From the Guidelines
The first line treatment for a child presenting with an immunization blister in a general practice setting in New Zealand is conservative management with monitoring and supportive care. No specific medication is typically required as these blisters are a normal immune response at the vaccination site. The blister should be kept clean and dry, and parents should avoid popping or draining it as this could introduce infection. A light, non-adhesive dressing may be applied if the blister is at risk of rupturing due to friction or clothing. Paracetamol can be given at age-appropriate doses (15mg/kg/dose, up to four times daily) for any associated discomfort. If the blister appears infected (increasing redness, warmth, swelling, purulent discharge, or the child develops a fever), then reassessment is needed and topical or oral antibiotics may be considered. Parents should be reassured that immunization blisters typically resolve spontaneously within 1-2 weeks without complications and represent a normal localized reaction to the vaccine as the body mounts an immune response.
Some key points to consider when managing immunization blisters include:
- Keeping the blister clean and dry to prevent infection
- Avoiding popping or draining the blister to prevent introducing infection
- Applying a light, non-adhesive dressing if the blister is at risk of rupturing
- Using paracetamol for associated discomfort
- Monitoring for signs of infection and seeking medical attention if necessary
It's worth noting that the provided evidence does not directly address the management of immunization blisters in children, but rather focuses on the management of pemphigus vulgaris and standards for pediatric immunization practices 1. However, the general principles of wound care and infection prevention can be applied to the management of immunization blisters.
In terms of specific guidance on managing blisters, the British Association of Dermatologists' guidelines for the management of pemphigus vulgaris provide some relevant advice, including gently cleansing the blister with an antimicrobial solution and avoiding deroofing the blister 1. However, it's essential to prioritize the child's overall health and well-being, and to seek medical attention if there are any concerns about the blister or the child's response to the vaccine.
From the Research
Immunisation Blister in Children
- The provided studies do not directly address the treatment of immunisation blisters in children in a general practice setting in New Zealand.
- The studies focus on immunisation services, coverage, and barriers to immunisation in New Zealand, but do not provide information on the treatment of adverse reactions such as blisters 2, 3, 4, 5, 6.
- There is no specific guidance on the first-line treatment for immunisation blisters in children in the provided studies.
General Treatment of Adverse Reactions
- While the studies do not provide specific guidance on treating immunisation blisters, they do highlight the importance of immunisation and the need to address barriers to immunisation in New Zealand 4, 5, 6.
- It is likely that treatment of immunisation blisters would follow general principles of wound care and management of adverse reactions, but this is not explicitly stated in the provided studies.