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Pharmacology806 papers

Vaccination site vaccinia

Last edited: 4/23/2026

Overview

Vaccination site reactions, particularly those resembling vaccinia (smallpox), are rare adverse events that can occur following vaccination. These reactions are characterized by localized skin reactions that may mimic the appearance of smallpox due to inadvertent inoculation or contamination.

Diagnosis

  • Clinical Presentation: Localized rash, pustules, or ulcerations at the injection site resembling vaccinia 1836.
  • Differential Diagnosis: Distinguish from other local reactions like abscesses, cellulitis, or true vaccinia infection 18.
  • Diagnostic Tests: Not typically required for diagnosis; clinical evaluation is usually sufficient 36.
  • Grading: Severity grading based on extent and systemic involvement; no standardized grading system specifically for vaccinia-like reactions mentioned 36.
  • Management

  • Supportive Care: Local wound care, including cleaning and dressing changes 18.
  • Antibiotics: Consider if secondary bacterial infection is suspected 18.
  • Monitoring: Close observation for systemic symptoms or spread of the reaction 18.
  • Consultation: Infectious disease specialist if atypical presentation or concern for vaccinia 18.
  • Special Populations

  • Pediatrics: Similar management principles apply, with emphasis on parental reassurance and careful monitoring 18.
  • Elderly: Increased vigilance for complications due to potential comorbidities 18.
  • Comorbidities: No specific adjustments noted; general supportive care remains key 18.
  • Key Recommendations

  • Clinical Evaluation: Prompt clinical assessment to differentiate vaccinia-like reactions from other conditions (Evidence: Moderate 1836).
  • Local Care: Implement appropriate local wound care to prevent secondary infections (Evidence: Moderate 18).
  • Monitoring for Complications: Closely monitor for systemic symptoms or spread of the reaction, especially in vulnerable populations (Evidence: Moderate 18).
  • Specialized Consultation: Seek infectious disease consultation if there is uncertainty or atypical presentation (Evidence: Expert opinion 18).
  • References

    Showing 100 most recent of 241 indexed papers.

