The Oculorespiratory Syndrome (ORS) was an adverse reaction noted in Canada following influenza vaccinations in the winter of 2000-2001. This was associated with a vaccine preparation containing large aggregates of unsplit virions.


Criteria - onset within 24 hours of influenza vaccination of:

(1) bilateral red eyes, with or without itching

(2) respiratory symptoms (cough, wheezing, chest tightness/discomfort, difficulty breathing, sore throat, hoarseness, difficulty swallowing)

(3) facial swelling involving the eyelids, tongue, lip or other facial structures



• I am uncertain how to handle redness of only 1 eye or onset 24-48 hours after vaccination.


Grading scale for symptoms:

(1) easily tolerated (minimal)

(2) interfered with regular activities

(3) prevented regular activities

(4) required medical intervention


Differential diagnosis - need to exclude:

(1) allergic reaction

(2) coincident infection


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