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Assess for local or systemic signs of infection, such as fever, chills, swelling, pain, and body malaise

LC-MS Mass spectrometry should show an ion consistent with the 5-amino-1-methylquinolinium component

Signs that shoulder pain after a vaccine may be abnormal include: Pain lasting longer than 37 days Pain that is worsening rather than improving Significant loss of shoulder motion Pain with lifting the arm Weakness in the shoulder Night pain In these situations, evaluation by a physician may be helpful

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Sterile syringes and needles with appropriate gauge and length based on the injection site