The possibility that the vaccine contributed to the serious adverse event reports of rheumatoid arthritis (n=1), peripheral edema/dyspnea with exertion (n=1), and autonomic dysfunction (n=1) cannot be excluded. Symptoms are usually mild and localised to the site of vaccination, with onset commonly occurring within the first 48 hours of vaccination and symptoms lasting 1-2 days. Therapists say it can damage your connection. Detailed discussion can be found here: Multiple Injections/Coadministration of Vaccines, COVID-19 vaccine and coadministration with other vaccines, Routine and Influenza Immunization Services During the COVID-19 Pandemic: Interim Guidance | CDC, Vaccine Administration: Intramuscular (IM) Injection Children 7 through 18 years of age, Vaccine Administration: Intramuscular (IM) Injection Adults 19 years of age and older], Vaccine Administration: Needle Gauge and Length, Giving all the Doses Under 12 Months of Age, COVID-19 vaccines can be given during the same visit, How to Hold Your Child During Vaccinations, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP), Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline, Subcutaneous (SC or Subcut) Injection: Sites [3:26 minutes], Subcutaneous (SC or Subcut) Injection: Administration [6:27 minutes], Intramuscular Injection: Sites [5:07 minutes], Live, Attenuated Influenza Vaccine (LAIV) [4:09 minutes], Comfort and Restraint Techniques for Children [4:46 minutes], You Call the Shots: Vaccine administration training for healthcare professionals, National Center for Immunization and Respiratory Diseases, Healthcare Professionals / Providers Home, Vaccine Adverse Event Reporting System (VAERS), Pediatric Vaccination Practices During COVID-19, Childhood Vaccination Toolkit for Clinicians, You Call The Shots: Vaccine Storage and Handling, Screen for Contraindications and Precautions, Temporary, Satellite, or Off-Site Vaccination Clinics, Easy-to-Read Recommended Immunization Schedules, Resources for Parents of Infants and Toddlers, Resources for Parents of Preteens and Teens, Resources for College Students, Young Adults, and Adults, Understanding Risks & Responsibilities, If You Choose Not to Vaccinate, Talking with Parents about Vaccines for Infants, Understanding Vaccines and Vaccine Safety, U.S. Department of Health & Human Services, DTaP, DT, HepA, HepB, Hib, HPV, , IIV4, RIV4, ccIIV4, IPV*, MenACWY, MenB, PCV13, PPSV23*, RZV, Td, Tdap, TT, Fatty tissue of thigh for infants younger or upper outer triceps area, DTaP-IPV, DTaP-IPV-HepB, DTaP-IPV/Hib, DTaP-IPV-HepB/Hib, HepA-HepB. c Axillary swelling or tenderness was collected as a solicited local adverse reaction (i.e. Detailed discussion can be found here: Pinkbook: Vaccine Administration | CDC Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Type I hypersensitivity reactions (e.g. Coronavirus (COVID-19) Update: FDA authorizes emergency use of Novavax COVID-19 vaccine, adjuvanted. Rothstein. Considerations for Coadministration of COVID-19 Vaccines and Other Vaccines. One grade 4 fever was erroneously reported in the placebo group after dose 1. Wei N, et al. Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases. (b) In presence of secondary allergens, increased COVID19 vaccinemediated immune recruitment may manifest as delayed (type IV) allergic reactions, such as COVID arm, maculopapular rashes, erythema multiforme and dermal filler reactions. See chart below to identify the route for each injectable vaccine. 2023 Feb 20:1-4. doi: 10.1007/s13691-023-00598-7. A new survey takes the worst traffic, road conditions, and infrastructure into consideration. And for more helpful tips from the CDC, discover why The CDC Doesn't Recommend This One Type of Face Mask. aGrade for fever: Any 38.0C; grade 3=39.6-40.0C; grade 4=> 40.0C. New research finds that some people develop a red, itchy, swollen, or even painful rash where they received their COVID-19 vaccine shot. Healthline Media does not provide medical advice, diagnosis, or treatment. COVID arm is a delayed hypersensitivity skin reaction that occurs on or around the injection site. Trial data has shown that the Pfizer-BioNTech and Moderna vaccines are safe and generally well tolerated. *Based on age. (2022). Any AEFI should be reported to the vaccine safety service in your state. Since the COVID-19 vaccines are new, we dont know definitively what exact mechanism triggers COVID arm symptoms. MVEC acknowledges the traditional owners of the lands on which we live, work and educate. Illustrating possible pathomechanisms of cutaneous findings following COVID19 vaccination. