Vaccine Overdose: What the Reaction Means (or Finding the Silver Lining)

January 26, 2011 at 12:17 pm 21 comments

If you have been reading this blog for a while, you may know that I am pro-immunization. I believe immunization is the safest, most cost-effective way to protect my children (and yours) and keep them healthy. So, writing this post has been an interesting exercise in telling it like it is.

In November, I took Lil C and Lil D to our family doc’s office for their annual influenza immunizations. Lil D was also due for his DTaP-IPV 4-6 year old booster (the shot that protects against diphtheria, tetanus, pertussis, and polio; between 4 and 6 years of age, the immunity gained from the earlier shots begins to wane).

The boys were not looking forward to this experience and they got each other more and more worked up to the point where they were both crying, begging and pleading for me to take them home.

The experienced, but not particularly helpful nurse left the exam room to go prepare the three syringes. As she left, I was getting Lil D ready.  But when she came back, I had Lil C sitting with me on the exam table. She was visibly harried and curtly instructed me how to hold him tight.

I did.

And she injected him. With the booster shot that was meant for Lil D. Not the influenza immunization that was meant for Lil C.

The second after she did it, I knew she had made a mistake. I asked her. She confirmed. She felt terrible. I felt nauseous. Lil C and Lil D were screaming.

The nurse went and got the doctor. She assured me that it would be okay and helped me to get the influenza shots into the 2 boys and the booster that was meant for Lil D into his arm. It took all I had to let them do this. But the thought of the anxiety that another visit would cause was too much to bear.

I gave the boys chocolate before and after their shots. They were both in their undershirts with snot and tears streaming down the faces running together with the melted chocolate around their mouthes. They looked like little street urchins.

And then Lil C’s arm swelled and got red and itchy.

We watched him for a few minutes and it seemed to get a bit better. I took the boys home. I was seething inside but trying to remain calm and nurturing for the boys.

Lil D told me he will not be like that next time he gets a shot because it wasn’t that bad.

Lil C got lots of cuddles and some ibuprofen. He woke up that night with a sore arm and got more analgesic.

Forty-eight hours later, this is what his arm looked like.

Overdosed arm

Healthy arm (with band aid from flu shot)

The morning after I took these photos, we had an appointment with the allergist for testing (since his brother, Lil D, has nut allergies). I asked the allergist to take a look at his arm; how convenient that I would get see a specialist in reactions! He said it would go away and that I should consider that this was a sign that he still had immunity to the antigens in the vaccine and his body recognized that.

We also learned that Lil C does not have any allergies to nuts and that in fact, he should eat them so that he doesn’t develop a sensitivity down the road. This presents some logistical issues since we have a nut-free home, but it is a relief in many ways.

Ultimately, no long-term or even medium-term physical harm came to Lil C, though I do wonder how he will be next year at flu shot time.

But, I am still angry with that nurse. She did so many things wrong beyond her blatant error. She did nothing to ease our anxiety on that visit. In fact, I would say she heightened it with her own anxiety.  I had come prepared with many tools but she did not give me the time or the assistance to use them (iPad, sugar in the form of chocolate, cuddles).

She needs some serious re-education in vaccine administration, from safety, through to pain-free administration techniques.

I am planning on sending some of the following resources to my physician’s office with a candid letter:

This experience will have no effect on my belief in vaccines.  In fact, it underscores my understanding of the process and the importance of having well-trained medical personnel to make the experience easier for families.

Silver-lining:  I know Lil C is immune to diphtheria, tetanus, whooping-cough and polio.  Yay!

Lessons learned:

1) Don’t take both children for shots at the same time; they work each other up.

2) Act as an extra check for the health-care provider; slow them down and check that they are administering the right procedure/medication.

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21 Comments Add your own

  • 1. Mom  |  January 26, 2011 at 12:48 pm

    This is a great teaching tool…..your conclusions/learned lessons are right on! Ask your physician to help you disseminate it in medical/nursing teaching siturations.
    Am I ever glad I didn’t hear about this at the time……!

  • 2. Jenn Beyak  |  January 26, 2011 at 1:13 pm

    Great post Liisa. One of the best “lessons learned” descriptions in a medical context. Your descriptions are excellent. I felt sick reading the first part, but glad C is ok. You handled it superbly!

  • 3. Alicia  |  January 26, 2011 at 1:32 pm

    Ouch, poor little guy. I always feel like I’m checking and double checking each of the nurses steps. I’m sorry you had to go through this even though you were very prepared.

  • 4. Julie Drury  |  January 26, 2011 at 6:42 pm

    Liisa, this is an excellent post!
    Let me tell you about a couple of experiences we’ve had with vaccinations:

    I also am pro-vaccination, but am also vigilant and wary because of my medically complex 3 year old.
    First Story:
    My daughter was hospitalized at CHEO, a visitor came to see us who then called that evening to say she had been exposed to chicken pox. My daughter was vaccinated, my son was not (or at least I thought he wasn’t). My husband called our doctors office to confirm – they could not, seems they weren’ sure (hmmm). They had no vaccines on hand and suggested another clinic. My husband took our son there and he was given a vaccine that was expired. The only reason we found out was that I asked my husband to get a copy of the vaccine date/number. This was done after the fact – and that is when the error was found. I then heard from our doctors office that in fact our son had been vaccinated.

