Injection Site Necrosis and Ulceration Following Vaccination in an Adult Patient

Area of Science:

• Dermatology
• Vaccinology

Background:

• Local reactions to vaccines are common but usually mild.
• Severe local reactions, including necrosis, are rare but can be associated with vaccine adjuvants like aluminum salts and improper vaccination technique.

Observation:

• This report details the first documented case of vaccine site necrosis in an adult patient.
• The reaction involved necrosis of the epidermis and dermis with central ulceration, affecting skin appendages like eccrine coils and hair follicles.

Findings:

• The presumed cause was a robust inflammatory response to aluminum salt adjuvants administered via subcutaneous injection.
• Improper vaccination technique, including incorrect placement, needle size, or length, may contribute to severe local adverse skin reactions.

Implications:

• This case underscores the need for meticulous vaccination technique to minimize the risk of severe local adverse reactions.
• Awareness of potential severe reactions is crucial for healthcare providers administering vaccines, especially those containing aluminum salt adjuvants.