Background

Eczema, or atopic dermatitis, is a skin condition affecting many people of all ages but is most common in infants and young children. It affects approximately 40% of babies and children worldwide and often appears in the first year of life. Many children grow out of eczema around the age of 5 years however, there are some individuals who will have eczema throughout their life.

Eczema, along with asthma, allergy and allergic rhinitis are more formally known as atopic conditions. Of those children with moderate to severe eczema, a small number will go on to develop food allergy, asthma of childhood and/or allergic rhinitis.

It is not well understood why some individuals develop eczema or other atopic conditions however, there is research and clinical trials currently underway looking into possible genetic, immunological and environmental causes for eczema.

Vaccines

It is safe and recommended for individuals with eczema to receive vaccines according to the National Immunisation Program (NIP); and there is currently no robust evidence suggesting a causal link between immunisation and eczema. Eczema affects people differently and there are multiple triggers that may cause flares including viral or bacterial infections, environmental allergens, stress and some medications.

Recommendations

Eczema may flare in the days following immunisation, however this is not a contraindication to future vaccines.  It is recommended to follow an eczema treatment plan which may include regular moisturiser, topical steroids and barrier creams. If the first presentation of eczema following immunisation, it is recommended to seek GP assessment for an appropriate management plan.

Precautions

If there is active eczema at the intended site of injection, an alternate site could be considered to reduce the risk of infection (or abscess). If no other site is deemed suitable, cleaning the site with an alcohol-based wash/single use alcohol swab and allowing the site to dry completely before injecting could be considered.

BCG vaccination should be deferred if there is active eczema at the injection site.

The smallpox vaccine ACAM2000™ is contraindicated in individuals with active eczema, atopic dermatitis or other exfoliative skin conditions due to the risk of developing eczema vaccinatum (a reaction to smallpox vaccination experienced by people with eczema/atopic dermatitis resulting in a severe rash and systemic illness).

Resources

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

Reviewed by: Mel Addison (SAEFVIC Research Nurse, Murdoch Children’s Research Institute) and Francesca Machingaifa (MVEC Education Nurse Coordinator)

Date: August 30, 2022

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.