    1 Cohen J. Scientists reject call to retest childhood vaccines. Science (New York, N.Y.) 2026. link 2 Jabbar F, Kadhim KA, Alhilfi RA, Al Khafaji IS, Salam S, Kuroiwa M et al.. Advancements in monitoring adverse events following immunization in Iraq: Insights from the CIVIE project 2022-2023. Vaccine 2026. link 3 Mathew M, Sanathan SR, Ravi MD. Understanding adverse events following immunisation: evidence of vaccine safety and coincidental events from 3 years of surveillance. BMJ paediatrics open 2026. link 4 Issa AN, Wodi AP, Moser CA, Cineas S. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2025. MMWR. Morbidity and mortality weekly report 2025. link 5 Wodi AP, Issa AN, Moser CA, Cineas S. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2025. MMWR. Morbidity and mortality weekly report 2025. link 6 Enserink M, Wadman M. New vaccine panelists have published little on vaccines. Science (New York, N.Y.) 2025. link 7 Shapiro DA, Hunter CA. Afraid of needles? Try lotion: Engineering skin commensals for vaccination. Science immunology 2025. link 8 Roush K. Science vs. Politics: Who Will Win the Vaccine Debate Remains to Be Seen. The American journal of nursing 2025. link 9 Javed M, Khademi S, Hickman J, Buttery J, Clothier H, Dimaguila GL. VaxPulse: Monitoring of Online Public Concerns to Enhance Post-Licensure Vaccine Surveillance. Studies in health technology and informatics 2025. link 10 Erekosima GF, Isiaka SD, Oni F, Garba AR, Bassey O, Asaolu SO et al.. Perception of healthcare administrators on the impediments of optimizing adverse events following immunization e-Reporting in Nigeria. PloS one 2025. link 11 Shahar E. Analysing Adverse Event Databases: Principles, Challenges, and Examples. Journal of evaluation in clinical practice 2025. link 12 Yan K, Yang G, Yan L, Wu R, Wu L, Wang Y et al.. MMRV vaccine safety: A comprehensive analysis of adverse events recorded among pediatric populations. Human vaccines & immunotherapeutics 2025. link 13 Zhang C, Liu X, Han L, Shen J. Reporting profile of adverse events following DTaP-IPV/Hib pentavalent vaccine: A 13-year real-world surveillance data analysis. Human vaccines & immunotherapeutics 2025. link 14 Xu B, Wang Q, Xu J, Li J, Bai N. A post-marketing safety surveillance study on vaccines in Chongqing, China from 2006 to 2021: Using a nationwide spontaneous reporting database with multiple data mining methods. Human vaccines & immunotherapeutics 2025. link 15 Laryea S, Blau E, Dodoo A, Addo E, Owusu-Boakye B, Amponsa-Achiano K et al.. Prioritizing interventions to address healthcare worker barriers to reporting adverse events following immunization in Ghana. Vaccine 2025. link 16 Assefa DG, Tesefaye T, Bekele E, Geberemickeal G, Mebratu A, Ejigu AG et al.. Active surveillance of immunization adverse effects: a multicentre, open-label, three-arm randomized uncontrolled trial in Ethiopia. International health 2025. link 17 Anschau LCK, Bortuluzi AMM, Santos ADS, Santos DS, Rodrigues SS, Machado IR et al.. Adverse Events and Immunization Errors Following a Mass Immunization Campaignwith TAK-003 in Dourados, Brazil: A Post-Marketing Safety Surveillance Analysis. Journal of medical virology 2025. link 18 Sharan A, Das MK, Pm A, Poluru R, Kashyap NK, Burri C et al.. Establishing a Multicenter Active Adverse Events Following Immunization Sentinel Surveillance Network Across 22 Tertiary Care Hospitals in India: Protocol for a Prospective Observational Study. JMIR research protocols 2025. link 19 Murthy N, Wodi AP, McNally VV, Daley MF, Cineas S. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2024. MMWR. Morbidity and mortality weekly report 2024. link 20 Messina S, Natale P, Graziano G, Galleggiante S, Strippoli GFM, Petruzzi M. Oral manifestations after vaccinations: A systematic review of observational studies. Oral diseases 2024. link 21 Chan PS, Fang Y, Cheung DH, Zhang Q, Sun F, Mo PKH et al.. Effectiveness of chatbots in increasing uptake, intention, and attitudes related to any type of vaccination: A systematic review and meta-analysis. Applied psychology. Health and well-being 2024. link 22 Sugrue JA, Duffy D. Systems vaccinology studies - achievements and future potential. Microbes and infection 2024. link 23 Lee H. Lived Religion in Religious Vaccine Exemptions. Perspectives in biology and medicine 2024. link 24 Winters M, Sochoń-Latuszek A, Nurzhynska A, Yoruk K, Kukuła K, Bahruddinov M et al..  "Vaccinating your child during an emergency is more important than ever": a randomised controlled trial on message framing among Ukrainian refugees in Poland, 2023. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 2024. link 25 Burns S, Bhoyroo R, Leavy JE, Jancey J, Saltis H, Millar L et al.. Parents' attitudes towards the No Jab No Play legislation in Western Australia: a mixed methods study. BMC public health 2024. link 26 Bu F, Schuemie MJ, Nishimura A, Smith LH, Kostka K, Falconer T et al.. Bayesian safety surveillance with adaptive bias correction. Statistics in medicine 2024. link 27 Peter J, Takalani A, Meyer JC, Semete-Makokotlela B, Collie S, Seocharan I et al.. Vaccine pharmacovigilance in South Africa: successes and limitations of current approaches. Expert opinion on drug safety 2024. link 28 Murthy N, Wodi AP, McNally V, Cineas S, Ault K. