Sex: F
Vaccine: TYP, YF
Symptoms: Injection site discolouration, Injection site vesicles, Type IV hypersensitivity reaction, Vaccination site erythema, Vaccination site induration
Clinical narrative: Initial unsolicited report received from the literature (VAERS Case ID: 041172-1) on 19-OCT-2017, and additional information received on 23-OCT-2017. This case was linked with 2017SA207244, 2017SA207248, 2017SA207251, 2017SA207263, 2017SA207267, 2017SA207271, 2017SA207273, 2017SA207275, 2017SA207277, 2017SA207279, 2017SA207280, 2017SA207282 (same literature). The following is the abstract from the article: Abstract Yellow fever vaccine is a live attenuated viral inoculation indicated for patients traveling to endemic areas. The vaccine is generally well tolerated with minimal adverse effects. Typical side effects include malaise, pain at the injection site, and, albeit rarely, immediate hypersensitivity reactions. We present a case of a rare adverse reaction to yellow fever vaccine in which a patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation. This case involves 31-year-old female patient who was vaccinated with 0.5 ml dose of YELLOW FEVER VACCINE via subcutaneously in the deltoid muscle (also reported as injected inferiorly and distal to the insertion of the deltoid muscle) and 0.5 ml dose of TYPHOID VACCINE via intramuscularly in the left deltoid (Batch number, expiry date and dose in series were not reported for both vaccines) and loratadine (Batch number, expiry date dose was not reported) on an unknown date. The patient's medical history included chronic rhinitis which was treated with loratadine and intranasal fluticasone. It was also reported that patient had no significant medical history presented to the travel clinic for guidance prior to travel. Concomitant medications were not reported. On an unknown date, after vaccination, patient developed type IV hypersensitivity to the vaccine or its components. On an unknown date, one day after vaccination, the patient developed a small single vesicle occurring at the vaccine injection Site (described as noted a small blister overlying the yellow fever inoculation site and over the ensuing days, multiple serosanguinous vesicles developed, with many coalescing into a primary 4 cm bulla, also the area was pruritic and erythematous with underlying Induration and on an unknown date (reported as following day), after vaccination, the area surrounding the newly denuded skin was noted to be hyperpigmented. Over the ensuing days, multiple serosanguinous vesicles developed, with many coalescing into a primary 4 cm bulla. The area was pruritic and erythematous with underlying induration. The patient denied any systemic symptoms including fever. Five days post-vaccination she presented to a local emergency room where the bullous lesions were unroofed. On the following day, the area surrounding the newly denuded skin was noted to be hyperpigmented. It was also reported that the vaccination procedure was well tolerated with no immediate adverse events. The patient denied ever receiving a yellow fever vaccine and had no history of a reaction to any vaccine in the past, or history of contact dermatitis. The patient's relevant lab tests were not reported. As corrective treatment, patient was discharged from the emergency room with topical antibiotic ointment and advised to keep the area clean and covered. Outcome of all the events was not reported (also reported as patient was closely monitored and had complete resolution of her symptoms within 3 weeks). List of documents held by sender: none.