Letters to the editor
Medwave 2014 Oct;14(9):e6025 doi: 10.5867/medwave.2014.09.6025

Visible vaccination scars

Juan Enrique Berner, Pedro Vidal

Since Edward Jenner introduced Vaccinology in the late eighteenth century, vaccines have saved millions of lives around the world. As an example, smallpox—responsible for 8 to 20% of mortality in Europe—was eradicated decades ago, and polio is not far from the same fate. Moreover, there are vaccines available for prevention of 24 other communicable infectious diseases. This is a key factor in the increased life expectancy witnessed in the last hundred years [2].

Chile has led the region in immunization programs. The smallpox vaccine was introduced in 1887, and by 1950, the disease had disappeared in the country. In 1949, tuberculosis (Bacillus Calmette-Guerin) BCG vaccination was introduced, giving way to a free universal vaccination program that covered each and every Chilean child with BCG, MMR (measles, mumps, and rubella), and DPT (diphtheria, pertussis, and tetanus) vaccines.

Thanks to this program, Chile was the third country able to eradicate polio in 1976, and to achieve the goal of controlling measles and rubella before the end of the century [3].

It is beyond discussion that immunization programs have been of paramount importance in Chile´s outstanding child mortality rates. Chileans carry on their upper arms multiple vaccination scars. However, some scars, can become hypertrophic or even become keloids [4]. There are also reports of shoulder joint damage following vaccination [5].

The choice of the upper arm or shoulder area as a vaccination site was probably due to ease of access. However, concern about scarring in exposed body areas may be a cause for a change of vaccination site and the choice of an easier-to-conceal place. The buttocks seem a more reasonable site.

We believe that a change in the traditional site of immunization would benefit a large number of patients who one day may appreciate not having visible vaccination scars.

Notes

Conflicts of interest
The authors have completed the ICMJE uniform disclosure form, translated into Spanish by Medwave (available on request from the corresponding author), and declare not having conflicts of interest with the subject of the letter.

Referencias
  1. André FE. Vaccinology: past achievements, present roadblocks and future promises. Vaccine. 2003 Jan 30;21(7-8):593-5. | CrossRef | PubMed |
  2. Artenstein AW, Poland GA. Vaccine history: the past as prelude to the future. Vaccine. 2012 Aug 3;30(36):5299-301. | CrossRef | PubMed |
  3. Valenzuela B. MT. Desarrollo y futuro del Programa Ampliado de Inmunizaciones en Chile. Rev Chil Infectol. 2001;18(1):31–6. | CrossRef |
  4. Coop CA, Schaefer SM, England RW. Extensive keloid formation and progression after each vaccination. Hum Vaccin. 2007 Jul-Aug;3(4):127-9. | PubMed |
  5. Bodor M, Montalvo E. Vaccination-related shoulder dysfunction. Vaccine. 2007 Jan 8;25(4):585-7. | CrossRef | PubMed |

 

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