    Experience 2:
    Our medically complex and fragile daughter has a bit of a wonky vaccination schedule due to frequent illness. As a result, she has been tested to see her immunity to the vaccinations she has received. Despite receiving a full vaccination schedule of Prevnar (pneumococal vaccine), she has no immunity. (Which is a problem for her and makes me wonder how often that happens).

    When I take my kids in. I make sure they understand (as best they can) what is going to happen, but I don’t prep them too far in advance – it gives them too much time to stew and think about things.
    We waste no time. Get it done.
    We use EMLA cream at the site. A skin numbing cream you can get over the counter. Use it! It works!
    We use distratction. DS or other.
    A lesson I learned from doing regular bloodwork and IVs with my daughter. As the needle is about to go in, rub another area of their body vigorously, or squeeze their other arm. It works.

    Great blog today!

  • 5. Julie Drury  |  January 26, 2011 at 6:44 pm

    PS. You are more than right to be angry/upset at that nurse. She did not do her job well at all. Being rushed/busy is no excuse. Writing a letter (with the resources) is exactly the right thing to do. Hopefully things will go better for the next child/family.

    Hope Lil C’s arms feels better soon.

    • 6. fitforakid  |  January 26, 2011 at 7:01 pm

      Thanks for your comments Julie. This actually happened in November and it’s still bothering me. That’s why I decided to write the post. Lil C’s arm took 4 weeks to look completely normal, though he felt better in a few days.

      Our experiences with your son and Lil C probably happen way more often than they should. I think it’s partially a product of the publicly-underfunded primary care environment in Ontario and the absence of a province-wide or preferably national vaccine registry.

      As far as your daughter goes, well, having a “unique” immune system might make many vaccines ineffective in her unfortunately since they are designed to work best in average immune systems. Did they test her for immunity to any of the other vaccine-preventable diseases? For some reason I’m thinking that the Prevnar vaccine is one of those that can be less effective.

      Great tips on distraction. Thank you so much. I’m coming back to this post before next year’s flu shots.

      • 7. Julie Drury  |  January 26, 2011 at 7:27 pm

        In fact her IG levels (immunoglobulin levels) are below normal. At one time they were all more than half below normal.
        No on has ever told me that a compromised immune system might make vaccinations less effective. What my ‘instinct’ tells me is to be wary and cautious about when she receives them, i.e. she needs to be at her optimum.
        Again, have never been told Prevnar is one of the least effective. We are being asked to give her Prevnar 13 (a newer and better?) form of the vaccine. I will be asking questions about this.
        She is being followed by an immunologist at CHEO (and was referred to Sick Kids as well).

      • 8. fitforakid  |  January 27, 2011 at 7:01 pm

        I know Prevnar 13 covers more strains for pneumo disease, but the question I would ask the immunologist is if it has any new technology that makes her more likely to develop antibodies. I’m not sure that is the case. Then again, the only downside to trying it is yet another needle for her (which I know is huge). I hope she is feeling better.

  • […] This post was mentioned on Twitter by Fit for a Kid, Fit for a Kid. Fit for a Kid said: Today I write about how an immunization advocate mom handles a vaccine error in her child. […]

  • […] She always asks how [insert last family member to visit] is doing. Even the nurse (not the one who screwed up the immunizations) will ask me about the boys when I am there for my own appointment without […]

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  • 15. Lisa  |  March 18, 2014 at 7:57 am

    Hi, my son has recently had his 4 yr old immunisations and had a similar reaction to what your son had but it was a lot more purplish. We were told it will go down and disappear, but it has now been two weeks and it certainly has gone down but now it looks like a birthmark of sorts and doesn’t look like its going anywhere. Just wondering if your sons disappeared altogether?
    Thanks Lisa

    • 16. Liisa  |  March 18, 2014 at 1:15 pm

      Yes! It did go away completely within a couple of weeks. I would wait a little longer but head back to the doc if its still there in a week or two. Best wishes!

  • 17. Jane  |  October 17, 2014 at 3:37 pm

    It is very unfortunate your children did not receive the vaccines correctly, she also did not administer the injections in the correct muscle site either. The top picture was too far to the side and the bottom picture, the vaccine was given too low. I would ask for a different nurse next time!!

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  • 21. Sam Hattersley  |  April 16, 2016 at 12:36 pm

    Thank you for you post. My lilT has a big red arm at the moment from his 4 year vacs two days ago. He is very robust and hardy ever ill so the reaction now makes a lot of sense after reading your experience . Thank you again


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