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Commonly observed adverse events following immunisation with vaccines used in the National Immunisation Program (NIP) schedule and what to do about them

The following information can be photocopied and given as post-vaccination advice.

All the common adverse events following immunisation are usually mild and transient and treatment is not usually required. If the adverse event following immunisation is severe or persistent, or if you are worried about yourself or your child’s condition, see your doctor or immunisation clinic nurse as soon as possible or go to a hospital. Adverse events may be reported via ADRAC, State and Territory Health Authorities or via immunisation service providers.

Diphtheria-tetanus-pertussis (acellular) DTPa-containing vaccines and dTpa (adolescent/adult) vaccines	Haemophilus influenzae type b vaccine (Hib)	Hepatitis A vaccine (HepA) (Indigenous children NT, QLD, SA, WA)	Hepatitis B vaccine (HepB)
Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever) In children the following may also occur: Irritable, crying, unsettled and generally unhappy Drowsiness or tiredness	Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)	Localised pain, redness and swelling at injection site Low-grade temperature (fever)	Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)
Human papillomavirus vaccine (HPV)	Influenza vaccine	Measles-mumps-rubella vaccine (MMR)	Meningococcal C conjugate vaccine (MenCCV)
Localised pain, redness and swelling at injection site Low-grade temperature (fever) Mild headache Mild nausea	Drowsiness or tiredness Muscle aches Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)	Occasionally injection site nodule, may last many weeks (no treatment needed) Seen 7–10 days after vaccination: Temperature (fever, can be >39.4 0 C) lasting 2–3 days, faint red rash (not infectious), head cold and/or runny nose, cough and/or puffy eyes Drowsiness or tiredness Swelling of salivary glands	Irritable, crying, unsettled and generally unhappy Loss of appetite Headache (usually observed in adolescents/adults) Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)
Pneumococcal vaccines (conjugate 7vPCV and polysaccharide 23vPPV)	Inactivated poliomyelitis vaccine (IPV) and IPV-containing vaccines	Rotavirus vaccine	Varicella vaccine (VV)
Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)	Muscle aches Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Low-grade temperature (fever)	Vomiting and diarrhoea can occur up to 7 days following vaccination	Localised pain, redness and swelling at injection site Occasionally injection site nodule, may last many weeks (no treatment needed) Temperature (fever, can be >39 0 C) Seen 5–26 days after vaccination: Pustular rash (2–5 lesions) usually at injection site, occasionally other parts of the body

Key to table

DTPa	diphtheria-tetanus-pertussis acellular (infant/child formulation)
dTpa	diphtheria-tetanus-pertussis acellular (adolescent/adult formulation)
HepA	hepatitis A vaccine
HepB	hepatitis B vaccine
Hib	Haemophilus influenzae type b vaccine (PRP-OMP or PRP-T)
HPV	human papillomavirus vaccine
Influenza	influenza or flu vaccine
IPV	inactivated poliomyelitis vaccine
MenCCV	meningococcal C conjugate vaccine
MMR	measles-mumps-rubella vaccine
7vPCV	7-valent pneumococcal conjugate vaccine
23vPPV	23-valent pneumococcal polysaccharide vaccine
Rotavirus	rotavirus vaccine
VV	varicella vaccine

What to do to manage injection site discomfort

Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for 1 to 2 days. Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump may persist for some weeks or months. This should not be of concern and requires no treatment.

Managing fever after immunisation

Give extra fluids to drink. Do not overdress an infant if hot. Although the routine use of paracetamol at the time of vaccination is no longer necessary, it may be required if, for example, an infant or child has a high fever following vaccination. The dose of paracetamol is 15 mg/kg of paracetamol liquid, up to a maximum daily dose of 90 mg/kg per day.

• Printable version of Adverse Events Following Immunisation (PDF 69 KB)

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