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. If possible, administer COVID-19 vaccine and other reactogenic vaccines (e.g., MenB, Tdap) in different limbs. e Chills Grade 3: prevented daily activity and required medical intervention; Grade 4: required emergency room visit or hospitalization. A recent study by the National Institute of Health (NIH) also found that these vaccines are effective, leading to a low hospitalization rate with severe symptoms or death from COVID-19. Local reactions in both groups were mostly grade mild or moderate; however, severe reactions were more frequent in the vaccine group than in the placebo group. And for more vaccine news to know, find out why If You're Over 65, You Shouldn't Get This New Vaccine, Experts Warn. A 2021 case report showed that the Pfizer-BioNTech vaccine might also cause COVID arm but appears less likely to do so. No grade 4 local reactions were reported. Such reactions can cause some pain and other symptoms around the. Let's discuss how this can affect different ages and how to, The most commonly reported side effect from the vaccine is injection site reaction. In the older age group, the most common serious adverse event occurring at higher rates in the vaccine group than the placebo group was pneumonias (2 cases in vaccine group vs. 0 cases in placebo group). . The https:// ensures that you are connecting to the Fever, headache, abdominal pain, diarrhea, nausea, and vomiting can happen after live typhoid vaccine. There are immune cells in your lymph nodes that are activated by the vaccine, and the ones near your armpit may be the most prone to swelling because they're typically the closest to your injection site, Parikh explained. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Observe recipients after vaccination to decrease the risk for injury should they faint. 2022 Melbourne Vaccine Education Centre. But in rare. government site. -, Carneiro DC, Sousa JD, MonteiroCunha JP. Other COVID19 vaccinerelated observations include functional angiopathies such as chilblainslike lesions and reactivation of viral conditions such as pityriasis rosea (PR), PRlike eruptions and herpes zoster [IgE = immunoglobulin E, APC = antigenpresenting cells, INF = interferon , TNF = tumour necrosis factor , Th1 = type 1T helper cells, M = macrophages, MHC = major histocompatibility complex]. document.addEventListener( 'DOMContentLoaded', function() { c Axillary swelling or tenderness was collected as a solicited local adverse reaction (i.e., lymphadenopathy: localized axillary swelling or tenderness ipsilateral to the vaccination arm); grade 3: any use of prescription pain reliever or prevented daily activity; grade 4: required emergency room visit or hospitalization. Skin reactions to COVID-19 vaccines. Most of the known reactions have occurred with Moderna. Receiving any of the COVID-19 vaccines is better than remaining unvaccinated. This information is accurate as of 05/3/2023. A sore arm is a common side effect of the COVID-19 vaccine. If you havent experienced COVID arm before after getting your first shot, youre even less likely to get it now. Imbalances in unsolicited adverse events in the vaccine group compared to the placebo group were observed and were primarily attributable to local injection site reactions including events of lymphadenopathy, erythema, induration, pain, pruritis, hypersensitivity, and urticaria. Centers for Disease Control and Prevention. Gum disease. COVID arm is a rare reaction. Be aware of symptoms that precede fainting (e.g., weakness, dizziness, pallor). No serious adverse events were considered by the FDA as related to vaccine. CDC twenty four seven. Procedural Pain Management There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID-19 vaccines can cause a variety of skin reactions. If you have any concerns about the accuracy of our content, please reach out to our editors by e-mailing After you get a vaccine shot in your upper arm to protect yourself against the flu, COVID-19, or another disease, there's a chance you'll feel some soreness where you got jabbed. If multiple vaccines are administered at a single visit, administer each injection in a different injection site. Nodules can occur following any vaccine. (a) Immediate (type I), MeSH After dose 1, the younger age group reported pain more frequently than the older age group (86.9% vs 74.0%); a similar pattern was observed after dose 2 (90.1% vs 83.4%). Systemic reactions were reported by the majority of vaccine recipients and at higher rates than placebo recipients. