Extensive Limb Swelling after Td Vaccination in a Pregnant Woman

Abstract

Introduction: Immunization is an indisputable necessity for personal and public health. Unfortunately, vaccines protecting people from disease can sometimes lead to unwanted side effects. Case Report: A 29-year old female at 21 weeks pregnant presented at our clinic with a painful swelling in the left forearm. The patient history revealed that tetanus (Td) vaccine had been applied to the left arm deltoid region at a health center one week previousy. On physical examination, the left deltoid region was tender to palpation with limited abduction, but there was no warmth, redness orswelling. Swelling (about 15 × 10 cm diameter) was observed throughout the left forearm. The patient was assessed as having vaccine-related adverse side effects, and the case was reported to the Adverse Effects Monitoring Committee commission of the province. Limb elevation and antiinflammatory treatment were recommended. At follow-up 1 week later, the lesion had regressed completely. Discussion: Most side effects from repeated Td vaccination are mild or moderate, and self-resolving. The most common side effects include erythema, swelling, pain, and tenderness at the injection site, body-ache, fatigue, or fever. Extensive limb swelling due to tetanus vaccine has been reported in children. To our knowledge, the present case is the first reported otherwise healthy pregnant woman with swelling distant from the vaccine injection site.