Vaccination

• Measles: Rash that starts at the hairline, high fever, Koplik spots in the mouth.
• Mumps: Parotid gland swelling, fever, headache, complications like orchitis in males.
• Rubella: Mild fever, rash starting on the face, lymphadenopathy, arthralgia.
• Pertussis (Whooping Cough): Severe coughing fits with a characteristic ‘whoop’ sound.
• Varicella (Chickenpox): Vesicular rash, fever, malaise, risk of secondary bacterial infections.
• Meningococcal Disease: Fever, petechial rash, neck stiffness, photophobia, altered mental status.

• Guillain-Barré Syndrome: Ascending paralysis, areflexia, history of recent infection or vaccination.
• Systemic Lupus Erythematosus (SLE): Butterfly rash, photosensitivity, arthritis, renal involvement.

• Hepatitis B: Jaundice, dark urine, fatigue, history of IV drug use or unprotected sex.
• Tetanus: Muscle stiffness, trismus (lockjaw), difficulty swallowing, recent wound or injury.
• Diphtheria: Sore throat, pseudomembrane in the throat, respiratory distress.
• Poliomyelitis: Flaccid paralysis, fever, history of inadequate vaccination.

• Anaphylaxis: Sudden onset, urticaria, angioedema, respiratory distress, hypotension.
• Arthus Reaction: Localised pain, swelling, erythema at the site of vaccination.

Assess the specific symptoms presented by the patient:

• Fever: Common post-vaccination, but persistent high fever suggests an underlying infection.
• Rash: Could indicate a vaccine reaction, or a differential like measles or rubella.
• Joint Pain: Consider rubella, SLE, or a reaction to a vaccine like MMR.
• Neurological Symptoms: Assess for weakness or paralysis, consider Guillain-Barré syndrome.

Gather a detailed background including:

• Vaccination History: Ensure the patient has received all scheduled vaccinations and ask about any recent vaccines.
• Past Medical History: Including any history of autoimmune disease, previous severe vaccine reactions, or known allergies.
• Drug History: Assess for any immunosuppressive therapies which might affect vaccine efficacy.
• Family History: Consider any familial autoimmune conditions or history of adverse vaccine reactions.
• Social History: Recent travel history, exposure to infectious diseases, occupational risks.

• Full Blood Count (FBC): Assess for infection, anaemia, or other haematological abnormalities.
• C-Reactive Protein (CRP) / Erythrocyte Sedimentation Rate (ESR): Evaluate for inflammation or infection.
• Liver Function Tests (LFTs): Especially if hepatitis is suspected.
• Viral Serologies: Confirm infection status for diseases like hepatitis B, rubella, measles.
• Autoantibodies: Test for SLE or other autoimmune conditions if clinically indicated.

• Chest X-ray: If there is respiratory involvement or if tuberculosis or pneumonia is suspected.
• MRI of the Brain/Spine: If neurological symptoms like weakness or paralysis are present.
• Ultrasound: In cases of suspected mumps, to assess the parotid glands or testes.