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID-19 vaccination campaigns all over the world. Administer vaccines that may be more likely to cause a local reaction (e.g., tetanus-toxoid-containing and PCV13) in different limbs, if possible. . 2 A small amount of pain or redness is expected with an intramuscular (IM) or subcutaneous injection, and a warning to this effect is included in Disclaimer. Label each syringe with the name and the dosage (amount) of the vaccine, lot number, the initials of the preparer, and the exact beyond-use time, if applicable. (2022). doi: 10.1111/jdv.18418. If you get a COVID-19 vaccine and you think you might be having a severe allergic reaction after leaving the vaccination provider site, seek immediate medical care by calling 911. We explain how it works and more. a Pain grade 3: any use of prescription pain reliever or prevented daily activity; grade 4: required emergency room visit or hospitalization. (Table 9), a Severe: prevents daily activity; Grade 4: emergency room visit or hospitalization, b Severe: any use of prescription pain reliever or prevents daily activity; Grade 4: emergency room visit or hospitalization, c Severe: prevents daily activity and requires medical intervention; Grade 4: emergency room visit or hospitalization. Injection site reactions are common after vaccines or treatments delivered through a shot. If you do experience anaphylaxis symptoms or symptoms of myocarditis after getting COVID vaccine, you should seek immediate help. You can review and change the way we collect information below. It is recommended that future vaccines continue to be given according to the immunisation schedule. Histopathological Patterns of Cutaneous Adverse Reaction to Anti-SARS-CoV-2 Vaccines: The Integrative Role of Skin Biopsy. This information is included in the manufacturers package insert for each vaccine. (2021). Headache and fatigue were the most common systemic reactions. Epub 2023 Jan 2. All information these cookies collect is aggregated and therefore anonymous. But any time you experience skin symptoms, its a good idea to speak with your doctor. For infants and younger children receiving more than two injections in a single limb, the thigh is the preferred site because of the greater muscle mass. Lymphadenopathy occurred in the arm and neck region and was reported within 2 to 4 days after vaccination. Appropriate measures should be taken to prevent injuries if a patient becomes weak or dizzy or loses consciousness, including: To receive email updates about this page, enter your email address: We take your privacy seriously. It will join the Pfizer-BioNTech and Moderna COVID-. For this reason, everyone who receives a COVID-19 vaccine is monitored by their vaccination provider for at least 15 minutes. Thank you for taking the time to confirm your preferences. If gloves are worn, they should be changed, and hand hygiene should be performed between patients. if( 'moc.enilnoefiltseb' !== location.hostname.split('').reverse().join('') ) { If possible, administer COVID-19 vaccine and other reactogenic vaccines (e.g., MenB, Tdap) in different limbs. The following were higher in the placebo group compared with the vaccine group by at least 1%: upper respiratory tract infection (12.2% vs 10.3%), COVID-19 (4.9% vs 3.5%), and otitis media (3.7% vs 2.6%). [emailprotected]. Injection site redness and swelling following either dose was reported slightly less frequently and was more common after dose 2 than dose 1. There were no grade 4 local reactions reported. Our website services, content, and products are for informational purposes only. It resolves on its own within a few days. Deviation from the recommended route may reduce vaccine efficacy or increase local adverse reactions. They may also affect other parts of the body. What We Know About the Side Effects of Pfizers COVID-19 Vaccine, What You Should Know About the AstraZeneca COVID-19 Vaccine, COVID-19 Vaccine Side Effects: What to Know Now, Monkeypox and the Smallpox Vaccine: Your Questions Answered. Bells palsy was reported by three vaccine recipients and one placebo recipient. In the placebo group serious adverse events, 1 participant experienced an abdominal wall abscess and 1 participant with rhinovirus infection and asthma. * Grade 4 event reported due to error in eDiary data entry, event was actually grade 0 (100.0F). c