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Intralymphatic Immunotherapy and Vaccination in Mice
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The vaccines-associated Arthus reaction.

Baozhen Peng1, Mingwei Wei2, Feng-Cai Zhu1

  • 1School of Public Health in Southeast University, 87 Hunan Rd, Nanjing 210009, China.

Human Vaccines & Immunotherapeutics
|April 5, 2019
PubMed
Summary

The Arthus reaction, a rare type III hypersensitivity after vaccination, causes severe local symptoms. This review highlights its characteristics, incidence, and the need for greater awareness and research into vaccine-induced Arthus reactions.

Keywords:
Arthus reaction; vaccination

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Area of Science:

  • Immunology
  • Vaccinology
  • Public Health

Background:

  • The Arthus reaction is a rare, severe local adverse event following vaccination, classified as a type III hypersensitivity reaction.
  • Characterized by pain, swelling, induration, and edema at injection sites, it can lead to necrosis or ulceration, though mild cases resolve without treatment.

Purpose of the Study:

  • To systematically review vaccine-induced Arthus reactions, addressing a gap in current literature.
  • To deepen understanding and awareness of this adverse phenomenon.

Main Methods:

  • A comprehensive literature search was conducted in PubMed, Web of Science, and Chinese databases (CNKI, Wan Fang) for studies on Arthus reaction and vaccines before January 28, 2019.
  • Retrospective review of case descriptions, characteristics, incidence, diagnostic criteria, treatment, and prevention.

Main Results:

  • Only 30 cases of Arthus reaction were identified, with one fatality. Incidence varied by vaccine dose (13.3% after dose 1, 50.0% after dose 2, 23.3% after dose 3).
  • Seventeen cases occurred in children under 6 years. Bacterial vaccines accounted for 18 cases, and viral vaccines for 12.
  • Data limitations prevented statistical comparison of incidence rates.

Conclusions:

  • Vaccine-associated Arthus reactions are rare but can be severe, necessitating further investigation.
  • A pre-existing specific IgG may contribute to Arthus reactions after a single vaccine dose.
  • Systematic review and increased awareness are crucial for managing and preventing Arthus reactions.