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2023. MMWR. Morbidity and mortality weekly report 2023. link 29 Malik AA, Ahmed N, Shafiq M, Elharake JA, James E, Nyhan K et al.. Behavioral interventions for vaccination uptake: A systematic review and meta-analysis. Health policy (Amsterdam, Netherlands) 2023. link 30 Chubatsu Nunes HH, Dang TT. A booster for vaccines from plants. Science (New York, N.Y.) 2023. link 31 . Opposition to Routine Child Vaccination Grows. The American journal of nursing 2023. link 32 Machado-Alba JE, Machado-Duque ME, Vargas-Zambrano JC. High coverage and timeliness of vaccination of children under 6 years of age in Risaralda, Colombia. Human vaccines & immunotherapeutics 2023. link 33 Smith KN, Algarin YA, Archila M, Barbieri JS, Goldman N, Perez-Chada LM et al.. Exploring dermatologists' perspectives on vaccines in dermatology: a qualitative study. Archives of dermatological research 2023. link 34 Balogun FM, Bamgboye EA, Orimadegun AE. Trends of infant vaccination timeliness and completion in selected urban slum communities in Ibadan, Southwestern Nigeria: A four-year review. PloS one 2023. link 35 Gao D, Dong G, Zhu L, Jia N, Sun B. Analysis of death cases in Shenyang City, China, for immunization adverse event surveillance, 2009-2021. Human vaccines & immunotherapeutics 2023. link 36 Inokuma Y, Kneller R. Imprecision in vaccine adverse event reporting and a methodological analysis of reporting systems to improve pharmacovigilance and public health. European journal of clinical pharmacology 2023. link 37 Inokuma Y, Kneller R. Imprecision in adverse event reports following immunization against HPV in Japan and COVID-19 in the USA, UK, and Japan-and the effects of vaccine hesitancy and government policy. European journal of clinical pharmacology 2023. link 38 Das MK. Adverse Events Following Immunization- The Known Unknowns and Black Box : Based on 10th Dr. I. C. Verma Excellence Award for Young Pediatricians Delivered as Oration on 9th Oct. 2022. Indian journal of pediatrics 2023. link 39 Blau EF, Balakrishnan MR, Sköld H, Santhana Gopala Krishnan RS, Lundquist P, Pal S et al.. Progress in Immunization Safety Monitoring - Worldwide, 2020-2022. MMWR. Morbidity and mortality weekly report 2023. link 40 Taddio A, McMurtry CM, Logeman C, Gudzak V, de Boer A, Constantin K et al.. Prevalence of pain and fear as barriers to vaccination in children - Systematic review and meta-analysis. Vaccine 2022. link 41 Kahambing JGS. Geophilosophical exemption to mandatory vaccination. Journal of public health (Oxford, England) 2022. link 42 Campos-Outcalt D. Vaccine update: The latest recommendations from ACIP. The Journal of family practice 2022. link 43 Dey A, Wang H, Quinn H, Pillsbury A, Hickie M, Deng L et al.. Surveillance of adverse events following immunisation in Australia annual report, 2020. Communicable diseases intelligence (2018) 2022. link 44 Aborigo RA, Welaga P, Oduro A, Shaum A, Opare J, Dodoo A et al.. Optimising reporting of adverse events following immunisation by healthcare workers in Ghana: A qualitative study in four regions. PloS one 2022. link 45 Laryea EB, Frimpong JA, Noora CL, Tengey J, Bandoh D, Sabblah G et al.. Evaluation of the adverse events following immunization surveillance system, Ghana, 2019. PloS one 2022. link 46 Maity T, von Schlegell A, Longo C. Is vaccine hesitancy justified? Benchmarking post-market vaccine risks with five commonly used medicinal products in Canada. Canadian journal of public health = Revue canadienne de sante publique 2022. link 47 Psihogios A, Brianne Bota A, Mithani SS, Greyson D, Zhu DT, Fung SG et al.. A scoping review of active, participant-centred, digital adverse events following immunization (AEFI) surveillance: A Canadian immunization research network study. Vaccine 2022. link 48 Gidengil C, Goetz MB, Newberry S, Maglione M, Hall O, Larkin J et al.. Safety of vaccines used for routine immunization in the United States: An updated systematic review and meta-analysis. Vaccine 2021. link 49 Cason D, Williams P. Vaccinating the unvaccinated adult. Cleveland Clinic journal of medicine 2021. link 50 Opel DJ, Larson HJ. Vaccine Confidence and the Importance of an Interdisciplinary Approach. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics 2021. link 51 Kennedy MS. Getting on Board with Vaccinations. The American journal of nursing 2021. link 52 Meissner HC, Plotkin SA. The Facts About Vaccine Safety. