Respond to discussion questions with references

#1-I would discuss with the patient’s mother that this is a type IV hypersensitivity reaction as evidenced by the elevated fever, the localized swelling, and the erythema to the local area that the vaccine was administer in. I would inform her that it is quite common in children after they receive their vaccinations (McNeil, et al., 2018). I would also discuss the fact that just because the patient had a localized reaction it is extremely rare for a patient to have an anaphylaxis reaction to an immunization and therefore the patient should continue to receive their vaccinations on schedule so as not to make them susceptible to unwanted diseases (McNeil, et al., 2018). I would advise the mother to administer the proper dose of acetaminophen, 15 mg/kg, or Motrin, 10 mg/kg, to help with the fever, to help with the localized swelling, and to make the patient more comfortable. Another recommendation I would make to the mother is to speak to her pediatrician about the possibility to giving Tylenol or Motrin prior to the next set of vaccinations for the patient’s comfort. #2 The pathophysiological basis of this presumed type III hypersensitivity reaction relates to the idea that an Arthus reaction represents a local vasculitis. The local vasculitis is linked to the deposition of a range of immune complexes as well as subsequent activation of complement (Williams, 2016). Complement activation is prompted by the intradermal administration of an antibody or antigen to individuals that have an instance of previous sensitization. Many of the produced immune complexes in type III hypersensitivity reactions have shown to develop in regions with increased vaccine antigen levels in terms of local concentration. The immune complexes also form in locations of the body with high antibody concentration in the circulation (Pool et al., 2020). Arthus reactions have been characterized in the past by induration, swelling, severe pain, hemorrhage, edema, and sometimes instances of necrosis. After vaccination, the signs, and symptoms of Arthus reactions are developed between four to twelve hours of vaccine administration.