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Vaccines may cause adverse events ranging from mild reactions like fever to serious events like seizures. Both the vaccine product and the process of vaccination can cause adverse events. Non-sterile abscesses are usually a program error (an event caused by an error in the transportation, storage, handling, or administration of a vaccine) that may occur due to contamination of a multi-dose vial. Sterile abscess may occur as a delayed hypersensitivity reaction due to the presence of aluminium salt as an adjuvant in the vaccine, and are classified as vaccine product related reactions. The Hepatitis B vaccine is recommended for all infants at birth and for children up to 18 years. Here, authors report a case of sterile abscess in an eight-month-old baby, after the administration of first dose of Hepatitis B Vaccination, possibly due to an error and hence classified as Immunisation error related reaction.

Fosphenytoin is used as an alternative phosphate ester prodrug to intravenous phenytoin for seizure treatment. Acute orofacial dyskinesia, secondary to phenytoin treatment is very uncommon. This case report gives the details of an 11-month-old baby girl, with post encephalitic sequelae, who developed orofacial dyskinesia during treatment with fosphenytoin. She was on fosphenytoin for the last 11 days. She presented with lip smacking movements on the 11th day of administration of fosphenytoin. At the time of presentation of orofacial dyskinesia, she found it difficult to keep her tongue inside her mouth and the involuntary movements subsided following the withdrawal of the drug. In this case, it was a probable cause of the relationship between the patient’s symptoms and the use of fosphenytoin according to the causality assessment scales such as the Naranjo scale and the World Health Organisation (WHO) Uppsala Monitoring Centre causality assessment system. She had a score of six. Also, the reaction is not likely to be owing to coexisting diseases or drugs. Though fosphenytoin induced orofacial dyskinesia is infrequent, there is a need to consider the adverse effects of fosphenytoin as a differential diagnosis in all patients with a movement disorder in the course of fosphenytoin treatment.