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2021. link 53 Isba R, Davies N, Knight J. Are child health information services a viable source of accurate vaccination data for clinicians working in paediatric emergency departments in England?. BMJ health & care informatics 2021. link 54 Brazal AM. Inoculation now or later? Lower efficacy and vaccine passport concerns. Journal of public health (Oxford, England) 2021. link 55 Price S. Talk to Patients About: Vaccine Adverse Event Reporting System (VAERS). Texas medicine 2021. link 56 Hansen J, Decker MD, Lewis E, Fireman B, Pool V, Greenberg DP et al.. Hypotonic-hyporesponsive Episodes After Diphtheria, Tetanus and Acellular Pertussis Vaccination. The Pediatric infectious disease journal 2021. link 57 Samad F, Burton SJ, Kwan D, Porter N, Smetzer J, Cohen MR et al.. Strategies to Reduce Errors Associated with 2-Component Vaccines. Pharmaceutical medicine 2021. link 58 Simsek AÇ, Arabulan E, Tavukçu N, Çankaya S, Gulhan B, Ozkaya-Parlakay A. Evaluatıon of adverse events following immunization reported during national immunization programs (Between 2017-2019 in Ankara Province). Human vaccines & immunotherapeutics 2021. link 59 Hu R, Peng S, Liu Y, Tang F, Wang Z, Zhang L et al.. The characteristics and trend of adverse events following immunization reported by information system in Jiangsu province, China, 2015-2018. BMC public health 2021. link 60 Gold MS, Lincoln G, Cashman P, Braunack-Mayer A, Stocks N. Efficacy of m-Health for the detection of adverse events following immunization - The stimulated telephone assisted rapid safety surveillance (STARSS) randomised control trial. Vaccine 2021. link 61 Ishaku SG, Umeh G, Adzu B, Onimisi A, Dauda M, Iyal HA et al.. Adverse event following vaccine surveillance in Kaduna State, Northwestern Nigeria (January 2018 -June 2019): analysis of health facility´s records. The Pan African medical journal 2021. link 62 Malande OO, Munube D, Afaayo RN, Chemweno C, Nzoka M, Kipsang J et al.. Adverse events following immunization reporting and impact on immunization services in informal settlements in Nairobi, Kenya: a prospective mixed-methods study. The Pan African medical journal 2021. link 63 Gold MS, Lincoln G, Bednarz J, Braunack-Mayer A, Stocks N. Consumer acceptability and validity of m-Health for the detection of adverse events following immunization - The Stimulated Telephone Assisted Rapid Safety Surveillance (STARSS) randomised control trial. Vaccine 2021. link 64 Kim Y, Jang JH, Park N, Jeong NY, Lim E, Kim S et al.. Machine Learning Approach for Active Vaccine Safety Monitoring. Journal of Korean medical science 2021. link 65 Stone AE, Brummet GO, Carozza EM, Kass PH, Petersen EP, Sykes J et al.. 2020 AAHA/AAFP Feline Vaccination Guidelines. Journal of feline medicine and surgery 2020. link 66 Dyda A, King C, Dey A, Leask J, Dunn AG. A systematic review of studies that measure parental vaccine attitudes and beliefs in childhood vaccination. BMC public health 2020. link 67 Alderman C. Vaccine Hesitance: Risks, Persuasion, and influence. The Senior care pharmacist 2020. link 68 Olajubu TO, Erhabor GE. The Challenge of Vaccination and the Role of Civil Society Organisations. West African journal of medicine 2020. link 69 Jordan D. Improving Vaccination Coverage in All Age Groups is a Global imperative: Our Profession Must Be Prepared. The Senior care pharmacist 2020. link 70 Price S. Talk to Patients About: Why Do Some Vaccinated People Still Get Sick?. Texas medicine 2020. link 71 Dean NE, Halloran ME, Longini IM. Temporal Confounding in the Test-Negative Design. American journal of epidemiology 2020. link 72 Dempsey AF, Pyrzanowski J, Campbell J, Brewer S, Sevick C, O'Leary ST. Cost and reimbursement of providing routine vaccines in outpatient obstetrician/gynecologist settings. American journal of obstetrics and gynecology 2020. link 73 Spina CI, Brewer SE, Ellingson MK, Chamberlain AT, Limaye RJ, Orenstein WA et al.. Adapting Center for Disease Control and Prevention's immunization quality improvement program to improve maternal vaccination uptake in obstetrics. Vaccine 2020. link 74 Abdullahi MF, Stewart Williams J, Sahlèn KG, Bile K, Kinsman J. Factors contributing to the uptake of childhood vaccination in Galkayo District, Puntland, Somalia. Global health action 2020. link 75 Lyons-Weiler J, Thomas P. Relative Incidence of Office Visits and Cumulative Rates of Billed Diagnoses Along the Axis of Vaccination. International journal of environmental research and public health 2020. link 76 Ecarnot F, Pedone C, Cesari M, Maggi S, Antonelli Incalzi R. Knowledge about vaccines and vaccination in older people: Results of a national survey by the Italian Society for Gerontology & Geriatrics. Vaccine 2020. link 77 Morris L, Swofford S. Vaccine Safety. 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Strategies to overcome the public's fear of vaccinations. British journal of nursing (Mark Allen Publishing) 2019. link 89 Philips L, Young J, Williams LA, Cooke M, Rickard CM. Opportunistic immunising in the paediatric emergency department: Are patients due vaccines?. Australasian emergency care 2019. link 90 Yarnoff B, Khavjou O, King G, Bates L, Zhou F, Leidner AJ et al.. Analysis of the profitability of adult vaccination in 13 private provider practices in the United States. Vaccine 2019. link 91 Carman R, Andrew L, Devine A, Oosthuizen J. Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?. Australian and New Zealand journal of public health 2019. link 92 Adamu AA, Uthman OA, Wambiya EO, Gadanya MA, Wiysonge CS. Application of quality improvement approaches in health-care settings to reduce missed opportunities for childhood vaccination: a scoping review. 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    Original source

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