the
soil in this
region. About
50 cases occur
each year in the
U.S.
Pertussis: 208
in King County
(usually
identified in
children <5
years old.
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Drowsiness: about half
Soreness, swelling, and redness at the site of
injection generally within 2 days: about 1/3 of
children, more frequent after 4th or 5th dose.
Fussiness, loss of appetite for 1 or 2 days: 1 in 5
Swelling of entire leg or arm after 4th or 5th dose,
lasting about 4 days.
Fever over 101°F: 1 in 20
Fever over 104°F: 1 in 3000.
Continuous crying, then full recovery: up to 1 in
900 children.
Convulsions or shock: 1 in 14,000 doses.
Encephalopathy.
Serious reactions to DTaP are more likely in
children who have had convulsions or nervous
disorders in the past.
Note that DTaP is associated with fewer adverse
reactions than DTP (risks not listed), and these
risks are associated with the pertussis component.
The only established risk for the DT and Td is
soreness and swelling at injection site and mild
fever.
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H.
influenzae
type b (Hib)
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Spread by coughing
and sneezing.
Hib can be serious
in children under
age 1, but there is
little risk of getting
Hib after age 5.
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Skin and throat infections, but not related to the flu.
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Hib meningitis, pneumonia, sepsis, and
arthritis. Death in one out of 20 children,
and permanent brain damage in 10% -
30% of the survivors.
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0 in children <6
years old.
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Mild fever, unsettled feeling, swelling or soreness
at the site of injection.
Fever over 101°F lasting for up to 2-3 days: 2 in
100.
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Inactivated
polio (IPV)
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Contact with an
infected person’s
stool (e.g., during a
diaper change).
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90-98% are similar to common cold or flu, with slight stiffness in
neck, back, and legs which soon resolves.
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Paralytic polio develops within the first
week of infection. Paralysis of legs,
arms, or muscles of respiration
(rarely). Death in 1-4% of children
with polio.
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0
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IPV: soreness and redness at site of injection:
common.
Severe allergic reaction: 1 in 1 million doses.
Oral polio vaccine (OPV) is still often used. It
commonly causes diarrhea, headache, and/or
muscle pain within 4 hours. OPV carries a slight
risk of polio for recipient and/or recipient’s family.
OPV has caused all recent cases of polio in the U.
S. Risk is 1 in 2.4 million doses.
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Pneumococ
cal
Conjugate
Vaccine
(against 7
strains of
Pneumococ
cal
bacteria)
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Airborne
transmission from
respiratory
secretions. Very
common.
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Streptococcus pneumonia bacteria are associated with ear
infections in children, primarily.
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Pneumonia (10-25% of pneumonias).
Meningitis (1 or 2 per 100,000
children--most common cause of bacterial
meningitis).
Bacteremia (160 per 100,000 children in <2
years old).
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Not reportable
in 2000.
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Redness or tenderness at site of injection; mild
fever (up to 40%).
Prolonged crying and febrile seizures (rare).
(Pneumococcal conjugate vaccine is relatively
new, so any additional risks will likely become
known with time.)
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MMR:
Measles
(Rubeola)
Mumps
(Parotitis)
Rubella
(German
measles)
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Measles: airborne
respiratory
secretions—very
contagious.
Infections and
complications much
more likely in
vitamin A deficient
children.
Mumps & Rubella:
airborne respiratory
secretions.
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Measles: cough, runny
nose, irritated eyes, high
fever, rash on 4th day.
Symptoms peak day 6
then subside.
Mumps: chills, fever,
headache, earache near
lobe of ear followed by
swelling of the salivary
glands in the cheek and
jaw.
Rubella: slight fever for
about 24 hours, rash on
face and trunk for 2-3 days,
and fatigue. Adults may
get swollen glands in the
back of the neck and
arthritis.
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Measles: ear infections (1 in 10);
pneumonia (1 in 20); encephalitis (1 in
1000); death (1-2 in 1000). Vitamin A
supplementation is associated with 7-fold
decrease in measles complications.
Mumps: orchitis may develop in males (1
in 4 after puberty); male sterility (rare);
acute pancreatitis with complete recovery;
deafness (1 in 20,000); mild meningitis in
up to 15% with minimal or no lasting
effect; encephalitis (1 in 300); death (1 in
10,000).
Rubella: Congenital Rubella Syndrome
(up to 80% chance if woman becomes
infected in early pregnancy) causes eye
and heart defects, deafness, and mental
retardation in infant. May cause
miscarriage of pregnancy.
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Measles: 2 (but
at least 12
cases in 2001).
Mumps: 9.
Rubella: 1.
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Measles: Mild fever, rash, unsettled, 1-2 weeks
after vaccine lasting a few days: 1 in 5 children.
Mumps: Occasional mild fever 1-2 wks after
vaccine or light swelling of a salivary gland after
vaccine.
Rubella:
Rash or swelling of lymph glands 1-2 wks after
vaccine lasting 1 or 2 days: 1 in 7.
Some mild pain or stiffness in the joints or painful
arthritis: 1 in 100.
MMR: Febrile seizures can occur due to the
vaccine-provoked fever at 1 or 2 wks post-vaccine
with no apparent permanent harm.
Encephalitis or severe allergic reaction: <1 in 1
million.
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Varicella
(Chicken
pox)
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Airborne respiratory
secretions: very
contagious.
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Achiness, fever, itchy
vesicles which scab over.
The rash lasts 3-5 days and
scabs fall off by 10 days.
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Secondary bacterial infection can develop
in ruptured vesicles.
Hospitalization required for 1 in 500 children
and 1 in 50 adults.
Death due to encephalitis: About 4 per
100,000 in infants < 1 years old, about 1
per 100,000 in children 1-14 years old;
very high risk to baby if woman is infected
with chicken pox at time of delivery.
After chicken pox infection, may always
be at risk for a shingles outbreak.
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95% of past
population got
chicken pox
before adulthood
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Redness, soreness at injection site: 1 in 5.
Mild rash 1-3 wks after vaccination.
Febrile seizures: <1 per 1000.
Loss of muscle coordination or
encephalitis: very rare.
Note: About 1 or 2 per 100 will develop chicken
pox later due to insufficient immunity from the
vaccine.
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Hepatitis A
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Usually spread by
the fecal-oral route
(An object
contaminated with
the stool of a person
with hepatitis A is
put into someone’s
mouth). Also
spread by
swallowing food or
water that contains
the virus.
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A disease of the liver which may cause symptoms including
yellow skin or eyes, tiredness, stomach ache, loss of appetite,
dark urine and nausea. Likelihood of symptoms increases with
the person's age.
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Not associated with long-term illness or
liver damage.
Liver failure (about 100/yr in the U.S.).
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98
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Mild local swelling and soreness at injection site in
about half of recipients.
Fatigue or mild fever: <1 in 10.
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