Photographing a severe local reaction

The majority of vaccines on the National Immunisation Program are administered as injections, either into the muscle (intramuscular- IM) or just under the skin (subcutaneous- sc). A common, expected side effect of vaccines is therefore a local reaction. They may occur following any vaccine usually within 24 hours post immunisation The majority of these local reactions are small, do not limit activity and no further action is required. Symptoms usually resolve with minimal intervention. Symptomatic relief may include analgesia and cool compress.

Some Injection Site Reactions (ISR), however, can be more severe: defined as an enlargement or swelling at the injection site that, depending on severity, may extend from joint to joint (e.g. shoulder to elbow) or crossing a joint.  Other features of ISR’s may include redness, pain and tenderness. Symptomatic relief is again all that is usually required (e.g. analgesia and cool compress).

Photography

To confirm the diagnosis of the moderate to severe ISR, it would be helpful to have a photograph of the affected limb.

Here are some simple steps to follow:

  1. Ensure you are standing in a position lit by plenty of natural light (i.e. a window with lots of sunlight or outside).
  2. You will need a ruler to show the length of the reaction against the affected limb.
  3. When photographing the limb, we need to see from above the shoulder to below the elbow. No more and no less. Try and keep identifying features such as the face, out of the picture. Clothing needs to be removed or minimised so as not to cover the area.
  4. The limb needs to be photographed from 2 angles. The first of which should be looking directly onto the limb with the ruler being held up at the side as a reference. See example below.

Injection Site Reaction - 1

5. The next image needs to show the profile of the arm from behind, so we can identify any swelling of the limb. Standing behind the child, photograph the limb from above the shoulder to below the elbow, again holding the ruler against the limb to reference the size of the reaction. See example below.

ISR_1

6. Once images have been taken, please email them together to enquiries@saefvic.org.au using your SAEFVIC report number as a reference in the subject line.

If you have any queries regarding any of the information posted above, please contact SAEFVIC either by email or by calling 1300 882 924 (Option 1).

Resources

Author: Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Date: February 2018

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.


Paediatric Integrated Cancer Service (PICS): Immunisation resources

The Paediatric Integrated Cancer Service (PICS) is a statewide initiative supported by Cancer Australia, with guidelines endorsed by the Australian and New Zealand Childrens Haemotology/Oncology Group (ANZHOG).

The PICS immunisation resources detail vaccines to consider during cancer therapy [e.g. influenza (flu)], as well as highlighting the vaccines that are required after completion of chemotherapy. These resources cross-link with the MVEC Cancer immunisation guidelines (see Resources below).

The PICS Immunisation information sheets have been translated into a number of different languages.

Resources

Author: Nigel Crawford (Director, SAEFVIC, Murdoch Children’s Research Institute)

Date: February 2018

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.


Pertussis

What is it?

Pertussis (whooping cough) is a serious, highly contagious, respiratory infection caused by the bacterium Bordetella pertussis.

What to look for

Pertussis can be very serious in young children, especially those under 6 months of age. It usually begins just like a cold, with a runny nose and sometimes a mild fever.  Coughing then develops, which may occur in bouts, sometimes followed by a deep gasp (or “whoop”). Hospital admission may be required.

Complications can include pneumonia, encephalitis/encephalopathy and brain damage. There are reported cases of death from Pertussis infection.

How is it transmitted?

The Bordetella pertussis bacterium is highly infectious and is spread by coughing and sneezing.

Prevention

Previous infection with Pertussis does not provide lifelong immunity.

Immunisation is the most effective form of prevention. Booster doses of the vaccine are required throughout life to ensure protection is maintained.

Pertussis immunisation is available for free for the following individuals:

  • Infants – doses at 6 weeks, 4 months and 6 months
  • Children – booster doses at 18 months and 4 years
  • Adolescents – 12 – 13 years of age
  • Pregnant women – 20 – 32 weeks gestation
  • Partners of pregnant women who are at least 28 weeks pregnant (if they have not received a dose in the last 10 years)
  • Parents/guardians of a baby under 6 months of age (if they have not received a dose in the last 10 years)

Resources

Authors: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Reviewed by: Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children’s Research Institute)) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Date: July 2019

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.


PAEDS (Paediatric Active Enhanced Disease Surveillance)

The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine preventable diseases and potential adverse events following immunisation (AEFI). PAEDS data is used to better understand these conditions, inform policy and practice under the National Immunisation Program, and enable rapid public health responses for certain conditions of public health importance. PAEDS enhances data available from other Australian surveillance systems by providing prospective, detailed clinical and laboratory information on children with selected conditions.

PAEDS consists of a network of clinicians and public health researchers in 7 tertiary paediatric hospitals across Australia.

  • The Royal Children’s Hospital, Melbourne, Victoria
  • Monash Children’s Hospital, Clayton, Victoria
  • The Children’s Hospital at Westmead, Sydney, New South Wales
  • Women’s and Children’s Hospital, Adelaide, South Australia
  • Perth Children’s Hospital, Perth, Western Australia
  • Queensland Children’s Hospital, Brisbane, Queensland
  • The Royal Darwin Hospital, Darwin, Northern Territory

The PAEDS group is jointly funded by the Commonwealth and State Departments of Health, with some grant funding for specific conditions.

The current conditions under surveillance by the PAEDS network are:

  • Acute Flaccid Paralysis (A condition causing paralysis and loss of tone in one or more limbs, which can be caused by the polio virus)
  • Intussusception (A rare type of bowel obstruction seen in infants)
  • Varicella (chicken pox) and herpes zoster (shingles) requiring hospitalisation
  • Pertussis (Whooping cough)
  • Acute Childhood Encephalitis (Inflammation and/or infection of the brain)
  • Influenza (Seasonal flu)
  • Invasive Meningococcal Disease (Severe bacterial sepsis and/or meningitis)
  • Invasive Group A Streptococcus (A severe bacterial infection)
  • Kawasaki Disease (rare disease in which blood vessels throughout the body become inflamed)
  • Gram Negative Bloodstream Infections (serious bacterial infections in the bloodstream)
  • COVID-19 (SARS-CoV-2)
  • PIMS-TS (Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2)

Contact Information

For more information about the PAEDS group in Melbourne, please contact the study team on:

The Royal Children’s Hospital

(03) 9345 5066 paeds.study@mcri.edu.au

Monash Children’s Hospital

(03) 8572 3581

Investigators

A/Professor Nigel Crawford nigel.crawford@rch.org.au

A/Professor Jim Buttery jim.buttery@monash.edu

PAEDS Network Website

www.paeds.edu.au

Author: Alissa McMinn (Research Manager, SAEFVIC, Murdoch Children’s Research Institute)

Reviewed by: Alissa McMinn (Research Manager, SAEFVIC, Murdoch Children’s Research Institute)

Date: October 2020

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.