The site of an intradermal or transcutaneous vaccination can be graded using the Vaccine Site Appearance Grading Scale (VSAGS).
Parameters, based on longest dimension:
(1) erythema (redness lasting > 30 minutes after vaccination; blanchable)
(2) induration (palpable firmness)
(3) edema (swelling)
(4) ecchymosis (bruising, non-blanchable)
(5) papules or plaques (papule if < 1 cm in diameter; plaque if >= 1 cm)
(6) vesicles or bullae (vesicle if < 1 cm in diameter; bullae if >= 1 cm)
(7) hyperpigmentation (darkening of skin)
(8) hypopigmentation (lightening of skin)
(9) other
|
Parameter |
Finding |
Points |
|
erythema |
none |
0 |
|
|
barely detectable |
1 |
|
|
mild |
2 |
|
|
moderate |
3 |
|
|
marked |
4 |
|
|
very dark red to purple |
5 |
|
induration |
none |
0 |
|
|
< 5 mm in diameter |
1 |
|
|
5 to 9.9 mm |
2 |
|
|
10 to 14.9 mm |
3 |
|
|
15 to 19.9 mm |
4 |
|
|
>= 20 mm |
5 |
|
edema |
none |
0 |
|
|
< 5 mm in diameter |
1 |
|
|
5 to 9.9 mm |
2 |
|
|
10 to 14.9 mm |
3 |
|
|
15 to 19.9 mm |
4 |
|
|
>= 20 mm |
5 |
|
ecchymosis |
none |
0 |
|
|
barely detectable |
1 |
|
|
mild |
2 |
|
|
moderate |
3 |
|
|
marked (dark red) |
4 |
|
|
violaceous/purple |
5 |
|
papules or plaques |
none |
0 |
|
|
barely palpable |
1 |
|
|
< 1 mm, discrete |
2 |
|
|
>= 1 mm, discrete |
3 |
|
|
coalescing papules, < 10 mm |
4 |
|
|
papules or plaques >= 10 mm |
5 |
|
vesicles or bullae |
none |
0 |
|
|
barely palpable |
1 |
|
|
discrete vesicle, <= 1 mm |
2 |
|
|
discrete vesicle > 1 mm |
3 |
|
|
coalescing vesicles, < 10 mm |
4 |
|
|
bullae (>= 10 mm) |
5 |
|
hyperpigmentation |
none |
0 |
|
|
barely detectable |
1 |
|
|
mild |
2 |
|
|
moderate |
3 |
|
|
marked |
4 |
|
|
black |
5 |
|
hypopigmentation |
none |
0 |
|
|
barely detectable |
1 |
|
|
mild |
2 |
|
|
moderate |
3 |
|
|
marked |
4 |
|
|
whhite |
5 |
A description of any other lesion should be written down.
Interpretation:
• The score for each type of skin reaction is reported.
Specialty: Infectious Diseases