Fatigue, Myalgia, Arthralgia Grade 3: significant; prevented daily activity; Grade 4: required emergency room visit or hospitalization. Onset is typically around one week after vaccination. Pain, swelling, and a. var xhr = new XMLHttpRequest(); (2021). Drago F, Ciccarese G, Guadagno A, Parodi A. J Eur Acad Dermatol Venereol. Within each age group, the frequency and severity of systemic reactions was higher after dose 2 than dose 1. Evidence-based strategies to reduce procedural pain include: Fear of injections is often a reason why adults, including health care personnel, decline vaccines. Grade 4 solicited systemic adverse reactions were reported for fever (placebo: 1/585, 0.2%; vaccine: 4/1758, 0.2%) in the 6-23 months age group. Sanomachi T, Sumiyoshi Okuma H, Yonemori K. Int Cancer Conf J. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In this article, well clue you in on the symptoms and treatments of COVID arm. The most common manifestations of localized injection-site reactions were swelling (44% after the first dose, 68% after the second), erythema (49% and 67%), and pain (35% and 59%). Your immune cells respond to the muscle cells that have absorbed the mRNA vaccine. It happens about one week after the first or second shot of the Moderna vaccine but may also occur after Pfizer. However, if you do experience a severe allergic reaction, it will usually happen immediately after receiving the injection. The majority of solicited local reactions occurred within the first 2 days after any dose, persisting for a median of 3.0 days. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. Less than 50% of people who got COVID arm after their first dose will get it after their second. Another complication of the mRNA vaccine can be myocarditis. Han TY, Shim DH, Lee YJ, Lee YB, Koo HYR, Shin MK, Kim TE, Jang YH, Bang JS, Kook HD, Ahn J, Jung HJ, Na CH. The frequency of systemic reactions was higher in the younger age group than the older age group (81.9% vs 71.9% after dose 2). b Headache Grade 3: significant; any use of prescription pain reliever or prevented daily activity; Grade 4: requires emergency room visit or hospitalization. You will be subject to the destination website's privacy policy when you follow the link. In a CDC report on the Moderna vaccine, the agency said that the swelling of lymph nodes, also known as lymphadenopathy, can occur in either the arm or the neck. The majority of solicited systemic reactions occurred within the first 2 days after each, persisting for a median of 2 days. Online ahead of print. Typical side effects for all COVID-19 vaccines are mild and require little more than rest. Local reactions were reported by the majority of vaccine recipients and at higher rates than placebo recipients. The following unsolicited adverse events were higher in the vaccine group compared with the placebo group by at least 1%: injection site lymphadenopathy (1.4% vs 0.2%); croup (1.3% vs 0.3%); diarrhea (3.2% vs 2.2%). Provide supportive care and take appropriate measures to prevent injuries if such symptoms occur. The most common serious adverse events occurring at higher rates in the vaccine group than the placebo group were myocardial infarction (5 cases in vaccine group vs. 3 cases in placebo group), cholecystitis (3 vs. 0), and nephrolithiasis (3 vs. 0). Fever was more common after the second dose (23.9%) compared to the first dose (3.3%). Injection site redness and swelling following either dose were reported less frequently. The .gov means its official. If youre worried about COVID arm, keep in mind that the protective benefits of the COVID-19 vaccine far outweigh the risks associated with COVID arm or developing COVID-19 itself. Thank you for taking the time to confirm your preferences. All health care professionals who administer vaccines to older children, adolescents, and adults should be aware of the potential for syncope after vaccination and the related risk of injury caused by falls. Grade 4 fever (>40.0C) was reported by four vaccine recipients after dose 1 and 11 vaccine recipients after dose 2. COVID arm is a harmless delayed skin reaction to the COVID vaccine. