Concerns About Sabin Vaccine: A Parent's Guide to Pediatric Reactions

Sabin vaccine issues?

Hello Doctor: My son received the quadrivalent vaccine (at 18 months) on February 18, and during the oral administration of the Sabin vaccine, the nurse seemed to have accidentally administered an extra drop (a total of three drops).
A week later, my son developed redness and swelling in both of his calves, with one side being larger (about 5 cm) and the other smaller (about 1 cm).
The swollen areas feel warm to the touch and are hard when pressed.
Is there a problem with the vaccine? What should I do? An anxious mother.
P.S.
Could you please respond as soon as possible? Thank you.

Ms. Zhang, 30~39 year old female. Ask Date: 2004/02/29

Dr. Zhang Jinglong reply Pediatrics

Hello Ms.
Chang,
1.
You asked about your one-and-a-half-year-old child who received the quadrivalent vaccine (at one and a half years) and the oral Sabin vaccine on February 18.
It seems the nurse may have administered an extra drop (a total of three drops).
Is this a concern? Here’s the response: The correct administration of the oral polio Sabin vaccine is to give 2 drops.
Although the nurse may have given an extra drop (totaling three drops), there have been no reported significant side effects associated with this.
Additionally, if the vaccine is vomited shortly after administration, you can give another dose without worrying about an overdose.
However, if vomiting occurs more than half an hour later, there is no need to administer an additional dose.
2.
About a week later, you noticed that your child has redness and swelling in both calves, one side being larger (about 5 cm) and the other smaller (about 1 cm).
The swollen areas feel warm and are hard to the touch.
You are concerned if this is related to the vaccine.
Here’s the response: This issue is not related to the oral Sabin vaccine and does not occur at the injection site.
It should not be associated with the vaccine.
The warmth in the swollen areas indicates an inflammatory response.
It is recommended that you consult a pediatric specialist nearby.
Wishing you and your child well.

Reply Date: 2004/02/29

More Info

Dear Concerned Parent,
Thank you for reaching out with your concerns regarding your son's recent vaccination experience. I understand how worrying it can be when a child experiences unexpected reactions after receiving a vaccine. Let’s break down your concerns regarding the Sabin vaccine and the reactions you observed.

Firstly, the Sabin vaccine, which is an oral polio vaccine, is generally well-tolerated and has a good safety profile. It is designed to provide immunity against poliovirus and is typically administered in two drops. In your case, it appears that your son received an extra drop, totaling three drops instead of the standard two. However, current medical guidelines indicate that receiving an extra drop of the Sabin vaccine does not pose a significant risk or lead to serious adverse effects. The vaccine is a live attenuated virus, and while there is a very small risk of vaccine-associated paralytic poliomyelitis (about 1 in 2.4 million doses), this is extremely rare.

Now, regarding the symptoms you described—redness and swelling in both of your son's calves, with one area being larger than the other—these reactions are not typical side effects of the oral Sabin vaccine. The redness and swelling you observed are more likely indicative of a localized inflammatory response, which can occur due to various reasons, including minor trauma, insect bites, or even a mild viral infection. The fact that the areas are warm and feel hard when pressed suggests that there may be some localized inflammation or possibly a mild infection.

It is important to monitor these symptoms closely. If the redness and swelling do not improve within a few days, or if your son develops a fever, increased pain, or any other concerning symptoms, it would be prudent to consult a pediatrician. They can perform a thorough examination to determine the underlying cause of the symptoms and provide appropriate treatment if necessary.

In the meantime, you can manage the discomfort by applying a cool compress to the affected areas and ensuring your son stays hydrated. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also be used to alleviate any discomfort, but please consult your pediatrician for the appropriate dosage based on your son's age and weight.

Additionally, it’s essential to keep in mind that while vaccines can cause mild side effects, such as fever or localized soreness, serious reactions are rare. The benefits of vaccination in preventing serious diseases far outweigh the risks of potential side effects. Vaccination is a critical component of public health and helps protect not only your child but also the community at large by contributing to herd immunity.

In summary, while the extra drop of the Sabin vaccine is unlikely to be the cause of your son's symptoms, it is essential to monitor his condition and consult a healthcare professional if you have any concerns. Vaccination is a vital step in protecting your child's health, and it’s understandable to have questions and concerns as a parent. Please feel free to reach out if you have further questions or need additional guidance.

Wishing you and your son good health,
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