In the 1960's many children were vaccinated with a measles vaccine made from killed measles virus. When vaccinated with a measles live virus vaccine these children may develop a significant local reaction.
Patient selection: person vaccinated with a killed measles virus vaccine in the past, recently vaccinated with a live measles virus vaccine
Clinical features:
(1) local tenderness and/or erythema at the vaccination site
(2) swelling and edema that may be severe
(3) febrile response, with high fevers possible
(4) fleeting maculopapular rash
Despite the risk of this reaction a person who received a killed measles virus vaccine should be vaccinated with the live measles virus vaccine. This is because the patient is at risk for developing atypical measles if exposed to a wild virus. Atypical measles can be a serious illness that requires hospitalization.
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