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions ("COVID arm"), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme-like rashes. Epub 2023 Jan 13. Pityriasis lichenoides chronica after BNT162b2 Pfizer-BioNTech vaccine: A novel cutaneous reaction after SARS-CoV-2 vaccine. The majority of reactions occurred within the first 2 days after dose 1 and dose 2, persisting for a median of 3 and 2 days for the 6-23 months and 2-5 age groups respectively. Online ahead of print. Lindgren AL, et al. Bookshelf In a CDC report on the Moderna vaccine, the agency said that the swelling of lymph nodes, also known as lymphadenopathy, can occur in either the arm or the neck. Well also explain why it happens. The overall incidence of unsolicited adverse events up to 28 days after any dose were similar in the vaccine group (40.0%) and the placebo group (37.5%) for participants ages 2 5 years. (Table 7), a Any: 38.0C; Severe: 39C to 40.0C; Grade 4: >40.0C, b Severe: prevents daily activity; Grade 4: emergency room visit or hospitalization. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Stay up to date with COVID-19 vaccines including boosters. Miao G, Chen Z, Cao H, Wu W, Chu X, Liu H, Zhang L, Zhu H, Cai H, Lu X, Shi J, Liu Y, Feng T. Biomed Pharmacother. The rabies vaccine can save your life after a bite or scratch from an unvaccinated animal. The most commonly reported unsolicited adverse events after any vaccine dose were injection site lymphadenopathy (4.3%) and headache (2.2%). Why does this happen? Curr Opin Virol 2021; 49: 5257. We are based at Murdoch Childrens Research Institute (MCRI), a research organisation, and are affiliated with SAEFVIC (Surveillance of Adverse Events Following Vaccination in the Community), the Victorian Vaccine Safety Service. Other serious adverse events in the vaccine group were bronchial hyperactivity, respiratory distress, adenovirus infection, seizure, rhinovirus infection (bronchiolitis due to rhinovirus), Epstein-Barr infection, urinary tract infection, and humerus fracture. The proportions of participants who reported at least one serious adverse event were 1% in the vaccine group and 1% in the placebo group. Pruritus (itch) is the most concerning symptom that motivates parents to seek medical attention. Axillary (or groin) swelling or tenderness was reported slightly more frequently in the younger age group than the older age group (9.3% vs 9.1% after dose 2). 3. If you get the Moderna COVID-19 vaccine, there is a small chance that you could develop a skin reaction. This happens with many of the common vaccines that infants receive, such as DTaP, polio, PCV, hepatitis A and B, chickenpox, MCV, and influenza. } else { The COVID-19 vaccine has shown to have high efficacy if given correctly intramuscularly. Do NOT mix more than one vaccine in the same syringe in an effort to create a combination vaccine.. The majority of systemic events were mild or moderate in severity, but there was a higher occurrence of grade 3 or higher reactions in the vaccine group. Each vaccine has a recommended administration route and site. The CDC recommends an mRNA vaccine over the J&J vaccine. official website and that any information you provide is encrypted The COVID19 vaccine development: a pandemic paradigm. The history of, or presence of, a nodule is not a contraindication to future vaccines. The most common solicited systemic adverse reactions after any dose were irritability/crying and fatigue for participants 636 months and 37 months5 years, respectively. Serious adverse events were defined as any untoward medical occurrence that resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, or resulted in persistent disability or incapacity. This reaction and others are continuing to be studied worldwide. There were no other systemic grade 4 reactions reported. (c) Mechanism of molecular mimicry caused by genetic similarities of SARSCOV2 spike protein components to endogenous crossreactive human antigens. Axillary (or groin) swelling or tenderness and injection site swelling following either dose were reported less frequently and were more common after dose 2. There were 2 SAEs among 2 recipients (obstructive nephropathy and suicide attempt). A nodule can persist for weeks and sometimes months. Three serious adverse events were considered by the U.S. Food and Drug Administration (FDA) as possibly related to vaccine: the one report of intractable nausea/vomiting and two reports of facial swelling in persons who had a previous history of cosmetic filler injections. J Am Acad Dermatol. Would you like email updates of new search results? The main imbalances between the vaccine and placebo groups were general disorders and administration site conditions, consistent with the known reactogenicity profile of the vaccine. The Society of Breast Imaging reports that 11.6% of patients who received Moderna's COVID-19 vaccine had swollen lymph nodes after the first dose, and 16% after the second dose. The Melbourne Vaccine Education Centre (MVEC) is an educational website, developed with the aim of providing up-to-date immunisation information for both healthcare professionals and members of the public. A severe allergic reaction can cause: difficulty breathing or wheezing, a drop in blood pressure, swelling of the tongue or throat, or Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology. 