From the Guidelines
Redness and swelling after a Tdap vaccine typically last 1-3 days, though it can occasionally persist for up to a week. These local reactions are common and normal immune responses to the vaccine, occurring in up to 80% of individuals after receipt of tetanus and diphtheria toxoid–containing vaccines without pertussis components 1. You may notice tenderness, warmth, and slight swelling at the injection site, which is usually the upper arm. To manage these symptoms, you can apply a clean, cool washcloth to the area, take over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) according to package directions, and gently exercise your arm to reduce stiffness.
Some key points to consider about these reactions include:
- Mild typical local reactions, including redness and swelling, are expected and usually self-limiting 1
- Severe local reactions, such as entire or extensive limb swelling (ELS), are less common, occurring in 2% to 6% of cases, and are usually self-limited 1
- Arthus type III hypersensitivity reactions, characterized by severe pain, swelling, induration, edema, hemorrhage, and occasionally necrosis, are rare but can occur within 4 to 12 hours after immunization 1
- The frequency of redness, swelling, or increased mid–upper arm circumference after Tdap vaccination is similar to that after Td vaccination, with severe degrees occurring in less than 4% of vaccine recipients 1
It's essential to monitor the reaction and seek medical attention if redness and swelling worsen after 3 days, spread beyond the injection site, or are accompanied by high fever or severe pain, as these could indicate a more serious reaction requiring medical attention. The immune system's response to the vaccine components is the cause of these reactions, which are a normal part of building protection against the diseases 1.
From the Research
Redness and Swelling after Tdap Vaccine
- Redness and swelling are common reactions after receiving the Tdap vaccine, with entire limb swelling reported in some cases 2.
- The reaction is usually associated with redness and pain, and all swelling subsided spontaneously without sequelae 2.
- The duration of redness and swelling is not explicitly stated in the studies, but it is mentioned that erythema nodosum, a type of skin reaction, can resolve within 2 weeks after initiating treatment 3.
- Local injection-site reactions, including redness and swelling, are the most common adverse events associated with the Tdap vaccine 3, 4.
Factors Influencing Redness and Swelling
- The rates of entire thigh swelling after dose 4 of the DTaP vaccine were associated with diphtheria toxoid content in the vaccine 2.
- Lesser degrees of swelling were correlated with pertussis toxoid content after dose 4 and aluminum content after dose 5 2.
- No relationship was established between levels of serum antibody to diphtheria, tetanus, or pertussis toxin and rates of swelling of the whole thigh 2.