Local Vaccine Site Reactions and Contact Allergy to Aluminum

:  Childhood vaccines are a routine part of pediatric care in the United States; clinicians must be able to recognize and interpret associated localized adverse reactions. Redness and induration at the site of injection are commonly reported and are considered to be the result of local inflammation...

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Published inPediatric dermatology Vol. 29; no. 1; pp. 68 - 72
Main Authors Beveridge, Mara G., Polcari, Ingrid C., Burns, Jennifer L., Adler, Amos, Hendrickson, Barbara, Stein, Sarah L.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.01.2012
Subjects
Aluminum
Aluminum Compounds - adverse effects
Aluminum Compounds - immunology
Children
Chlorides - adverse effects
Chlorides - immunology
Dermatitis, Allergic Contact - diagnosis
Dermatitis, Allergic Contact - etiology
Dermatitis, Allergic Contact - immunology
Differential diagnosis
Diphtheria
Diphtheria-Tetanus-acellular Pertussis Vaccines - adverse effects
Diphtheria-Tetanus-acellular Pertussis Vaccines - immunology
Haemophilus
Hematoma
Hepatitis B Vaccines - adverse effects
Hepatitis B Vaccines - immunology
Humans
Hypersensitivity
Immunodeficiency
Infant
Infant, Newborn
Infants
Infectious diseases
Inflammation
Male
Nodules
Patch Tests
Pediatrics
Pertussis
Pneumococcal Vaccines - adverse effects
Pneumococcal Vaccines - immunology
Poliovirus
Side effects
Streptococcus pneumoniae
Tetanus
Vaccines
Vaccines - adverse effects
Vaccines - immunology
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Summary::  Childhood vaccines are a routine part of pediatric care in the United States; clinicians must be able to recognize and interpret associated localized adverse reactions. Redness and induration at the site of injection are commonly reported and are considered to be the result of local inflammation or hematoma formation, although other atypical reactions can occur. We report the case of a 6‐month‐old infant who developed subcutaneous nodules at the sites of his 4‐ and 6‐month Pentacel (DTaP/Hib/IPV, diphtheria, tetanus, acellular pertussis, Haemophilus b conjugate, and inactivated poliovirus vaccine) and 6‐month Prevnar (heptavalent pneumococcal vaccine) injections. Infectious disease and immunodeficiency examinations were unremarkable. Aluminum contact allergy was considered, and contact allergy testing confirmed sensitivity to aluminum. Although rare, aluminum contact allergy after routine immunization can occur and should be considered in the differential diagnosis of persistent subcutaneous nodules after vaccination.
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ISSN:0736-8046
1525-1470
DOI:10.1111/j.1525-1470.2011.01541.x