2022 Dec;36(12):e979-e981. 2022 Galvanized Media. Some vaccines are approved by the Food and Drug Administration (FDA) for administration by the Pharmajet Stratis needle-free injection system. What Does an Alternative Childhood Vaccine Schedule Look Like? CDC and the Advisory Committee on Immunization Practices (ACIP) guidance states COVID-19 vaccines can be given during the same visit with other vaccines, including flu vaccine, if the recipient is eligible for the vaccines. The majority of reactions occurred within the first 1 to 2 days after each dose and persisted for a median of 2 days. Bojan Story/Getty Images. Ramos CL, et al. ACS Central Sci 2021; 7: 512533. Referral to a Specialist Immunisation Clinic should be considered for specialist consultation. Authors: Mel Addison (SAEFVIC Research Nurse, Murdoch Childrens Research Institute), Rachael McGuire (SAEFVIC Research Nurse, Murdoch Childrens Research Institute) and Georgina Lewis (Clinical Manager, SAEFVIC, Murdoch Childrens Research Institute), Reviewed by:Mel Addison (SAEFVICResearch Nurse, Murdoch Childrens Research Institute). In Victoria reports can be made to SAEFVIC. Overall, the median onset of local reactions in the vaccine group was 1 day after either dose, with a median duration of 2 days. An alternative childhood vaccine schedule is getting a child vaccinated on a schedule different from what the CDC recommends. The proportions of participants who reported at least one serious adverse event were 0.5% in the vaccine group and 0.2% in the placebo group. COVID arm: Very delayed large injection site reactions to mRNA COVID vaccines. Severe, life-threatening reactions following vaccinations are rare. Swelling, redness (erythema), pain and itch at the site of injection can be a common side effect from any vaccine. You may want to consider talking with your doctor to learn more about the COVID-19 vaccines benefits and side effects. Eleven (52%) had received the Moderna mRNA vaccine while the remaining 10 (48%) received the Pfizer-BioNTech mRNA vaccine. Injecting vaccines rapidly without aspiration, Using tactile stimulation (rubbing/stroking near the injection site before and during injection), Distracting the patient (done by either the parent or clinician), Having the patient seated rather than lying down. A conservative approach to treatment is recommended and is usually to provide symptomatic relief of pruritus. COVID arm is a relatively rare occurrence, which should not be confused with the early onset arm reactions caused by many vaccines. These cookies may also be used for advertising purposes by these third parties. (d) Generation of autoreactive lymphocytes and crossreactive antibodies due to molecular mimicry leading to autoimmune reactions, such as vaccineinduced immune thrombocytopenia (VIIT) lupus erythematosus, vasculitis and bullous pemphigoid. Itching, pain, and swelling are the main symptoms. The swelling typically goes down in about two to 11 days. It's not yet approved for use in the United States. aGrade for fever: grade 3=39-40.0C; grade 4=> 40.0C. During the study period, there were 322 patients referred for post-COVID-19 vaccine cutaneous reactions. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Often, more than one vaccine is needed during the same doctors visit, requiring more than one shot. Sometimes, your doctor or vaccination provider may recommend alternating arms if you had a strong skin reaction to your first vaccine. Effect of COVID-19 (SARS-CoV-2) Vaccination on Patients with Atopic Dermatitis Treated with Dupilumab: A Multicenter, Observational Study. Multiple studies have found that COVID-19 vaccines, including boosters, are safe, and that adverse reactions are rare. d Nausea/Vomiting Grade 3: prevented daily activity, required outpatient intravenous hydration; Grade 4: Requires emergency room visit or hospitalization for hypotensive shock. Unspecific injection-site reactions very early occurring after the vaccination are most frequent.
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