Usually, this is a self-limited reaction and no therapy is indicated, but VIG may be indicated for severe cases. These included generalized urticarial exanthems, such as erythema multiforme and Stevens-Johnson syndrome. Encephalitis occurs in approximately two individuals per million receiving the vaccine. This complication produced a case fatality rate of 10 to 30 percent and neurologic sequelae in survivors. The pathogenesis is unknown but is probably due to an immunopathologic mechanism because vaccinia cannot be cultured from CSF or brain tissue of patients.
Treatment is supportive.
Eczema vaccinatum is a severe dermatitis featuring replication of vaccinia at sites of eczema, psoriasis, burns, or other chronic or severe cutaneous lesions. This condition featured an intense local reaction at the site of the vaccination, progressing to local necrosis. The prognosis for the fetus is poor, resulting in stillbirth. The University of Iowa. All rights reserved.